This study provides preliminary evidence that Zn and Fe redistribution is operating as a primary host defence mechanism to reduce the availability of metals for microbial metabolism during infection. The study also calls attention to the fact that anti-tuberculosis treatment is sufficient to enhance the concentration of the antioxidant species (Cu and ceruloplasmin). The data obtained suggest that serum Cu, Zn and Cu/Zn levels may serve as indirect pointers in the diagnosis of a disease but they cannot be considered as specific markers for TB.

Figure 1 Two views of computed tomography scan of (a) the chest and (b) showing large pericardial effusion with cystic tumour (arrows) compressing the right atrium with infiltration of the mediastinum and small right-sided pleural effusion.

These data suggest that the extra sensitivity provided by AF bronchoscopy improves the ability of trainees to make the correct diagnosis at bronchoscopy and suggest a role for AFI in teaching hospitals in training inexperienced bronchoscopists.Our preliminary study shows how a ''slide bank'' of bronchoscopic images can be used to asses the diagnostic performance of a bronchoscopic system by multiple operators. We believe it is valid and eminently transferable to other studies. This work needs to be repeated with a larger sample of patients and in a population with a higher incidence of intra-epithelial neoplasia.

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