Association of radiation dose to cardiac substructures with major ischaemic events following breast cancer radiotherapy.

BACKGROUND AND AIMS: Patients with left-sided breast cancer receive a higher mean heart dose (MHD) after radiotherapy, with subsequent risk of ischaemic heart disease. However, the optimum dosimetric predictor among cardiac substructures has not yet been determined. METHODS AND RESULTS: This study retrospectively reviewed 2158 women with breast cancer receiving adjuvant radiotherapy. The primary endpoint was a major ischaemic event. The dose-volume parameters of each delineated cardiac substructure were calculated. The risk factors for major ischaemic events and the association between MHD and major ischaemic events were analysed by Cox regression. The optimum dose-volume predictors among cardiac substructures were explored in multivariable models by comparing performance metrics of each model. At a median follow-up of 7.9 years (interquartile range 5.6-10.8 years), 89 patients developed major ischaemic events. The cumulative incidence rate of major ischaemic events was significantly higher in left-sided disease (P = 0.044). Overall, MHD increased the risk of major ischaemic events by 6.2% per Gy (hazard ratio 1.062, 95% confidence interval 1.01-1.12; P = 0.012). The model containing the volume of the left ventricle receiving 25 Gy (LV V25) with the cut-point of 4% presented with the best goodness of fit and discrimination performance in left-sided breast cancer. Age, chronic kidney disease, and hyperlipidaemia were also significant risk factors. CONCLUSION: Risk of major ischaemic events exist in the era of modern radiotherapy. LV V25 ≥ 4% appeared to be the optimum parameter and was superior to MHD in predicting major ischaemic events. This dose constraint could aid in achieving better heart protection in breast cancer radiotherapy, though a further validation study is warranted.

Simplified small-scale backlight unit tester.

A novel design is the concept of using charge coupled device camera embedded with calibrated image processing algorithm as a two-dimensional luminance meter to measure the luminance and uniformity of small-scale backlight of unit. A small-scale backlight unit tester was successfully realized and performed to verify this concept.

Phylogenetic analysis of Newcastle disease virus in Taiwan.

The virulent forms of Newcastle disease virus cause a devastating disease of poultry. Between 1998 and 2000, sporadic outbreaks of Newcastle disease occurred in Taiwan despite vaccination. The causes of the failure of the vaccination remain unclear. The purpose of this study was to investigate the possible factors causing these outbreaks by serologic and virologic methods. Anti-Newcastle disease virus hemagglutination-inhibition titers were measured for serum samples obtained from a breeder farm and a broiler farm. The serologic data showed continued presence of virulent Newcastle disease viruses in the field during inter-outbreak periods. Phylogenetic analysis demonstrated that the field virulent Newcastle disease viruses were genetically similar and were grouped into genotype VIIa. Efficacy testing by virulent Newcastle disease virus challenge revealed that the vaccines used were effective for protecting chickens from infections. This investigation demonstrated that the Newcastle disease virus strain can spread quickly and widely throughout a large geographic area, and that the sporadic cases originate from virulent Newcastle disease viruses present in the field.

Clinical epidemiologic and experimental evidence for the transmission of Newcastle disease virus through eggs.

Sporadic outbreaks of Newcastle disease (ND) occurred in Taiwan during 1998-2000. In some cases, the disease occurred in broilers less than 2 wk old that originated in a broiler breeder farm, so spread of the ND virus (NDV) from the infected breeder farm to broiler ranches was suspected. The purpose of the present study was to examine the possibility of the transmission of NDV through eggs. Both clinical and experimental evidence were used to prove that this is possible. From epidemiological investigation, the possibility of transmission through eggs was suggested in two separate ND cases from a breeder farm and its progeny because two identical NDVs were isolated from both cases. In order to clarify the possibility of the transmission through eggs, one mean egg lethal dose (ELD50) of NDV was inoculated into the allantoic cavity of 155 9-to-11-day-old specific-pathogen-free (SPF) chicken embryos. Seventy-one hatching chicks from the inoculated embryos were raised for 14 days. The cloacal swabs from those chicks at the ages of 1, 4, and 7 days and the tissues after necropsy at the ages of 14 days were taken for virus isolation. The same NDV was reisolated from three hatching chicks. This experiment confirms that a few chicken embryos infected in ovo with a low titer of NDV can hatch and contain NDV after hatching, which results in NDV spreading through eggs.