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Minimally invasive surgery/coronary artery bypass grafting (MICS CABG) via left thoracotomy and multiple CABG is a reported alternative to the standard sternotomy approach. However, harvesting the right internal thoracic artery (RITA) under direct vision requires high surgical skill. We describe MICS CABG with the left internal thoracic artery (LITA) and a composite graft using the in situ right gastroepiploic artery (GEA) and radial artery (RA) to achieve complete coronary revascularization. No complications occurred, and postoperative computed tomography showed patency of all grafts. Our experience suggests that this composite graft can be used safely and effectively in MICS CABG for complete arterial revascularization without difficulty.

Minimally invasive surgery/coronary artery bypass grafting (MICS CABG) via left thoracotomy and multiple CABG is a reported alternative to the standard sternotomy approach. However, harvesting the right internal thoracic artery (RITA) under direct vision requires high surgical skill. We describe MICS CABG with the left internal thoracic artery (LITA) and a composite graft using the in situ right gastroepiploic artery (GEA) and radial artery (RA) to achieve complete coronary revascularization. No complications occurred, and postoperative computed tomography showed patency of all grafts. Our experience suggests that this composite graft can be used safely and effectively in MICS CABG for complete arterial revascularization without difficulty.

Background Jehovah’s Witnesses refuse allogeneic blood transfusions, which makes cardiovascular surgery challenging. Surgeons must minimize blood and fluid loss within one procedure. Case presentation We herein describe a 17-year-old male Jehovah’s Witness with bicuspid aortic valve regurgitation and coarctation of the aorta. The procedures were performed in the following order: aortic valve replacement combined with Nick’s aortic root enlargement, right axillary artery–bilateral external iliac artery bypass, and distal arch–descending aorta bypass. Conclusions Axillary artery–bilateral external iliac artery bypass maintained distal perfusion and reduced the amount of heparin during distal arch–descending aorta bypass surgery.

Patients with severely calcified aorta are at high risk of embolic stroke during surgery and it is not feasible to clamp the aorta, necessitating alternative surgical strategies. We present a clampless anastomosis technique using the aortic cannula mounted by a prosthetic graft for a severely calcified aorta in a patient with subclavian–vertebral artery steal syndrome.

To assess the relationship between the systolic sac pressure index (SPI) and the presence of endoleaks 12 months after endovascular abdominal aortic aneurysm repair (EVAR). We performed a single-center prospective trial of consecutively treated patients. SPI (calculated as systolic sac pressure/systolic aortic pressure) was measured by catheterization immediately after EVAR. Contrast-enhanced computed tomography was scheduled 12 months after EVAR to detect possible endoleaks. Data were available for 34 patients who underwent EVAR for an AAA. Persisting type II endoleak was found in 8 patients (endoleak-positive group) but not in the other 26 patients (endoleak-negative group). The mean ± standard deviation SPI was significantly greater in the endoleak-positive group than in the endoleak-negative group (0.692 ± 0.048 vs. 0.505 ± 0.081, respectively; P = .001). Receiver-operating characteristic curve analysis revealed that an SPI of 0.638 was the optimum cutoff value for predicting a persistent endoleak at 12 months with high accuracy (0.971; 33/34), sensitivity (1.00), and specificity (0.962) values. The mean change in AAA diameter was −4.28 ± 5.03 mm and 2.22 ± 4.54 mm in patients with SPI of

Purpose: The outlines of primary lung cancers are more complicated than those of metastatic lung tumors on computed tomography (CT) images. This feature is useful for clarifying the diagnosis of pulmonary nodules before surgery. We applied fast Fourier transform (FFT) analysis for quantification of complexity of tumor outline. Methods: Sequential cases of 72 primary lung cancers (Group PL) and 54 metastatic lung tumors (Group MT) were included. The outline of each tumor on chest CT images was described using polar coordinates, and converted to rectangular coordinates, yielding wave data of the tumor outline. The FFT was then used to analyze the wave data. The complexity index (Cxi) was defined as the sum of the amplitude of all harmonics over a fundamental frequency. Results: The Cxi was higher (P

OBJECTIVE. The purpose of this study was to assess the utility of 99mTc–human serum albumin diethylenetriamine pentaacetic acid (99mTc-HSAD) SPECT in the detection of endoleaks after endovascular abdominal aortic aneurysm repair. SUBJECTS AND METHODS. Fifteen patients (11 men, four women) with aneurysm sac expansion of 5 mm or greater after endovascular abdominal aortic aneurysm repair underwent three-phase CT, 99mTc-HSAD SPECT, and CT during aortography. Sensitivity calculations for three-phase CT and 99mTc-HSAD SPECT were performed with CT during aortography as the reference standard. The volume of each endoleak was measured with CT during aortography. Seven subjects underwent embolization with N-butyl cyanoacrylate (NBCA)-Lipiodol (ethiodized oil, Guerbet and metallic coils. Three-phase CT and 99mTc-HSAD SPECT were repeated after embolization to assess their efficacy. RESULTS. Endoleaks were interpreted as perigraft radioisotope accumulation in 12 patients (80.0%) on 99mTc-HSAD SPECT images, in 13 pati...

We report a case of primary clear-cell sarcoma (CCS) in the mediastinum. In October 2011, a 63-year-old man was admitted to our hospital for surgical resection. The tumor was completely excised by video-assisted thoracoscopic surgery. The tumor was well encapsulated and did not invade the pleura. Histological examination led to a final diagnosis of primary CCS in the mediastinum. The patient remains alive without evidence of recurrence at 15 months after surgery.

Background Intra-airway and intra-arterial administration of gelatin-embedded, sustained-release basic fibroblast growth factor has stimulated regeneration of emphysematous lungs in animal experiments, but these routes of administration may also cause harm. This study investigated the effectiveness of intrapleural administration of gelatin-embedded, sustained-release basic fibroblast growth factor. This animal experiment preceded our clinical trial of intrapleural administration of sustained-release basic fibroblast growth factor in patients with chronic obstructive pulmonary disease accompanied by pneumothorax. Methods Pulmonary emphysema was induced in Sprague-Dawley rats using porcine elastase. Gelatin-embedded, sustained-release basic fibroblast growth factor was administered via the left pleural cavity. The rats were divided into a group that received gelatin-embedded, sustained-release basic fibroblast growth factor (FGF + group, n = 6), and a group that did not (FGF – group, n = 6). Animals were sacrificed after 14 days, and the results were evaluated by histologic examination. Results In the FGF + group, the mean linear intercept value of the alveolar septa was significantly shorter on the treated side than on the untreated side (65.1 ± 7.0 vs 114.4 ± 7.5 μm; P = .0005). There was no significant difference in the mean linear intercept value between the treated and untreated sides in the FGF − group. Conclusions Intrapleural administration of sustained-release basic fibroblast growth factor induced lung regeneration in rats with elastase-induced pulmonary emphysema.

The main objective of this study was to verify the effect of oral intake of a yolk-derived peptide preparation (HYP) obtained by enzymatic hydrolysis of yolk water-soluble protein on bone markers and bone density in 65 perimenopausal women with an average age of 47.6 ± 5.2 years. Subjects were divided into three groups, and then enrolled in a 6-month, randomized, double-blind clinical trial. Bone formation and resorption markers were measured at 0, 3, and 6 months, while bone mineral density (BMD) in the lumbar spines was measured at 0 and 6 months. Although the bone formation marker levels showed the similarity changes among the groups, bone resorption markers in the test HYP group were significantly decreased after 3 and 6 months in comparison to other groups (P < 0.05). After 6 months, BMD in the test HYP group maintained at healthy numerical values whereas BMD values were decreased in other groups. Hence HYP would be an antiosteoporotic agent originated from natural food to maintain bone health, especially for women.

A 62-year-old woman with breast cancer received neoadjuvant chemotherapy followed by breast-conserving surgery and sentinel node biopsy. During adjuvant endocrine therapy with aromatase inhibitor, she developed multiple bone metastases. Thereafter, she received tamoxifen and zoledronate therapy. In May 2011, she developed a tongue deviation and was diagnosed as having meningeal carcinomatosis. The tongue deviation disappeared 3 weeks after taking capecitabine (2,400 mg/day). Magnetic resonance imaging of the brain showed regression of meningeal carcinomatosis. Levels of tumor markers CEA and CA15-3 changed from 96.0 IU/ml and 3.5 ng/ml to 47.0 IU/ml and 1.5 ng/ml, respectively. Progression-free survival with capecitabine monotherapy was 5 months.

Background Pressure guidewire pullback recording can differentiate between functional focal and diffuse disease types in coronary artery disease. The aim of this study was to compare the outcome of coronary artery bypass graft (CABG) patency between patients with functional focal versus diffuse disease types in recipient coronary arteries. Methods and results We investigated 89 patients who underwent pressure guidewire pullback in the left anterior descending (LAD) artery before CABG using internal mammary artery (IMA). Based on the pressure guidewire pullback data, the LAD lesions were classified into functional focal disease (abrupt pressure step-up; n=58) or functional diffuse disease (gradual pressure increase; n=31). Follow-up computed tomography (CT) angiography was conducted within 1year after CABG to assess the bypass graft patency. Pre CABG, LAD angiographic percent diameter stenosis (57±10% vs. 54±12%, p=0.228) and fractional flow reserve (FFR) (0.68±0.07 vs. 0.69±0.07, p=0.244) were not different between the functional focal and diffuse disease groups. The CABG procedure characteristics were similarly comparable between the two groups. In the follow-up CT angiography after CABG, occlusion or string sign of the IMA graft to LAD was more frequently observed in the functional diffuse disease group than in the functional focal disease group (26% vs. 7%, p=0.021). Conclusion In CABG, functional diffuse disease in the recipient coronary artery was associated with an increased risk of the graft failure in comparison with functional focal disease.

A 54-year-old woman with long-lasting pleural effusion developed abdominal distention due to ascites from bilateral ovarian tumors. The patient had undergone breast-conserving surgery and axillary lymph node dissection for left breast cancer in October 2000, and had developed left pleural effusion in July 2006. Cytological examination of the pleural effusion found no malignant cells. Thoracic drainage with intrathoracic administration of OK-432 (Picibanil) had failed to control the pleural effusion. Positron emission tomography taken at the abdominal distention showed bilateral ovarian tumors. After failure to control the ascites with systemic and intra-abdominal chemotherapy, bilateral oophorectomy resulted in normalization of elevated serum tumor-marker levels and the disappearance of both the ascites and pleural effusions (i.e., pseudo-Meigs' syndrome). Pathological examination showed the tumors to be estrogen receptor-positive metastatic ovarian tumors from her breast cancer. The patient remained well with no further recurrence for 40 months under aromatase inhibitor therapy.

We report two patients who developed a tracheo-innominate artery fistula (TIF) after tracheostomy. Contrast-enhanced computed tomography revealed a pseudoaneurysm of the innominate artery protruding into the trachea. Stent grafts were deployed for the innominate artery via two different access routes: the transfemoral approach and the right carotid artery approach. Endovascular stent-graft repair resulted in complete exclusion of the TIF and control of the bleeding from the tracheal stoma. At 12- and 16-month follow-ups, neither patient had clinical signs of graft infection, recurrent fistulization, or ischemic complications. It is feasible and useful to employ the carotid artery approach for stent-graft implantation in patients who have vascular anatomical limitations for the transfemoral approach. Endovascular repair of TIF by stent grafting is a minimally invasive treatment that can be tolerated by patients in poor clinical condition, and is a feasible alternative to surgical treatment.

This report presents a 73-year-old woman with intraperitoneal bleeding from a superior mesenteric artery (SMA) pseudoaneurysm and dissection after pancreaticoduodenectomy (PD). A self-expanding bare metal stent was placed in the distal SMA across the area of dissection, and a stent-graft was subsequently placed across the pseudoaneurysm emerging from the proximal site by overlapping the bare stent, resulting in complete exclusion of the pseudoaneurysm and control of the dissection. Bleeding was controlled after the endovascular procedure. The combination of endovascular stenting and stent-graft repair is feasible and useful in comorbid cases of SMA pseudoaneurysm and dissection.

SummaryBackground and purposeThere have been no large-scale studies on the impact of diabetes mellitus (DM) on outcomes in Japanese patients undergoing coronary artery bypass grafting (CABG).Methods and subjectsA multi-institutional retrospective cohort study was conducted in 14 Japanese centers. All adult patients who underwent isolated CABG from 2007 to 2008 were included (n=1522, mean age: 68.5years). The definitions of DM were all patients admitted with diagnosis of DM and preoperative glycated hemoglobin (Hb) A1c≥6.5%. Univariate and multivariate analyses were performed to identify the risk of morbidity and mortality.ResultsThere were 849 DM and 572 non-DM patients. Preoperative mean HbA1c were 7.1% in the DM group and 5.7% in the non-DM group (p

PURPOSE To clarify whether fibulins-5 is associated with primary spontaneous pneumothorax (PSP) in young PSP patients. METHODS Forty-six surgically resected, fresh lung specimens were used. Patients were divided into 3 groups: younger than 25 years with pneumothorax (group Y), 25 years or older with pneumothorax (group O), and without pneumothorax (group C). Chest X-ray, computed tomography data, height/width ratio (H/W) and anteroposterior/transverse diameter ratio (a/b) were measured. Elastica van Gieson staining and immunofluorescence staining for fibulin-5 were performed. Fibulin-5 mRNA expression and protein levels were measured by real-time PCR and western blotting. Direct sequences of the fibulin-5 gene in PSP patients were performed. RESULTS The mean H/W ratio in group Y was significantly larger than that in the other groups (p

Introduction A recent large randomized controlled trial revealed that patients with lung cancer with epidermal growth factor receptor (EGFR) mutations had better prognoses when treated with the EGFR-tyrosine kinase inhibitor, gefitinib, than with cytotoxic chemotherapeutic agents. Lung cancer with EGFR mutations is highly sensitive to EGFR-tyrosine kinase inhibitors. The previous trial implied that EGFR mutations might be predictive of the response to cytotoxic chemotherapy. Methods Forty-six tumor tissue specimens (32 adenocarcinomas and 14 nonadenocarcinomas) were obtained from patients with lung cancer who underwent surgical resection. EGFR mutations were detected using polymerase chain reaction-invader assay. A histoculture drug response assay was used as an in vitro drug sensitivity test. The inhibition rates of cisplatin, docetaxel (DOC), vinorelbine, and gemcitabine were measured. Results Sensitizing EGFR mutations were detected in samples from 14 patients, all with adenocarcinomas. The inhibition rate of cisplatin in tumors with EGFR mutations (group M) was 34.8 ± 15.5%, which was significantly lower (p = 0.0153) than in wild-type tumors (group W; 46.6 ± 14.0%). The inhibition rate of DOC in group M (18.8 ± 13.4%) was also significantly lower (p = 0.0051) than in group W (35.4 ± 19.1%). There were no significant differences in inhibition rates of gemcitabine and vinorelbine between groups M and W. Inhibition rates of DOC were significantly lower in group M (p = 0.0256) than in group W (32.6 ± 18.4) in samples from patients with adenocarcinoma. Conclusion The histoculture drug response assay indicated that lung cancers with EGFR mutations were less sensitive to DOC than EGFR wild-type tumors.

Autologous blood transfusion in cardiac surgery is currently widely practiced to avoid homologous blood transfusion. To assess the benefit of recombinant human erythropoietin (rhEPO), the authors studied 72 patients (53 men, 19 women) who underwent elective cardiac surgery over a 15-month period and agreed to this protocol. Of these, 47 had coronary artery bypass grafting, 19 had valve replacement, and 6 had other procedures. Each patient was scheduled to preserve more than 800 mL of autologous blood preoperatively. They received rhEPO (100 to 40 U/kg) IV 3 times weekly during a 2 to 3-week preoperative period. During surgery, an autotransfusion system was also applied. During the preoperative period, 49 patients (68.1%) increased their hemoglobin by more than 1.0 g/dL, and 66 patients (91.7%) had their operation without homologous blood transfusion. This is a significantly high incidence compared with the group who had neither preoperative preservation nor rhEPO (55 of 109 patients; 50.5%).

We present a case of an 80-year-old male who had a right buttock claudication after embolization of the right internal iliac artery and endovascular aneurysm repair (EVAR) for aneurysms of the right common iliac and abdominal arteries. We used follow-up dynamic computed tomography to measure the diameter of the superior gluteal artery (SGA). The comparison ratio (SGA diameter after EVAR / SGA diameter before EVAR) of the right SGA at 1, 3, and 9 months was 0.74, 0.80, and 1.1, respectively, while that of the left SGA at 9 months was 0.97. The patient reported using a walking stick at 1- and 3-month follow-ups but not at the 9-month follow-up. The computed tomography (CT) showed sequential dilatation of the SGA, which appeared to be associated with the relief of the buttock claudication.

症例は34歳男性．嗄声，胸痛を主訴に受診．右胸腔に突出する10×15cmの腫瘤を認め，AFP，β-HCG高値より，非セミノーマ性縦隔胚細胞腫と診断．シスプラチン，エトポシドを含む放射線同時併用化学療法を2クール施行した．腫瘍マーカーは正常化したが，腫瘍はさらに増大した．初診から2ヵ月後に手術を施行した．術後の病理診断は体細胞型腫瘍成分を有する胚細胞腫瘍（以下GCTSTM）であった．術後37日後に再発，その後肺炎を合併し術後57日目に永眠された．GCTSTMは通常使用される化学療法のレジメンでは効果を得にくく，予後は非常に不良である．腫瘍マーカーが正常化しても腫瘍が増大傾向を示す場合，体細胞型腫瘍成分の存在の可能性を念頭に置く必要がある．

An intraoperative fluorescence imaging (IFI) system, which can provide visual images, could be the common method for assessing graft patency intraoperatively. We conducted a prospective comparison of the diagnostic accuracy of both the fast Fourier transformation (FFT) analysis of transit-time flowmetry (TTFM) waveform and the IFI system to determine graft failure.The study included 10 saphenous vein grafts (SVGs), all of which were aortocoronary grafts. Each patient underwent isolated coronary artery bypass grafting (CABG), including conventional CABG or off-pump CABG, and then underwent X-ray angiography after CABG. When intraoperative hemodynamics had stabilized, the grafts were evaluated with both the IFI system and TTFM. Based on the obtained flow profile of TTFM, certain variables were calculated. The waveforms of TTFM were analyzed with the FFT series. Harmonic distortion (HD) was calculated from the amplitudes, and the fundamental frequency was thus determined using the FFT series.The IFI system demonstrated a satisfactory flow of all grafts. X-ray angiography demonstrated that one SVG was 75% stenosed, and the others were patent. The mean graft flow (MGF) and the pulsatility index (PI) of the patent SVGs were not significantly different from those of the stenosed SVG. The HD of the patent SVGs was significantly different from that of the stenosed SVG.The HD of the TTFM waveform can provide better diagnostic accuracy for detecting clinically significant grafts than MGF and PI of TTFM and the IFI system.

Left ventricular (LV) thrombus after acute myocardial infarction (AMI) is a frequent complication that is associated with a risk of systemic embolism. Essential thrombocythemia (ET) has opposing tendencies towards hemorrhage and thrombogenesis and it can cause AMI via thrombogenesis. Ball-like LV thrombus is associated with a high risk of systemic embolism. We describe surgical resection of LV ball-like thrombus from a patient with ET. A 60-year-old woman presented at our hospital with transient ischemic attack accompanied by transient hemiplegia. Ultrasonic cardiography revealed a mobile ball-like thrombus in the LV after transmural AMI of the anterior wall. We performed emergency LV thrombectomy because of the mobile LV thrombus with embolism. Platelet aberrations and pathological bone marrow findings were consistent with a diagnosis of ET. We administered the patient with anti-coagulation drugs and the DNA replication inhibitor hydroxycarbamide to decrease the platelet count. She continues to survive and is doing well without major postoperative complications.

Anomalous subaortic left brachiocephalic vein (ASLBV) is a rare systemic venous anomaly. We review our experience with patients associated with ASLBV who underwent cardiac surgery at three institutions. From 1989 to 2009, the medical records of surgically treated patients with ASLBV were analyzed; the incidence of ASLBV, clinical characteristics, and associated anatomical findings were assessed. Fifteen patients had ASLBV. All ASLBVs coursed left lateral to the aortic arch, passed under the ascending aorta anterior to the central pulmonary artery, and joined the right brachiocephalic vein. Fourteen patients had congenital heart disease (CHD), and the remaining patient did not have cardiac anomalies. Its incidence was 0.57% (14 of 2,449) in patients with CHD and only 0.02% (1 of 4,805) in patients without CHD. In patients with CHD, 73.3% (11 of 15) of the patients had conotruncal cardiac anomalies such as tetralogy of Fallot, ventricular septal defect with pulmonary atresia, truncus arteriosus, and interruption of the aortic arch. Eight patients had aortic arch anomalies, including right aortic arch and cervical aortic arch. The deletion of chromosomal 22q11.2 was confirmed in two patients, and one patient was diagnosed with DiGeorge syndrome. ASLBV was clinically silent even without any surgical intervention. ASLBV is a very rare anomaly and is highly associated with conotruncal cardiac anomalies and aortic arch anomalies, including right aortic arch and cervical aortic arch. Preoperative diagnosis is important when any surgical interventions are intended, especially, in patients with conotruncal cardiac anomalies.

Background Patients with acute myocardial infarction (AMI) whose culprit lesion lies in a branch of the 3 major coronary arteries have well-preserved cardiac function. A first MI with preserved cardiac function is a risk factor for left ventricular free wall rupture (LVFWR), so the aim of this study was to investigate the possible relationship between AMI with branch segment occlusion and LVFWR. Methods and results The 439 patients with AMI were retrospectively studied. They were divided into 2 groups: group B (n=70; segments 4 atrioventricular node artery, 4 posterior descending coronary artery, 8, 9, 10, 12, 14, or 15 according to the AHA classification), and group P (n=369; segments 1, 2, 3, 5, 6, 7, 11, or 13). Primary percutaneous coronary intervention (PCI) was more often performed in group P (75% vs 57%; P=0.0018). In-hospital mortality tended to be lower in group B (1.4% vs 6.2%; P=0.105). The incidence of LVFWR was significantly higher in group B (10.0% vs 1.6%; P=0.0002).By multivariate logistic regression analysis, 1-vessel disease, absence of primary PCI, branch segment occlusion, and age were identified as independent predictors of LVFWR. Conclusions The incidence of LVFWR was higher in group B and branch segment occlusion was identified as an independent predictor of LVFWR.

A flow-mediated endothelium-dependent vasodilation and endothelium-independent nitroglycerin-induced vasodilation were carried out in 70 patients and 15 age-matched adults without any atherosclerotic risk factors to clarify vascular responsiveness in patients with atherosclerotic peripheral vascular disease. The percent change in flow-mediated vasodilation was significantly lower in patients than in controls (5.4 ± 0.7% vs 12.8 ± 2.2%, P < .001). Moreover, the percent change in nitroglycerin-induced vasodilation measured after sublingual administration of nitroglycerin was lower in patients than in controls (5.8 ± 0.6% vs 10.2 ± 1.5%, P < .01). On multiple regression analysis, none of the determinant factors showed a significant correlation with flow-mediated vasodilation. In contrast, Fontaine classification was found to be a significant predictor for nitroglycerin-induced vasodilation ( r = −0.307, P < .05). There is a significant positive correlation between nitroglycerin-induced vasodilation and ankle-brachial pressure index in the patients. The data showed that vasoditation function were markedly impaired in end-stage patients with peripheral vascular disease.

術前血清KL-6値が高値を示した大腸癌肺転移の2例を経験した．症例1：75歳男性．直腸癌術後follow-up中，血清CEA値の上昇と胸部CTの異常陰影を指摘された．術前KL-6値1800 U/ml．2005年6月，胸腔鏡下肺部分切除術を施行．病理組織診断で直腸癌肺転移と診断された．症例2：68歳男性．直腸癌術後follow-up中，胸部CTにて異常陰影を指摘された．術前KL-6値4010 U/ml．2005年11月，左上葉切除術を施行．病理組織診断で直腸癌肺転移と診断された．2例とも術後に血清KL-6値の低下を認めた．当科で術前に血清KL-6値が測定された転移性肺腫瘍22例の検討では大腸癌由来11例中KL-6陽性例は4例（36％）．他臓器由来の11例では陽性例はなかった．機序は不明であるが大腸癌の肺転移では血清KL-6値の上昇が生じる可能性が考えられる．

非小細胞肺癌術後補助化学療法として，paclitaxel単剤による治療が選択された症例についてretrospectiveにその有用性を検討した．対象と方法：2001～2006年の手術例のうち19例でpaclitaxel単剤による治療が選択された．1回投与量は80mg/m2とし，weeklyで12週連続投与を行うこととした．結果：標準量で完遂できた症例は4例のみであった．総投与量は完遂9例で843±115mg/m2，中止10例で390±213mg/m2．29±17（6～69）ヵ月のfollow-up期間中，癌死が5例で，5生率は65.5％であった．完遂例は中止例に比し癌死，再発が少ない傾向が見られた．まとめ：paclitaxel単剤による肺癌術後補助化学療法は予後改善効果を有する可能性があるが，コンプライアンスの高い投与法を確立する必要があると考えられる．

In the present article, we quantitatively evaluated the dose-response relationship of hormetic reactions of anticancer agents in vitro. Serial dilutions of gemcitabine, cisplatin, 5-fluorouracil, vinorelbine, and paclitaxel were administered to the A549 non-small-cell lung cancer cell line. The bi-phasic sigmoidal curve with hormetic and cytotoxic effects is given by the formula y=(a-b/(1+exp(c(*)log(x)-d)))/(1+exp(e(*)log(x)-f)), that was used to perform a non-linear least square regression. The dose-responses of the five anticancer agents were fitted to this equation. Gemcitabine and 5-fluorouracil, which had the lowest ED50 for their hormetic reaction, had the most pronounced promotive effects out of the five anticancer agents tested. The hormetic reaction progressed exponentially with culturing time. Our theoretical model will be useful in predicting how hormetic reactions affect patients with malignant tumors.