[Frozen section telepathology in the clinical routine of a breast cancer center]. / Schnellschnitttelepathologie im klinischen Alltag eines Brustzentrums.

For an intraoperative frozen section service, the period from surgeon's sample excision to the time of transmitting the diagnosis by the pathologist, should not last longer than 20 min. In a period of 16 months we performed 389 frozen sections by telepathology (298 patients) in our breast cancer center, using the Leica telepathology system (TPS 1.5). In 173 out of the 389 sections, an invasive carcinoma was diagnosed (312 frozen sections with the aim to verify malignancy and 77 to verify a tumor-free retroareolar resection margin). The overall error rate amounted to 7 out of 389 sections (about 2%; false-negative in 5 cases, false-positive in 2 cases) and is equivalent to the error rate without telepathology. The mean time for diagnosis per case was 15 min. For the future, it is desirable that hospitals without their own pathologists also perform frozen sections within an adequate time by using telepathology systems.

[Drug therapy in the old age. Drug effects in the elderly]. / Arzneimitteltherapie im Alter. Misten Sie die Pillendöschen aus!

The frequency of multimorbidity in elderly patients may mislead the physician into practicing polypragmasy (polypharmacy), resulting in unpredictable drug interactions. Such interactions are a quite common cause of hospitalization in geriatric patients. Pharmacokinetics are often altered in the aged, and individualized medication should take into consideration not only the patient's age, liver and kidney function, but also the individual variability of hepatic metabolism and drug absorption from the gastrointestinal tract dictated by genetic polymorphism. Drug treatment in the elderly should always be carefully assessed as to its risks and benefits, and, where indicated, certain medications should be replaced by or omitted.

[Adenocarcinoma of the vermiform appendix]. / Adenokarzinom der Appendix vermiformis.

Primary adenocarcinoma of the appendix vermiformis is very rare. We report on a patient who died with the age of 75 years. On the occasion of an inguinal herniotomia scrotal mucinous metastases were discovered. After appendectomy the diagnosis of primary adenocarcinoma of the appendix vermiformis was ensured. The further course was very unusual. Even though metastases were spread all over the abdominal cavity, the patient survived for further 13 years without therapy. At the postmortem examination there was found a widespread carcinosis of peritoneum and pleura as well as several liver metastases.