Evaluation of the radiofrequency identification lung marking system: a multicenter study in Japan.

BACKGROUND: The radiofrequency identification (RFID) lung marking system is a novel technique using near-field radio-communication technology. The purpose of this study was to investigate the utility and feasibility of this system in the resection of small pulmonary nodules. METHODS: We retrospectively reviewed clinical records of 182 patients who underwent sublobar resection with the RFID marking system between March 2020 and November 2021 in six tertial hospitals in Japan. Target markings were bronchoscopically made within 3 days before surgery. The contribution of the procedure to the surgery and safety was evaluated. RESULTS: Target nodule average diameter and depth from the lung surface were 10.9 ± 5.4 mm and 14.6 ± 9.9 mm, respectively. Radiologically, one third of nodules appeared as pure ground-glass nodules (GGNs) on CT. The average distance from target nodule to RFID tag was 8.9 ± 7.1 mm. All surgical procedures were completed by video-assisted thoracoscopic surgery. Planned resection was achieved in all cases without any complications. The surgeons evaluated this system as helpful in 93% (necessary: 67%, useful; 26%) of cases. Nodule radiological features (p < 0.001) and type of surgery (p = 0.0013) were associated with the degree of contribution. In most cases, identification of the RFID tag was required within 1 min despite adhesion (p = 0.27). CONCLUSION: The RFID lung marking system was found to be safe and effective during successful sublobar resection. Patients with pure GGNs are the best candidates for the system.

Postoperative tegafur-uracil for stage I lung adenocarcinoma: first real-world data with an exploratory subgroup analysis.

PURPOSE: The effect of postoperative tegafur-uracil on overall survival (OS) after resection of stage I adenocarcinoma has been shown in clinical trials. The purpose of this study was to investigate whether findings from randomized trials of adjuvant tegafur-uracil are reproducible in a real-world setting. METHODS: A retrospective cohort study was performed using a multi-institutional database that included all patients who underwent complete resection of pathological stage I adenocarcinoma between 2014 and 2016. Survival outcomes for patients managed with and without tegafur-uracil were analyzed using the Kaplan-Meier method and a Cox proportional hazards model for the whole patient cohort and in a selected cohort based on eligibility criteria of a previous randomized trial. Propensity score matching was used to adjust for confounding effects. RESULTS: After propensity score matching, the hazard ratios for OS were 0.57 (95% confidence interval (CI) 0.29-1.14, P = 0.11) in the whole cohort and 0.69 (95% CI 0.32-1.50, P = 0.35) in the selected cohort. CONCLUSIONS: The effects of tegafur-uracil in this retrospective study appear to be consistent with those found in randomized clinical trials. These effects may be maximized in patients aged from 45 to 75 years.

Effect of Deuteration on Relaxation Dynamics of the Perylene Excimer Studied by Subnanosecond Transient Absorption Spectroscopy.

We studied the effect of deuteration on the relaxation dynamics of the excimer of perylene in solution using subnanosecond time-resolved transient absorption spectroscopy based on the randomly interleaved pulse-train method. We found that the deuterated perylene excimer in solution had a longer lifetime than the undeuterated excimer but that deuteration had a little effect on the ground-state and transient absorption spectra of the excimer, suggesting that deuteration altered the relaxation dynamics by inducing small changes in vibrational properties. To confirm the origin of the deuteration effect, we quantitatively analyzed the kinetics of transient absorption decay, including the decay of triplet-triplet absorption. In addition, we evaluated the effects of temperature on the lifetime of the excimers. On the basis of these results, we concluded that the rate of internal conversion was suppressed by deuteration. By comparing our results with previously reported results on the effect of deuteration on the fluorescence properties of crystalline perylene, we proposed a model that may explain the effect of deuteration on the lifetime of the perylene excimer in solution.

Are volume-dependent parameters in positron emission tomography predictive of postoperative recurrence after resection in patients with thymic carcinoma?

This study aimed to investigate the association between the volume-dependent parameters in 18F-fluorodeoxyglucose-positron emission tomography (18F-FDG PET/CT) and a recurrence of thymic carcinoma. A retrospective chart review was performed based on our multi-institutional database to identify patients undergoing PET prior to resection of thymic carcinoma or neuroendocrine carcinoma between 1991 and 2018. The PET parameters (metabolic tumor volume and total lesion glycolysis) were evaluated retrospectively. The relevant factors were extracted and a survival analysis was performed using the Kaplan-Meier method. Sixteen patients were thus deemed to be eligible for analysis. The median follow-up period following resection was 2.65 years (range: 0.96-0.68 years). The recurrence-free survival was significantly longer in patients with a metabolic tumor volume < = 22.755 cm3 and with total lesion glycolysis < = 105.4006 g/mL (p = 0.001 and 0.001, respectively, by a log-rank test). The metabolic tumor volume and total lesion glycolysis may, therefore, be predictive of the postoperative recurrence of thymic carcinoma.

The treatment and survival of patients with postoperative recurrent thymic carcinoma and neuroendocrine carcinoma: a multicenter retrospective study.

PURPOSE: There are few data available on the outcomes of postoperative recurrent thymic carcinoma (TC) and thymic neuroendocrine carcinoma (TNEC). The aim of this study is to evaluate the treatment and survival in patients with recurrent TC and TNEC after undergoing surgical resection. METHODS: A retrospective chart review was performed using our multicenter database to identify patients with a postoperative recurrence of TC and TNEC from 1995 to 2018. The clinicopathological factors were reviewed and the survival outcomes were analyzed. RESULTS: Sixty patients were identified among 152 patients who underwent resection of TC and TNEC. The median follow-up period from the first recurrence was 14.8 months (range 0-144). The 5-year post-recurrence survival was 23% for the whole cohort. According to a univariable analysis, advanced stage [hazard ratio (HR) 2.81, 95% confidence interval (CI) 1.09-9.54], interval between primary surgery and recurrence (HR 0.97, 95% CI 0.95-0.99), any treatment for recurrence (HR: 0.27, 95% CI 0.13-0.58) and chemotherapy for recurrence (HR: 0.46, 95% CI 0.22-0.95) were significant factors related to post-recurrence survival. CONCLUSIONS: Chemotherapy rather than surgery appears to be the mainstay treatment for managing patients with postoperative recurrent TC and TNEC and it may also be considered in multidisciplinary management. Further studies with a larger sample size are required to confirm our findings.

Effect of oxybutynin patch versus mirabegron on nocturia-related quality of life in female overactive bladder patients: A multicenter randomized trial.

OBJECTIVES: To investigate the effect of oxybutynin patch versus ß3-adrenoceptor agonist mirabegron on nocturia-related quality of life in female overactive bladder patients. METHODS: In the present study, female overactive bladder patients were enrolled. The patients were randomly allocated into two groups: the oxybutynin patch group and the mirabegron group. Each of the drugs was given for 8 weeks. The changes in the total Nocturia Quality of Life Questionnaire score were evaluated. Parameters on a frequency volume chart were also evaluated. RESULTS: In total, 100 patients (51 oxybutynin patch, 49 mirabegron) were treated with oxybutynin patch or mirabegron. The changes in the Nocturia Quality of Life Questionnaire score 4 weeks after administration were 3.8 ± 18.6 and 8.7 ± 13.1 with the oxybutynin patch group and the mirabegron group, respectively, which were significantly higher than those at the baseline. Furthermore, the changes in the Nocturia Quality of Life Questionnaire score 8 weeks after administration were 4.3 ± 16.5 and 7.7 ± 12.3, respectively. A statistical difference was seen only in the mirabegron group. Regarding the Nocturia Quality of Life Questionnaire subscores, oxybutynin patch and mirabegron significantly improved the Nocturia Quality of Life Questionnaire bother/concern subscore 4 and 8 weeks after administration, whereas the Nocturia Quality of Life Questionnaire sleep/energy subscore was not significantly improved in each period. Eight weeks after administration, 24-h frequency, 24-h urinary urgency and mean voided urine volume were improved in both groups statistically. CONCLUSIONS: The oxybutynin patch improves quality of life, focusing mainly on nocturia by improving the bother/concern subscores of the Nocturia Quality of Life Questionnaire in the short term.

10-Plex Digital Polymerase Chain Reaction with Four-Color Melting Curve Analysis for Simultaneous KRAS and BRAF Genotyping.

Digital PCR (dPCR) is a promising method for performing liquid biopsies that quantifies nucleic acids more sensitively than real-time PCR. However, dPCR shows large fluctuations in the fluorescence intensity of droplets or wells due to insufficient PCR amplification in the small partitions, limiting the multiplexing capability of using the fluorescence intensity. In this study, we propose a measurement method that combines dPCR with melting curve analysis for highly multiplexed genotyping. A sample was digitized into a silicon chip with up to 2 × 104 wells in which asymmetric PCR was performed to obtain more single-stranded amplicons that were complementary to molecular beacon probes. Fluorescence images were captured while controlling the temperature of the chip, and the melting curve was measured for each well. Then, genotyping was performed by using the fluorescence intensity, the dye color of the probe, and the melting temperature (Tm). Because the Tm of the PCR products is not highly dependent on the amplification efficiency of PCR, genotyping accuracy is improved by using Tm values, enabling highly multiplexed genotyping. The concept was confirmed by simultaneously identifying wild-type KRAS, BRAF, and eight mutants of these genes (G12D, G12R, G12V, G13D, G12A, G12C, G12S, and V600E) through four-color melting curve analysis. To the best of our knowledge, this is the first demonstration of the genotyping of 10 DNA groups including single mutations of cancer-related genes by combining dPCR with four-color melting curve analysis.

Reaction of Oxygen with the Singlet Excited State of [n]Cycloparaphenylenes (n = 9, 12, and 15): A Time-Resolved Transient Absorption Study Seamlessly Covering Time Ranges from Subnanoseconds to Microseconds by the Randomly-Interleaved-Pulse-Train Method.

Reaction of 3O2 with singlet excited state (S1) of highly luminescent cycloparaphenylenes (CPPs), i.e., [n]CPP where n = 9, 12, and 15 in solution has been studied by transient absorption (TA) measurements seamless for the time range from subnanosecond to microsecond based on the randomly-interleaved-pulse-train (RIPT) method recently developed by our group. We found efficient quenching of S1 by 3O2 through observation of Sn ← S1 transient absorption and the steady state fluorescence measurements. Concomitantly, we have become aware of the acceleration of the rate of intersystem crossing (ISC) from S1 to the triplet excited state (T1) through the observation of the evident enhancement of Tn ← T1 absorption intensity. We have established the analysis procedure to evaluate the rate constant of ISC (kISC0) in the absence of O2 and the bimolecular rate constant of ISC induced by 3O2 (kISCO2) only by using TA decay data in the presence of O2. On the basis of these analyses, we further succeeded in determining the quantum yield of T1 (ΦT) with and without O2. In addition, the absorption coefficient of T1 (εT1) and S1 (εS1) could be estimated with reference to that of T1 of C60. These photophysical parameters are largely dependent on the ring size, where the lifetime of S1 (τS) in the absence and presence of O2 dominates ΦT as well as the quantum yield of fluorescence (ΦF).

Carrier-Selective Blocking Layer Synergistically Improves the Plasmonic Enhancement Effect.

Plasmonic enhancement is a versatile and convenient way to enhance the conversion efficiency of various photoenergy conversion systems, such as photocatalysts and solar cells. We refine a plasmonic enhancement system by focusing on a carrier blocking layer (between a plasmonic metal and a photoactive layer), which is commonly used to prevent a major quenching channel in a plasmonic enhancement system. The hydrogen evolution reaction (HER) activity is enhanced by 33 times from the introduction of a carrier-selective blocking layer (CSBL) in Ag-CdS nanoparticles. The Ag2S layer, a typical example of a CSBL, synergistically improves the plasmonic enhancement effect of Ag on the photocatalytic HER activity of CdS by both the selective blocking of photoexcited electrons and the effective transfer of holes, which extends the lifetime of the active species (electrons in the conduction band) in the semiconductor photocatalyst (CdS) to accelerate the photocatalytic HER. We propose a new strategy for a further improvement of plasmonic enhancement systems.

Photodriven Oxidation of Water by Plastoquinone Analogs with a Nonheme Iron Catalyst.

Photoirradiation of an acetonitrile solution containing p-benzoquinone derivatives (X-Q) as plastoquinone analogs, a nonheme iron(II) complex, [(N4Py)FeII]2+ (N4Py = N, N-bis(2-pyridylmethyl)- N-bis(2-pyridyl)methylamine), and H2O afforded the evolution of O2 and the formation of the corresponding hydroquinone derivatives (X-QH2) quantitatively. During the photodriven oxidation of water by X-Q, [(N4Py)FeII]2+ was oxidized by the excited state of X-Q to produce the iron(IV)-oxo complex ([(N4Py)FeIV(O)]2+) quantitatively. The concentration of [(N4Py)FeIV(O)]2+ remained virtually the same during the repeated cycles of photodriven oxidation of water by X-Q. [(N4Py)FeIV(O)]2+ was further oxidized by the excited state of X-Q to [(N4Py)FeV(O)]3+; this FeV-oxo species is proposed as an active oxidant that affects the water oxidation. The photocatalytic mechanism of the water oxidation by X-Q with [(N4Py)FeII]2+ was clarified by detecting intermediates using various spectroscopic techniques, such as transient absorption and electron paramagnetic resonance measurements. To the best of our knowledge, the present study reports the first example of a functional model of Photosystem II (PSII) using X-Q as plastoquinone analogs in the photocatalytic oxidation of water.

Photocatalytic Oxygenation Reactions with a Cobalt Porphyrin Complex Using Water as an Oxygen Source and Dioxygen as an Oxidant.

Photocatalytic oxygenation of hexamethylbenzene occurs under visible-light irradiation of an O2-saturated acetonitrile solution containing a cobalt porphyrin complex CoII(TPP) (TPP2- = tetraphenylporphyrin dianion), water, and triflic acid (HOTf) via a one-photon-two-electron process, affording pentamethylbenzyl alcohol and hydrogen peroxide as products with a turnover number of >6000; in this reaction, H2O and O2 were used as an oxygen source and a two-electron oxidant, respectively. The photocatalytic mechanism was clarified by means of electron paramagnetic resonance, time-resolved fluorescence, and transient absorption measurements as well as 18O-labeling experiments with H218O and 18O2. To the best of our knowledge, we report the first example of efficient photocatalytic oxygenation of an organic substrate by a metal complex using H2O as an oxygen source and O2 as a two-electron oxidant.

A case report of pulmonary Botrytis sp. infection in an apparently healthy individual.

BACKGROUND: Botrytis species are well known fungal pathogens of various plants but have not been reported as human pathogens, except as allergenic precipitants of asthma and hypersensitivity pneumonitis. CASE PRESENTATION: The asymptomatic patient was referred because of a nodule revealed by chest X-ray. Computed tomography (CT) showed a cavitary nodule in the right upper lobe of the lung. He underwent wedge resection of the nodule, which revealed necrotizing granulomas and a fungus ball containing Y-shaped filamentous fungi, which was confirmed histopathologically. Culture of the specimen yielded white to grayish cotton-like colonies with black sclerotia. We performed multilocus gene sequence analyses including three single-copy nuclear DNA genes encoding glyceraldehyde-3-phosphate dehydrogenase, heat-shock protein 60, and DNA-dependent RNA polymerase subunit II. The analyses revealed that the isolate was most similar to Botrytis elliptica. To date, the pulmonary Botrytis sp. infection has not recurred after lung resection and the patient did not require any additional medication. CONCLUSIONS: We report the first case of an immunocompetent patient with pulmonary Botrytis sp. infection, which has not recurred after lung resection without any additional medication. Precise evaluation is necessary for the diagnosis of pulmonary Botrytis infection because it is indistinguishable from other filamentous fungi both radiologically and by histopathology. The etiology and pathophysiology of pulmonary Botrytis infection remains unclear. Further accumulation and analysis of Botrytis cases is warranted.

Survival outcomes after minimally invasive thymectomy for early-stage thymic carcinoma.

Minimally invasive surgery (MIS) has occasionally been used for selected patients with thymoma, but there is little information on the MIS approach for thymic carcinoma. The aim of this study was to evaluate survival outcomes after MIS for early-stage (Masaoka stage I-II) thymic carcinoma and thymic neuroendocrine carcinoma. A retrospective chart review of the cases recorded in our multi-institutional database was performed to identify patients who underwent resection for thymic carcinoma between 1995 and 2017. MIS thymectomy was performed in 17 cases (VATS, n = 14; RATS, n = 3. male, 41%; median age, 72 years). The median follow-up period was 32.7 (range 7.4-106) months. The five-year overall survival and relapse-free survival rates were 84.4% and 77.8%, respectively. The present study demonstrated encouraging preliminary results regarding MIS for the treatment of early-stage thymic carcinoma and thymic neuroendocrine carcinoma. Further studies with a larger sample size are required to evaluate the indications for this surgery.

Photoinduced Electron Transfer in 9-Substituted 10-Methylacridinium Ions.

A series of 9-substituted 10-methylacridinium ions (Acr+ -R) in which an electron-donor moiety (R) is directly linked with an electron-acceptor moiety (Acr+ ) at the 9-position was synthesized, and the photodynamics was fully investigated to determine the rate constants of photoinduced electron transfer (ET) and back electron transfer. The driving forces of photoinduced electron transfer and back electron transfer were determined by means of electrochemical and photophysical measurements. The dependence of the ET rate constants on driving force was well analyzed in the light of the Marcus theory of ET. The quantum yields of formation of the triplet ET states vary significantly, depending on the interaction between the donor (R) and acceptor (Acr+ ) moieties. Among the Acr+ -R examined, the 9-mesityl-10-methylacridinium ion (Acr+ -Mes) exhibits the best performance in terms of the lifetime of the triplet ET state and the quantum yield. Photoexcitation of Acr+ -Mes results in formation of the triplet ET state [3 (Acr. -Mes.+ )], which has a long lifetime, a high energy (2.37 eV), and a high quantum yield (>75 %) in acetonitrile. The triplet ET state exhibits both the oxidizing and reducing activity of the Mes.+ and Acr. moieties, respectively.

Rib resection using a pneumatic high-speed power drill system for lung cancer with chest wall invasion: our clinical experience.

Rib resection for chest wall tumors, including lung cancer with chest wall invasion, is usually performed through open thoracotomy. Resection of part of the external rib cage requires an elongated or additional incision depending on the location and extension of the tumor, eventually becoming more invasive to patients. We recently introduced a technique of rib resection using a pneumatic high-speed power drill system known as "air tome". This novel technique is easy to perform through a small incision or even via video-assisted thoracoscopic surgery (VATS) in selected patients. We present our clinical experience and discuss the usefulness of this technique for rib resection in patients with lung cancer and chest wall invasion.

Probing with randomly interleaved pulse train bridges the gap between ultrafast pump-probe and nanosecond flash photolysis.

Despite the long-standing importance of transient absorption (TA) spectroscopy, many researchers remain frustrated by the difficulty of measuring the nanosecond range in a wide spectral range. To address this shortcoming, we propose a TA spectrophotometer in which there is no synchronization between a pump pulse and a train of multiple probe pulses from a picosecond supercontinuum light source, termed the randomly-interleaved-pulse-train (RIPT) method. For each pump pulse, many monochromatized probe pulses impinge upon the sample, and the associated pump-probe time delays are determined passively shot by shot with subnanosecond accuracy. By repeatedly pumping with automatically varying time delays, a TA temporal profile that covers a wide dynamic range from subnanosecond to milliseconds is simultaneously obtained. By scanning wavelength, this single, simple apparatus acquires not only wide time range TA profiles, but also broadband TA spectra from the visible through the near-infrared regions. Furthermore, we present a typical result to demonstrate how the RIPT method may be used to correct for fluorescence, which often pollutes TA curves.

A newly developed surgeon-controlled suction device in robotic-assisted thoracoscopic surgery.

INTRODUCTION: Assistant surgeons usually clean the surgical field with a suction cannula in robotic-assisted surgery. This manipulation requires skill and experience to avoid interfering with the operation of the console surgeon. Recently, we created a new suction device that a console surgeon can manipulate with the robotic arms. MATERIALS AND SURGICAL TECHNIQUE: A small metal suction tip with as a lumen and small side pores for suction and can be connected to a silicone tube connected to wall suction. The tip of the silicone tube can be grasped with robotic forceps and used for organ retraction as well as suction. The suction device has been used in eight lung lobectomy cases and four lung segmentectomy cases to date. There were no major difficulties related to the new suction device except for metal tip disconnection and blood clots clogging. DISCUSSION: Our newly developed surgeon-controlled suction device is inexpensive, easy to handle, and useful for suction, blunt dissection, and organ retraction in robotic-assisted thoracoscopic surgery, especially when performing lymph node dissection.

Overall reaction mechanism of photocatalytic CO2 reduction on a Re(i)-complex catalyst unit of a Ru(ii)-Re(i) supramolecular photocatalyst.

Rhenium(i) complexes fac-[ReI(diimine)(CO)3(L)]n+ are mostly used and evaluated as photocatalysts and catalysts in both photochemical and electrochemical systems for CO2 reduction. However, the selective reduction mechanism of CO2 to CO is unclear, although numerous mechanistic studies have been reported. A Ru(ii)-Re(i) supramolecular photocatalyst with fac-[ReI(diimine)(CO)3{OC(O)OCH2CH2NR2}] (R = C2H4OH) as a catalyst unit (RuC2Re) exhibits very high efficiency, selectivity, and durability of CO formation in photocatalytic CO2 reduction reactions. In this work, the reaction mechanism of photocatalytic CO2 reduction using RuC2Re is fully clarified. Time-resolved IR (TR-IR) measurements using rapid-scan FT-IR spectroscopy with laser flash photolysis verify the formation of RuC2Re(COOH) with a carboxylic acid unit, i.e., fac-[ReI(diimine)(CO)3(COOH)], in the photocatalytic reaction solution. Additionally, this important intermediate is detected in an actual photocatalytic reaction using steady state irradiation. Kinetics analysis of the TR-IR spectra and DFT calculations demonstrated the reaction mechanism of the conversion of the one-electron reduced species of RuC2Re with a fac-[ReI(diimine˙-)(CO)3{OC(O)OCH2CH2NR2}]- unit, which was produced via the photochemical reduction of RuC2Re by 1,3-dimethyl-2-phenyl-2,3-dihydro-1H-benzo[d]imidazole (BIH), to RuC2Re(COOH). The kinetics of the recovery processes of the starting complex RuC2Re from RuC2Re(COOH) accompanying the release of CO and OH- was also clarified. As a side reaction of RuC2Re(COOH), a long-lived carboxylate-ester complex with a fac-[ReI(diimine)(CO)3(COOC2H4NR2)] unit, which was produced by the nucleophilic attack of TEOA to one of the carbonyl ligands of RuC2Re(CO) with a fac-[ReI(diimine)(CO)4]+ unit, was formed during the photocatalytic reaction. This complex works not only as a precursor in another minor CO formation process but also as an external photosensitiser that photochemically reduces the other complexes i.e., RuC2Re, RuC2Re(COOH), and the intermediate that is reductively converted to RuC2Re(COOH).

Comparison of efficacy and safety of 1- and 3-month luteinizing hormone-releasing hormone agonist depots as initial therapies for prostate cancer.

BACKGROUND: We compared the efficacy and safety of 1- and 3-month depots of the luteinizing hormone-releasing hormone (LH-RH) agonist goserelin acetate in prostate cancer patients. METHODS: Patients were randomly assigned to the Direct Group that received the goserelin 3-month depot or the Switch Group that began with the 1-month depot for the first 3 months and then switched to the 3-month depot. All patients were co-administered the antiandrogen agent bicalutamide. Serum testosterone and prostate-specific antigen (PSA) levels and adverse events were recorded at weeks 4, 8, 12, and 24. RESULTS: Baseline testosterone levels in the Direct and Switch Groups were 4.98 and 5.07 ng/mL, respectively (P = 0.798). At each week, the levels in both groups were ≤0.50 ng/mL (castration level) with no significant differences between them. All of the patients in the Switch Group and 98.1 % in the Direct Group had achieved castration levels at week 12, and 100 % had achieved such levels at week 24. Baseline PSA levels in the Direct and Switch Groups were 52.37 and 46.72 ng/mL, respectively (P = 0.793). Levels in both groups dropped continuously, to about 1.0 ng/mL at week 24, with no significant differences between the groups at any time. Three patients in the Direct Group experienced adverse events that were attributed to the co-administered bicalutamide. CONCLUSIONS: There was no difference in the efficacy or safety between the 1- and 3-month depots of goserelin when given as initial prostate cancer treatment in combination with bicalutamide. Patients must be monitored for adverse events associated with bicalutamide.

Association between oxygen consumption and stepping exercise standardized with a triaxial accelerometer.

OBJECTIVE: According to the current American College of Chest Physicians (ACCP) guideline, a cardiopulmonary exercise test (CPET) is indicated in patients with lung cancer being considered for lung surgery. The measurement of maximum oxygen consumption ([Formula: see text] max) is not sufficiently prevalent because it requires special technical equipment. Considering that stepping is a simple and common exercise, we aimed to establish a simple and reproducible test with standardization of exercise intensity using a triaxial accelerometer. METHODS: Twenty healthy volunteers (10 male, 10 female) were included in the study. The subjects were obliged to step on the same spot at the rate of 80 and 110 counts for 1 min each and then step as quickly as possible for the last minute. Oxygen consumption ([Formula: see text]) (mL/kg/min) for every breath was continuously measured during the exercise. A triaxial accelerometer was attached to the hip of test subjects whereby metabolic equivalents (METs) at each test level were measured. RESULTS: The mean age of the study subjects was 42.9 ± 11.4 (mean ± SD). The mean value of [Formula: see text] at each level increased linearly along with the stepping level in each individual but varied among subjects. Using METs instead of step counts minimized the difference in regression lines among subjects. A receiver operating characteristic analysis revealed the possibility of [Formula: see text] prediction for the critical values of 10 and 20 mL/kg/min using METs. CONCLUSION: A simple and reproducible stepping test was suggested as applicable to standardizing the intensity of exercise using a triaxial accelerometer.