Background: The question of which combination of procedures gives the best diagnostic yield following fiberoptic bronchoscopy is controversial. Objectives: To evaluate the value of various diagnostic techniques following fiberoptic bronchoscopy in the diagnosis of endoscopically visible lung cancer. Methods: The study included 98 patients found to have endobronchially visible tumor during routine daily bronchoscopy. Endobronchial lesions were classified as mass, submucosal lesion and infiltration. Washings, brushings and forceps biopsies were obtained in all subjects. Transbronchial needle aspirations were performed in 67 of 76 cases with mass or submucosal lesions. Results: Bronchoscopy was diagnostic for cancer in 88 (89.8%) of the 98 patients. Forceps biopsy specimens gave positive result in 82.7% of cases, transbronchial needle aspirates in 68.6%, brushings in 68.4%, and washings in 31.6%. Combination of forceps biopsy and brushing cytology yielded a positive result for lung cancer in 87 patients. The addition of brushings increased the diagnostic yield of bronchoscopy from 82.7% to 88.8% (p < 0.05). Collection of washing specimens in addition to forceps biopsy did not increase the yield of forceps biopsy. Transbronchial needle aspiration gave an additional yield of 1%. Conclusions: Routine cytological examination of bronchial washings does not increase the yield of forceps biopsy specimens. Transbronchial needle aspiration may give an additional positive yield to forceps biopsy. We conclude that a combination of forceps biopsy and brushing is the best strategy in the diagnosis of bronchoscopically visible lung cancer.

Melatonin reduces oxidative stress markers and augments anti-oxidant capacity in the rat lens.

Background Two main aims of this animal study were to inspect the possible effects of periodontitis on the structure and functions of the kidneys and the therapeutic effectiveness of melatonin. Methods Twenty‐four male Sprague‐Dawley rats were randomly divided into three groups: control, experimental periodontitis (Ep), and Ep‐melatonin (Ep‐Mel). Periodontitis was induced by placing 3.0‐silk sutures sub‐paramarginally around the cervix of right‐left mandibular first molars and maintaining the sutures for 5 weeks. Then melatonin (10 mg/kg body weight/day, 14 days), and the vehicle was administered intraperitonally. Mandibular and kidney tissue samples were obtained following the euthanasia. Periodontal bone loss was measured via histological and microcomputed tomographic slices. On right kidney histopathological and immunohistochemical, and on the left kidney biochemical (malonyl‐aldehyde [MDA], glutathione, oxidative stress [OSI], tumor necrosis factor [TNF]‐α, interleukin [IL]‐1β, matrix metalloproteinase [MMP]‐8, MMP‐9, and cathepsin D levels) evaluations were performed. Renal functional status was analyzed by levels of serum creatinine, urea, cystatin‐C, and urea creatinine. Results Melatonin significantly restricted ligature‐induced periodontal bone loss (P <0 .01) and suppressed the levels of proinflammatory cytokines (TNF‐α and IL‐1β), oxidative stress (MDA and OSI), and proteases (MMP‐8, MMP‐9, and CtD) that was significantly higher in the kidneys of the rats with periodontitis (P <0.05). In addition, periodontitis‐related histological damages and apoptotic activity were also significantly lower in the Ep‐Mel group (P <0.05). However, the markers of renal function of the Ep group were detected slightly impaired in comparison with the control group (P >0.05); and the therapeutic activity of melatonin was limited (P >0.05). Conclusion Melatonin restricts the periodontitis‐induced inflammatory stress, apoptosis, and structural but not functional impairments.

Thymolipoma is a benign tumour composed of thymic elements and adipose tissue. It may be associated with myasthenia gravis or immune disorders. We aimed to evaluate the clinical and radiological features of thymolipoma. The clinical data from 10 cases of thymolipoma, diagnosed at our centre between 2002 and 2004, were analysed retrospectively. There were six female and four male patients, whose ages ranged from 16 to 67 years, with a mean age of 34.1 years. All but two patients had pulmonary or extrapulmonary symptoms. Five patients also had myasthenia gravis. All thymolipomas were localized in the anterior superior mediastinum. The surgical approach was sternotomy in nine cases and thoracotomy in one case. Thymectomy was performed on all patients. Thymolipomas are unusual tumours and may be associated with myasthenia gravis. Surgical resection is the most appropriate treatment modality.

Occult tracheobronchial foreign body aspirations are infrequently seen in adults because there is usually a high index of suspicion. Occult foreign bodies can remain undetected for months to years and often are misdiagnosed. The aim of this paper is to report the cases of four adult patients with occult bronchial foreign body aspiration. None of the patients had a previous history of aspiration. One patient had been misdiagnosed as having asthma. One was thought to have tuberculosis, while unresolved pneumonia was present in another. A CXR showed the presence of a foreign body in only one patient because it was metallic. The foreign bodies included a stone, a tooth fragment, a bone fragment, and a needle. The foreign bodies were removed using a rigid bronchoscope in two patients and via a surgical procedure in the other two. In conclusion, tracheobronchial foreign body aspiration should always be taken into consideration in the differential diagnosis of radiographic lesions or chronic respiratory symptoms that are poorly explained, even in the absence of a previous history of aspiration.