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Fifty‐one primary intracranial germ cell tumors (GCT), including germinoma, teratoma, endodermal sinus tumor, choriocarcinoma and mixed GCT, were studied. The incidence of GCT in the surgically removed intracranial neoplasms was 11.1% for pediatric patients and 0.6% for adult patients. The age/sex of the patients and the location of the tumors were analyzed. Morphologic findings of these tumors were identical to that of their gonadal counterparts. Immunohistochemical studies showed that alpha‐fetoprotein (a‐AFP), human chorionic gonadotropin (HCG), and placental alkaline phosphatase (PLAP) were helpful, whereas carcinoembryonic antigen (CEA) and cytokeratin (CKER) were of little help in determining the diagnosis. Serum tumor markers, a‐AFP and HCG, were helpful in recognizing GCT producing them. However, they could not be used for specific diagnosis because different tumors could have similar serum levels. Histopathologic study was handicapped by the small size of most specimens (which usually could not include all of the components if the tumor was a mixed GCT), but it was the only means for specific diagnosis.

Whether Castleman disease is superficial or deep has no effect on surgical outcome as long as resection is complete.

Silicone T-tube can effectively resolve the complex laryngotracheal lesions with limited complications. Concurrent cardiopulmonary diseases and intractable infection were the two major causes for failure after the T-tube reconstruction.

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s u m m a r yBackground: The number of elderly patients who undergo surgery for esophageal cancer is increasing as a result of longer life expectancy, but little is known about the morbidity and outcome of such procedures in the elderly. This study compared the results of surgery for evaluating the effect of age on esophageal cancer patients. Methods: Patients who underwent surgery with curative intent for esophageal cancer from January 1999 to July 2009 were included in this retrospective study. Data were compared between patients !70 years (elderly group) and patients <70 years old (younger group). Patient characteristics, hospital course, surgical mortality, morbidity, and survival were compared between patients in these two age groups. Results: Of the 166 patients included, 35 (21.1%) were at least 70 years old (mean age, 75.2 years) and 131 (78.9%) were younger than 70 years old (mean age, 51.8 years). All 29 eligible elderly and 29 randomly selected, age-adjusted younger patients were included for a balanced comparison. The elderly group had significantly longer hospital stays (46 vs. 22 days) and a significantly higher incidence of surgical morbidity (51.7% vs. 20.7%). Cardiopulmonary-related complications were the main causes of operative morbidity in the elderly group. The elderly group also had higher performance state scores. On the basis of less adjuvant anticancer treatment received, the overall survival of elderly patients was comparable to their younger counterparts (12.1 vs. 12.7 months; p ¼ 0.77). Conclusion: The results of this study suggest that curative surgery for esophageal cancer in elderly patients may result in comparable overall survival and greater, but acceptable, morbidity in comparison with younger patients. Our data suggest that age !70 years old should not be considered a counterindicator for curative surgery in esophageal cancer patients.

The presence of multimorbidity in middle-aged and older adults, which reduces their physical activity and quality of life, is a global health challenge. Exercise is one of the most important health behaviors that individuals can engage in. Previous studies have revealed that aerobic exercise training is beneficial for healthy middle-aged and older adults and those with various chronic diseases, but few studies have designed individualized aerobic exercise training for individuals with multimorbidity. Although individuals with multimorbidity are considerably less adherent to physical activity interventions, telephone-based motivational interviewing may help in strengthening motivation and promoting behavioral change for increasing physical activity and health-related physical fitness. This study aimed to examine whether a 12-week individualized aerobic exercise training in a rehabilitation center combined with telephone-based motivational interviewing is effective in promoting physical activity and health-related physical fitness among middle-aged and older adults with multimorbidity. A randomized controlled trial was conducted. Forty-three participants (aged > 40) were recruited and randomly assigned to the intervention group, comparison group, or control group. The participants’ physical activity and health-related physical fitness were assessed at baseline and at 12 weeks. The results indicated that after individualized aerobic exercise training combined with telephone-based motivational interviewing, the participants reported increased total physical activity (Fin = 481.3, p = 0.011), vigorous-intensity physical activity (Fin= 298.9, p = 0.007), dominant and nondominant hand grip (kg) (Fin = 1.96, p = 0.019; Fin = 2.19, p = 0.027, respectively), FEV1/FVC (Fin = 0.045, p = 0.043), VO2 max (ml/kg/min) (Fin = 5.30, p = 0.001), VO2 max predicted (%) (Fin = 21.6, p = 0.001), work (watts) (Fin = 22.5, p = 0.001), and anaerobic threshold (L/min) (Fin = 0.165, p = 0.011). Twelve weeks of individualized aerobic exercise training in the rehabilitation center combined with telephone-based motivational interviewing can increase the total physical activity, vigorous physical activity, and cardiorespiratory fitness of middle-aged and older adults with multimorbidity.

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