In 50% of BALB/c mice pretreated with atropine, tongue tumours were induced by fortnightly application of DMN-OAc (2 mg/kg) on the tongue. When DMN-OAc + TPA was used for the initiation-promotion protocol, tumours were observed on the tongue, the site of application, in only 10% of animals. In the same group, stomach tumours were obtained in 63% of mice, denoting that initiation-promotion could be successfully used to induce stomach tumours. Using a protocol of DMN-OAc + chilli as a promoter, we observed induction of stomach tumours. The promoter effect of chilli extract was also seen in the BHC-induced hepato-carcinogenesis system. It thus appears that, in BALB/c mice, chilli acts as a promoter in stomach and liver carcinogenesis.

Flexible bronchoscopy is one of the most important diagnostic procedures in respiratory medicine. The investigator operates in a vital organ and therefore must face a broad range of potential complications. This article provides an overview of all important complications associated with flexible bronchoscopy. It is further discussed how this risk can be minimized. A skillfull team, close monitoring and readily available resuscitation facilities are mandatory to avoid and to deal with major complications.

Primary tracheal tumours are rare and often only cause symptoms at a late stage, when the tumour obstructs most of the tracheal lumen. We report the case of a 45-year-old woman with pulmonary tuberculosis and a tumour in the trachea, which had been interpreted as a tuberculous lymph node perforating the tracheal wall. Bronchoscopy revealed a white, glossy, papillomatous lesion in the ventral wall of the trachea, which was identified by histology as a granular cell tumour. After culture conversion of the underlying tuberculosis, which led to the detection of the lesion, the tumour was surgically removed. Granular cell tumours rarely appear in the trachea, they may be multifocal and sometimes follow a malignant course. Complete resection is the treatment of choice and recurrence rates are low.

!Objective: To determine the diagnostic yield of EBUS guided TBB performed in routine practice with flexible bronchoscopy and under moderate sedation in ambulatory and hospitalized patients. Methods: Bronchoscopy was performed under standard conditions in ambulatory and hospitalised patients. Bronchoscopically invisible peripheral pulmonary lesions were located with 20 MHZ-EBUS-probe and transbronchial biopsy was taken using a guiding sheath. Fluoroscopy was additionally performed as required to identify the lesion. Results: 257 patients with peripheral pulmonal lesions were investigated, with malignancy in 70 % of those with a diagnosis established. 175/ 257 (68.1 %) of lesions were detected with EBUS. In 139/176 (79.4 %) of these lesions, TBB enabled a final diagnosis. The TBB yield depended on lesion size. It was 61.3 % in lesions ≤ 20 mm, 85.5 % > 20 mm/≤ 30 mm, and 81.2 % in ≥ 30 mm (p < 0.0001). This yield was also affected by the position of the probe (centrally 84.5 %, tangentially 57.6 %, p = 0.01)). Operator experience did not influence the diagnostic yield but considerably shortened investigation time (4.9 ± 3.5 vs. 6.2 ± 4.2 min, p = 0.042). Relevant complications occurred in only 1.9 % (3 cases of postinterventional pneumothorax). Conclusions:In an unselected population, EBUSguided TBB has a high diagnostic yield in peripheral lesions > 20 mm whereas its yield decreases considerably in smaller lesions. Complications are very rare. EBUS-guided TBB can successfully and safely be performed by flexible bronchoscopy. (68,1 %) der Herde wurden mittels EBUS lokalisiert. In 139/176 (79,4 %) wurden diese Herde mittels TBB histologisch diagnostiziert. Die Ausbeute der TBB war abhängig von der Herdgröße: sie betrug 61,3 % in Herden von einer Größe ≤ 20 mm, 85,5 % bei > 20/≤ 30 mm und 81,2 % bei Herdgrößen ≥ 30 mm (p < 0.0001). Die Ausbeute hing zusätzlich ab von der Lage der Herde (zentral 84,5 %, peripher 57,6 %, p = 0.01). Die Erfahrung des Untersuchers hatte keinen Einfluss auf die Ausbeute, wohl aber ging eine größere Erfahrung mit kürzeren Untersuchungszeiten einher (4,9 ±3,5 vs. 6,2 ±4,2 min, p = 0,042). Relevante Komplikationen traten nur in 1,9 % der Fälle auf (3 Fälle eines Pneumothorax). Schlussfolgerungen: In einer unselektierten Population hat die EBUS-orientierte TBB eine hohe diagnostische Ausbeute bei peripheren Herden > 20 mm. Die Ausbeute sinkt deutlich bei kleineren Herden. Komplikationen waren sehr selten. Die EBUS-geleitete TBB kann erfolgreich und sicher auch mit flexibler Bronchoskopie durchgeführt werden. ZusammenfassungThis document was downloaded for personal use only. Unauthorized distribution is strictly prohibited.

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