Bronchology – Past, Present and Future Diagnostic Procedures 27 Combined bronchoscopy with rigid HOPKINS^®  bronchoscopes and flexible broncho-fiberscopes is used as described above for autofluorescence without administration of 5-Aminolevulinic acid (ALA). The procedure can be monitored and documented and biopsies taken, if required. Both systems are incorporated in the same KARL STORZ equipment and easy to handle, and also allow for ap- plications of routine white light bronchoscopy. Conclusion The exploration of the “Terra Incognita” of the bronchial tree in the past 100 years has been painfully slow. On average, the vital bronchopulmonary region is exposed to 18 sources of exogenous infections (by respiration) and 72 sources of endogenous infections (by blood circulation) every minute. Many infections are active, while others leave evidence behind. Therefore, the introduction of autofluorescence in bronchology is a most exciting recent inven- tion as it provides the bronchologist with a ”searchlight“ to obtain a submucosal view in all directions. The emphasis in Europe is mainly on the early detection of malignancy, when it is still curable. However, once bronchologists become fully acquainted with the normal and abnormal observation by means of autofluorescence, new ways for detection of other bronchopulmonary diseases are apt to become available. The  time  is  not  far  when  autofluorescence  shall  become  the  routine  mode of bronchoscopy using both rigid and flexible bronchoscopes in “Combined Bronchoscopy.” Fig. 31 I. Blue Excitation (380–440 nm) light. (I) is blocked by the obversation filter in the eye piece of the telescope. II. A very strictly defined amount of blue light (about 2%) passes the filter. This allows color contrast and orientation in fluorescence negative areas. The PPIX spectrum is represented in (III) with the typical peak at 635 nm. 100 80 60 40 20 0 % 400 500 600 700 nm III I II Back –––––––Table of Contents–––––––Next Back –––––––Table of Contents–––––––Next