Clinical applications of custom-made vaginal cylinders constructed using three-dimensional printing technology.

PurposeThree-dimensional (3D) printing technology allows physicians to rapidly create customized devices for patients. We report our initial clinical experience using this technology to create custom applicators for vaginal brachytherapy.Material and methodsThree brachytherapy patients with unique clinical needs were identified as likely to benefit from a customized vaginal applicator. Patient 1 underwent intracavitary vaginal cuff brachytherapy after hysterectomy and chemotherapy for stage IA papillary serous endometrial cancer using a custom printed 2.75 cm diameter segmented vaginal cylinder with a central channel. Patient 2 underwent interstitial brachytherapy for a vaginal cuff recurrence of endometrial cancer after prior hysterectomy, whole pelvis radiotherapy, and brachytherapy boost. We printed a 2 cm diameter vaginal cylinder with one central and six peripheral catheter channels to fit a narrow vaginal canal. Patient 3 underwent interstitial brachytherapy boost for stage IIIA vulvar cancer with vaginal extension. For more secure applicator fit within a wide vaginal canal, we printed a 3.5 cm diameter solid cylinder with one central tandem channel and ten peripheral catheter channels. The applicators were printed in a biocompatible, sterilizable thermoplastic.ResultsPatient 1 received 31.5 Gy to the surface in three fractions over two weeks. Patient 2 received 36 Gy to the CTV in six fractions over two implants one week apart, with interstitial hyperthermia once per implant. Patient 3 received 18 Gy in three fractions over one implant after 45 Gy external beam radiotherapy. Brachytherapy was tolerated well with no grade 3 or higher toxicity and no local recurrences.ConclusionsWe established a workflow to rapidly manufacture and implement customized vaginal applicators that can be sterilized and are made of biocompatible material, resulting in high-quality brachytherapy for patients whose anatomy is not ideally suited for standard, commercially available applicators

Target Spaces from Chiral Gauge Theories

Chiral gauge theories in two dimensions with (0,2) supersymmetry are central in the study of string compactifications. Remarkably little is known about generic (0,2) theories. We consider theories with branches on which multiplets with a net gauge anomaly become massive. The simplest example is a relevant perturbation of the gauge theory that flows to the CP(n) model. To compute the effective action, we derive a useful set of Feynman rules for (0,2) supergraphs. From the effective action, we see that the infra-red geometry reflects the gauge anomaly by the presence of a boundary at finite distance. In generic examples, there are boundaries, fluxes and branes; the resulting spaces are non-Kahler

(Supersymmetric) Kac-Moody Gauge Fields in 3+1 Dimensions

Lagrangians for gauge fields and matter fields can be constructed from the infinite dimensional Kac-Moody algebra and group. A continuum regularization is used to obtain such generic lagrangians, which contain new nonlinear and asymmetric interactions not present in gauge theories based on compact Lie groups. This technique is applied to deriving the Yang-Mills and Chern-Simons lagrangians for the Kac-Moody case. The extension of this method to D=4, N=(1/2,0) supersymmetric Kac-Moody gauge fields is also made.Comment: 21 pages, no figures, latex. Minor change

Mass Deformation of the Multiple M2 Branes Theory

Based on recent developments, in this letter we study the one parameter deformation of 2+1 dimensional gauge theories with scale invariance and N = 8 supersymmetry, which is expected to be the field theory living on a stack of M2 branes. The deformed gauge theory is defined by a Lagrangian and is based on an infinite set of novel 3-algebras constructed by relaxing the assumption that the invariant metric is positive definite. Under the Higgs mechanism, we can obtain the D-branes world volume theory in the presence of background fluxes.Comment: 13pages, no figures, reference adde

The Conformal Anomaly of M5-Branes

We show that the conformal anomaly for N M5-branes grows like $N^3$. The method we employ relates Coulomb branch interactions in six dimensions to interactions in four dimensions using supersymmetry. This leads to a relation between the six-dimensional conformal anomaly and the conformal anomaly of N=4 Yang-Mills. Along the way, we determine the structure of the four derivative interactions for the toroidally compactified (2,0) theory, while encountering interesting novelties in the structure of the six derivative interactions.Comment: 38 pages, LaTeX; references adde

Regulatory interactions of αβ and γλ T cells in glomerulonephritis

Regulatory interactions of αβ and γλ T cells in glomerulonephritis.BackgroundSeveral lines of evidence suggest that cellular immune mechanisms contribute to glomerulonephritis.MethodsThe roles of αβ and γλ T cells in the pathogenesis of glomerulonephritis were investigated in a model of nephrotoxic nephritis in mice deficient in either T-cell population [T-cell receptor (TCR)β and TCRλ knockout mice]. The model, induced by the injection of rabbit anti-mouse glomerular basement membrane antibody, is characterized by the development of proteinuria and glomerular damage over a 21-day observation period in wild-type mice.ResultsMice deficient in either αβ or γλ T cells developed minimal proteinuria and glomerular lesions and had a significant reduction in macrophage accumulation compared with wild-type mice. In γλ T-cell–deficient mice, circulating levels and glomerular deposition of autologous IgG were comparable to wild-type levels, while αβ T-cell–deficient mice had no autologous IgG production. Autologous antibody production was not required for the development of glomerulonephritis since mice that lack IgG and B cells (μ-chain-/-) developed similar proteinuria to that observed in wild-type mice.ConclusionsThese studies suggest a proinflammatory role for both αβ and γλ T cells in glomerular injury, independent of the humoral response. This is the first demonstration, to our knowledge, that both T-cell subsets contribute to the progression of a disease, and it suggests that complex regulatory interactions between αβ and γλ T cells play a role in glomerular injury

Using Gravitational Lensing to study HI clouds at high redshift

We investigate the possibility of detecting HI emission from gravitationally lensed HI clouds (akin to damped Lyman-$\alpha$ clouds) at high redshift by carrying out deep radio observations in the fields of known cluster lenses. Such observations will be possible with present radio telescopes only if the lens substantially magnifies the flux of the HI emission. While at present this holds the only possibility of detecting the HI emission from such clouds, it has the disadvantage of being restricted to clouds that lie very close to the caustics of the lens. We find that observations at a detection threshold of 50 micro Jy at 320 MHz (possible with the GMRT) have a greater than 20% probability of detecting an HI cloud in the field of a cluster, provided the clouds have HI masses in the range 5 X 10^8 M_{\odot} < M_{HI} < 2.5 X 10^{10} M_{\odot}. The probability of detecting a cloud increases if they have larger HI masses, except in the cases where the number of HI clouds in the cluster field becomes very small. The probability of a detection at 610 MHz and 233 MHz is comparable to that at 320 MHz, though a definitive statement is difficult owing to uncertainties in the HI content at the redshifts corresponding to these frequencies. Observations at a detection threshold of 2 micro Jy (possible in the future with the SKA) are expected to detect a few HI clouds in the field of every cluster provided the clouds have HI masses in the range 2 X 10^7 M_{\odot} < M_{HI} < 10^9 M_{\odot}. Even if such observations do not result in the detection of HI clouds, they will be able to put useful constraints on the HI content of the clouds.Comment: 21 pages, 7 figures, minor changes in figures, accepted for publication in Ap

World-sheet Stability of (0,2) Linear Sigma Models

We argue that two-dimensional (0,2) gauged linear sigma models are not destabilized by instanton generated world-sheet superpotentials. We construct several examples where we show this to be true. The general proof is based on the Konishi anomaly for (0,2) theories.Comment: 18 pages, LaTe

R^4 Couplings in M and Type II Theories

We discuss several implications of R^4 couplings in M theory when compactified on Calabi-Yau (CY) manifolds. In particular, these couplings can be predicted by supersymmetry from the mixed gauge-gravitational Chern-Simons couplings in five dimensions and are related to the one-loop holomorphic anomaly in four-dimensional N=2 theories. We find a new contribution to the Einstein term in five dimensions proportional to the Euler number of the internal CY threefold, which corresponds to a one-loop correction of the hypermultiplet geometry. This correction is reproduced by a direct computation in type II string theories. Finally, we discuss a universal non-perturbative correction to the type IIB hyper-metric.Comment: 21 pages, harvmac, misprints corrected, version to appear in Nuclear Physics