Right And Left Research Articles

9. Novel murine model of heterotopic ossification induced by spinal cord injury

<h3>BACKGROUND CONTEXT</h3> Heterotopic ossification (HO) is a painful and debilitating condition causing abnormal bone formation in the soft tissues reported in up to 50% of polytrauma patients with spinal cord injury (SCI) and limb damage. In the absence of knowledge regarding the pathogenesis of HO, prophylactic treatment with NSAIDs, bisphosphonates, and radiation therapy do little to relieve the chronic pain and joint contractures resulting from HO or prevent its recurrence after surgical intervention to remove ectopic bone. A lack of clinically relevant animal models has been a major obstacle to understanding the pathogenesis of SCI-induced HO. <h3>PURPOSE</h3> The goal of this research is to characterize a clinically relevant mouse model of SCI-induced HO based on the hypothesis that simultaneous SCI and musculotendinous injury (MTI) can cause HO. <h3>METHODS</h3> Four-week-old C57BL/6J wild type mice were subjected to spinal cord transection between T10 and T11 using a pair of spring scissors via posterior open incision. The quadriceps were then crushed using a surgical clamp and a No. 15 surgical blade used to induce a 2mm MTI at the quadriceps insertion into patella in the LEFT hindlimb. The RIGHT hindlimb remained intact as internal procedural control. During the postoperative course, urine was expelled from the paraplegic using twice daily bladder massage. Soft food and water were placed in petri dishes on the bottom of the cages. Buprenorphine SR at 1mg/kg was administered subcutaneously on Day 0 and Day 4 to provide postoperative analgesia. All mice were euthanized at postoperative Day 21 when both hindlegs were dis-articulated at hip and ankle and fixed in formaldehyde overnight. High resolution micro-CT scans of the specimens were captured at the spatial resolution of 8µm. The volume of ectopic bone around the knee joint was quantified in a 3D reconstructed model. Undecalcified samples were then dehydrated, infiltrated, and embedded in low temperature MMA, and sectioned at 5µm. Consecutive sections were assessed by Von Kossa and Toluidine Blue staining to show ossification of peri-articular soft tissues, alkaline phosphatase (ALP) staining for osteoblasts, and tartrate-resistant acid phosphatase (TRAP) staining for osteoclasts. Mann-Whitney U test was used for statistical analysis of ectopic bone volumes. <h3>RESULTS</h3> Of the seven mice euthanized at three weeks post SCI/MTI, two sustained patellar dislocation in the LEFT knee and were excluded from analyses. Quantitative microCT analysis of the remaining five revealed ectopic bone deposits in the peri-articular region of all LEFT knees but none in the RIGHT knees. The HO volume of the LEFT hindlimb was consistently higher than that of RIGHT hindlimb of each mouse (25th - 75th percentile 0.02 - 0.34 vs 0.00 - 0.00, P=0.09). Histological evaluation confirmed ectopic bone deposited in the peri-articular soft tissues of the LEFT knees while the musculotendinous tissue was intact on the RIGHT side. <h3>CONCLUSIONS</h3> This mouse model represents a novel, reproducible and clinically relevant preclinical model of SCI-induced HO that will facilitate investigation of pathogenic mechanisms and assessment of novel therapeutics for this condition. <h3>FDA DEVICE/DRUG STATUS</h3> This abstract does not discuss or include any applicable devices or drugs.

Embryologic Origin of the Primary Tumor and RAS Status Predict Survival after Resection of Colorectal Liver Metastases.

Background and objectives. In colorectal cancers, the embryologic origin of the primary tumor determines important molecular dissimilarities between right-sided (RS) and left-sided (LS) carcinomas. Although important prognostic differences have been revealed between RS- and LS-patients with resected colorectal liver metastases (CLMs), it is still unclear if this observation depends on the RAS mutational status. To refine the impact of primary tumor location (PTL) on the long-term outcomes of patients with resected CLMs, the rates of overall survival (OS), relapse-free survival (RFS) and survival after recurrence (SAR) were compared between RS- vs. LS-patients, according to their RAS status. Material and Methods. All patients with known RAS status, operated until December 2019, were selected from a prospectively maintained database, including all patients who underwent hepatectomy for histologically-proven CLMs. A log-rank test was used to compare survival rates between the RS- vs. LS-group, in RAS-mut and RAS-wt patients, respectively. A multivariate analysis was performed to assess if PTL was independently associated with OS, RFS or SAR. Results. In 53 patients with RAS-mut CLMs, the OS, RFS and SAR rates were not significantly different (p = 0.753, 0.945 and 0.973, respectively) between the RS and LS group. In 89 patients with RAS-wt CLMs, the OS and SAR rates were significantly higher (p = 0.007 and 0.001, respectively) in the LS group vs. RS group, while RFS rates were similar (p = 0.438). The multivariate analysis performed in RAS-wt patients revealed that RS primary (p = 0.009), extrahepatic metastases (p = 0.001), N-positive (p = 0.014), age higher than 65 (p = 0.002) and preoperative chemotherapy (p = 0.004) were independently associated with worse OS, while RS location (p < 0.001) and N-positive (p = 0.007) were independent prognostic factors for poor SAR. Conclusions. After resection of CLMs, PTL had no impact on long-term outcomes in RAS-mut patients, while in RAS-wt patients, the RS primary was independently associated with worse OS and SAR.

Left sided breast cancer is associated with aggressive biology and worse outcomes than right sided breast cancer

Breast cancer is more common on the left side than the right side. We aim to evaluate differences in clinicopathological and genomic characteristics based on laterality. We analyzed survival outcomes and clinical characteristics of 881,320 patients recorded by the Surveillance, Epidemiology, and End Results (SEER) program. The Cancer Genome Atlas (TCGA) was used to explore genomic and clinical features from 1,062 patients. Gene expression data was used to quantitate cytolytic activity and hallmark gene-sets were used for gene set enrichment analysis. An institutional retrospective review was conducted on 155 patients treated with neoadjuvant chemotherapy (NACT). Patient characteristics were summarized by pathological complete response (pCR). Left sided tumors were found to be more prevalent than right sided tumors. No major clinicopathological differences were noted by laterality. Left sided breast cancer demonstrated poorer outcomes versus right sided tumors (HR 1.05, 95% CI 1.01–1.08; p = 0.011). Cell proliferation gene sets, including E2F Targets, G2M Checkpoint, Mitotic spindle, and MYC Targets, were enriched on the left side compared to the right. Left sided tumors had lower pCR rates versus right sided tumors (15.4% versus 29.9%, p = 0.036). Our findings suggest that left sided breast cancer is associated with aggressive biology and worse outcomes compared to right sided breast cancer.

REVIEW OF THE INTERNET BLOCKING CASE IN PAPUA IN CYBER LAW PERSPECTIVE

The internet has become an essential part of modern life, increasing the efficiency of everything. It should be no surprise that internet abuse can lead to crimes that harm everyone. As a result, there is a need for legal safeguards known as Cyber Law, which intersects with Human Rights. The case of internet blocking in Papua, in which the government blocked or slowed internet connections in Papua, is the subject of this article because it raises many issues in the fields of Human Rights and Cyber Law, which, on the human rights side, is regulated in the 1945 Constitution, which states that everyone has the right to benefit from technology. In this case, the government cannot meet the aspect of Human Rights. However, in Cyber Law, this is intended as a limitation to reduce a crime on social media or the internet that causes chaos. As a result, this paper will elaborate on the Papua case from the standpoint of Cyber Law. The Administrative Court's decision used a normative legal approach and an objective case approach to investigate this phenomenon experimentally. The study then employs a qualitative method with literature and empirical approach, obtaining data through legal analysis and social phenomena that occur in society. Although further investigations are needed, the present study contributes to a better understanding of the case that occurred in Papua related to the government's blocking or disconnection of the internet. It was not a violation of the law because the government at the time made good decisions for the entire community's benefit, ensuring that everyone was safe from cybercrime or false news, which has the potential to sever Indonesia's unity.

Left sided Amyand hernia - A case report.

IntroductionAmyand hernia is a clinical condition wherein content of the inguinal hernial sac is formed by the vermiform appendix.Case presentation1 year 3-month-old male child presented to our OPD with an irreducible left inguinal hernia for which he was taken up for an emergency herniotomy. The terminal ileum, caecum and appendix were found to be the contents of the hernial sac.DiscussionAs the appendix is anatomically located on the right, Amyand hernia more commonly occurs on the right, however its occurrence on the left, is a rare event and is usually associated with congenital anomalies like Intestinal malrotation, Situs inversus and mobile caecum.ConclusionAmyand hernia presenting on the left is extremely rare and high index of clinical suspicion is required to manage such patients. We report one such rare case of a Left sided Amyand hernia in a young child.

The Effects of Unwritten Laws and How it Affects the Positive Attributes of Human Rights

From the traditional form of laws, human rights were introduced with the need of finding ways to protect humans. Later on, it enumerated to international level setting the obligations of different states defining the laws in particular to protect their citizens. This study involves defining unwritten laws and how they are linked in affecting the human rights. Human right laws make it clear to everyone being entitled to a set of rights and freedom which basically protects one from discrimination and being engaged in forceful activities. The study focuses on human rights being the baseline reflection on how humans should live or be handled. From explanation on how social justice was achieved, the study will shade the light on low flexibility based on different generation. The study will define what is meant by the term unwritten laws and human rights that will promote a clear view on the overall research and make an effective conclusion that will allow other researchers and other users in understanding the need of human right as part of unwritten laws. Through qualitative analysis as the methodology, the study will evaluate other researchers’ findings and their argument on how the unwritten law impacts the good side of human rights. The conclusion will discuss the findings and elaborate on how the unwritten laws impact the effectiveness of human right from the past to the current generation.&#x0D; Keywords: Unwritten Laws, Human Rights, Traditional Laws, Social Justice, Law Flexibility, Law Evolution

P.157 Adjunctive treatment of chronic subdural hematoma with middle meningeal artery embolization – is the left side more common?

Background: Embolization of middle meningeal artery (EMMA) is an emerging treatment for CSDH and a method to decrease CSDH recurrence. We report a single Canadian center experience of EMMA for the management of CSDH. Methods: Consecutive EMMA patients during the period July 2020 to September 2021 were retrospectively included in this series. EMMA procedures were performed using polyvinyl alcohol particles or liquid embolic agent. All patients were followed clinically and radiographically as per standard of care. Results: A total of 20 patients CSDH (mean 65.6 years; range 14-85 yrs; male 16) underwent 20 EMMA procedures. CSDH occured on the left in 13 patients, right in 4 patients and bilateral in 3 patients. No patients had periprocedural complications. There was no recurrence of CSDH on the EMMA treated side. The mean SDH size decreased from 18.4 +/- 6.34 mm at the time of presentation to 5.31 +/ 3.84 mm at last follow up. The proportion of patients with an mRS of 2 or less increased from 65% to 76%. Conclusions: EMMA was found to be effective and safe in the management of CSDH with no evidence of recurrence on the treated side. Left sided hematomas appear to be more common that right sided hematomas.

107 Tapia’s syndrome – is the mechanism neuropraxia from intubation or is it more complex?

An otherwise well 23 year old lady had a septorhinoplasty with bilateral implants under general anaesthesia for nasal blockage and right sided nasal deviation.The operation was successful but six hours later the left side of her tongue felt odd, she had dysphonia and ‘it felt funny to swallow’. She had deviation of the tongue to the left on protrusion; couldn’t quickly it it from side to side; and the sensation on its left side was altered. There wasn’t obvious tongue swelling or haematoma and no weakness or numbness in the face or limbs. Naso-endoscopy confirmed a left vocal cord paralysis.This was recognised as a left sided hypoglossal and vagal nerve palsy. The ENT and anaesthetic teams, felt that it might have been due to over-packing of the throat causing compression and neuropraxia. Her symptoms substantially improved after 5 days with a course of dexamethasone.This case will be discussed with reference to both the first described and more recent case reports of Tapia’s syndrome along with the hypothesised mechanisms of injury. Tapia’s syndrome is a thought to be due to pressure during intubation but most case reports follow surgeries with hammering and other sudden applications of force, rather than in emergency situations which would be expected to have more problems resulting from intubation. It seems important that those who resuscitate patients are aware of this potential complication.hut898@gmail.com

Anatomical morphometry of superior articular surface of proximal end of dried human tibiae in Rajasthan population

Background: The geometric mismatch between patient anatomy and implant components responsible for failure of knee replacement surgeries. Aim of the study: To study anatomical morphometry of superior articular surface of proximal end of dried human tibiae in Rajasthan population. Materials and methods: The present study was conducted in the Department of Anatomy, S.M.S. Medical College, Jaipur. The study period was from approval of plan till 15th December 2019. The study is a descriptive type of observational study. 120 dry tibiae (60 right sided and 60 left sided) were required as sample size. Results: The difference in the mean AP diameter of medial condyle between right and left side was found to be statistically non-significant. The difference in the mean transverse diameter of the medial condyle values between right and left side was found to be statistically non-significant. The difference in the mean AP diameter of the lateral condyle between right and left side was found to be statistically non-significant. The difference in the mean transverse diameter of the lateral condyle between right and left side was found to be statistically non-significant.

Morphometric study of tibial condylar area in Rajasthan population

Background: Indians are the part of Asian-pacific population and they have a smaller build and stature in comparison of western population. The prosthesis for knee replacement surgeries which are presently being used are best suited for the western population therefore leading to implant size incompatibility with the resected bony surfaces. Aim of the study: To perform morphometric study of tibial condylar area in Rajasthan population. Materials and methods: The present study was conducted in the Department of Anatomy, S.M.S. Medical College, Jaipur. The study period was from approval of plan till 15th December 2019. The study is a descriptive type of observational study. 120 dry tibiae (60 right sided and 60 left sided) were required as sample size. The ethical clearance for the study was approved from the ethical committee of the hospital. Results: The mean AP diameter of the total tibial condyle was 45.28±2.93 mm on the right side and 44.68±4.29 mm on the left side and the total mean AP diameter of total tibial condyle was 44.98±3.67 mm. The difference in the mean AP diameter values between right and left side was found to be statistically not significant.

Impact of high-power and very high-power short-duration radiofrequency ablation on procedure characteristics and first-pass isolation during pulmonary vein isolation

Abstract Funding Acknowledgements Type of funding sources: None. Introduction High-power short-duration (HPSD) radiofrequency ablation has been proposed as a method for producing rapid and effective lesions for pulmonary vein isolation.We aimed to evaluate the procedural characteristics and the FPI rate of HPSD and very high-power short-duration (vHPSD) compared to low-power long-duration (LPLD) ablation techniques. Methods 156 patients with atrial fibrillation (AF) were enrolled and assigned to LPLD, HPSD, or vHPSD PVI. The energy setting was 30W, 50W, and 90W in the LPLD, HPSD, and vHPSD groups, respectively. Results Bilateral PVI was achieved in all cases. The procedure time was 85 [75-101] min, 79 [65-91] min, and 70 [53-83] min in the LPLD, HPSD, and vHPSD groups, respectively (p&amp;lt;0,0001). LA dwelling times were also decreased significantly with the increase of RF energy (61 [55-70] min, 53 [41-56] min, and 45 [34-52] min, in the LPLD, HPSD, and vHPSD groups, respectively, p&amp;lt;0.0001). The total RF ablation time was 1398 [1021-1711] sec, 1567 (1366-1761) sec, and 336 [247-386] sec in the LPLP, HPSD, and vHPSD group, respectively ( p&amp;lt;0,0001). Bilateral FPI was rate was 57%, 78% and 80% in the LPLD, HPSD, and vHPSD groups, respectively (p=0,0097). On the left side, FPI was achieved in 66% in the LPLD, in 92% in the HPSD, and in 85% in the vHPSD ablation group (p=0.0015). FPI on the right side was achieved in 72% in the LPLD, in 88% in the HPSD, and in 88% in the vHPSD ablation group (p=0,0188). FPI rates were significantly higher in the HPSD group compared to the LPLD group: both sided FPI rate was 57% vs. 78% (p=0.021), left sided FPI rate was 66% vs. 92% (p=0.0015), and right sided FPI rate was 72% vs. 88% (p=0.0401). Further increase in the RF power did not result in a significant additional increase in the FPI rate. In the HPSD vs. vHPSD group both sided FPI rate was 78% vs. 80% (p=0,8080), left sided FPI rate was 92% vs. 85% (p= 0,5275), and right sided FPI rate was 88% vs. 88% (p= 0,7561). Univariate analysis revealed that the use of HPSD ablation technique is associated with a higher probability of FPI (both sides: OR=2.72, 95% CI 1.15-6.44, p=0.023; right side: OR=2.90, 95% CI 1.02-8.20, p=0.045; left side: OR=5.91, 95% CI 1.84-19.04, p=0.003). The mid-term arrhythmia-free survival was similarly high in all three groups. Conclusion Our prospective, observational cohort study showed that both HPSD and vHPSD RF ablation is effective, as it shortens procedure time and RF time and results in a higher rate of FPI compared to LPLD ablation. Moreover, the mid-term arrhythmia-free survival was similarly high in all three groups. In our study, no safety concerns were raised due to HPSD ablation.

The association between tumour sub-site and local nodal and/or distant metastasis at the time of resection of colorectal cancer: a prospective study of 3,360 consecutive cases

The concept that right and left sided colorectal cancer may be biologically different has led to a review of the pathology and molecular characteristics expressed by the two sides. The aim of this cross-sectional study was to examine the association between tumour sub-sites and the presence of any metastasis by multivariable modelling. Pathology data were drawn from a hospital series of 3360 consecutive patients who had their first cancer resected between 1995 and 2019 inclusive. A preliminary analysis of the distribution of sex, age and a range of routinely reported pathology features showed that the simple division of the bowel into right and left sides masks the considerable variation in pathology features which occurs between sub-sites within each side. Logistic regression adjusting for sex, age, a range of routinely reported pathology features and tumour sub-site showed that age ≤70, direct tumour spread (T3 and T4), high grade, venous invasion and perineural invasion all carried a significantly increased risk for the presence of metastatic spread. The only tumour sub-sites to show an increased risk were the sigmoid colon and rectum (adjusted odds ratio 1.72, P<0.001 and 1.78, P<0.001, respectively). These findings suggest that multivariable modelling could usefully be applied to identify associations between sub-sites and molecular characteristics.

KAJIAN FILSAFAT HUKUM TERHADAP PELAKSANAAN PIDANA MATI MENURUT HAK AZASI MANUSIA

The provisions of article 10 of the Criminal Code (CRIMINAL CODE) state that in addition to 4 (four) main criminal types, namely: death penalty, imprisonment, imprisonment and fines, there are 3 (three) additional criminal types, namely the revocation of certain rights, confiscation of certain goods, and the announcement of the judge's decision. The death penalty is the most severe type of criminal in the composition of sanctions and is one of the main forms of criminal. The existence of the death penalty is basically a type of criminal that robs a legal interest (rechtsbelang), which is in the form of human life. The existence of the death penalty among jurists there is a difference of opinion. The formulation of the issue raised is how the execution procedure for death row inmates is viewed from the human rights side. The type of research used is normative juridical with a statutory approach. The results found that the death penalty has existed since antiquity through the regulation of positive laws, customary laws, and religion. The death penalty is a guarantee of recognition and respect for the right of freedom of others in fulfilling justice in accordance with moral considerations, religious values, security and public order. The death penalty in Indonesia is only applied to very serious crimes in accordance with applicable law. The Constitution in addition to protecting human rights also allows such human rights to be restricted. &#x0D; Keywords: Philosophy of law, death penalty, human rights.

Time after time: detecting annual patterns in stream bacterial biofilm communities.

SummaryTo quantify the major environmental drivers of stream bacterial population dynamics, we modelled temporal differences in stream bacterial communities to quantify community shifts, including those relating to cyclical seasonal variation and more sporadic bloom events. We applied Illumina MiSeq 16S rRNA bacterial gene sequencing of 892 stream biofilm samples, collected monthly for 36‐months from six streams. The streams were located a maximum of 118 km apart and drained three different catchment types (forest, urban and rural land uses). We identified repeatable seasonal patterns among bacterial taxa, allowing their separation into three ecological groupings, those following linear, bloom/trough and repeated, seasonal trends. Various physicochemical parameters (light, water and air temperature, pH, dissolved oxygen, nutrients) were linked to temporal community changes. Our models indicate that bloom events and seasonal episodes modify biofilm bacterial populations, suggesting that distinct microbial taxa thrive during these events including non‐cyanobacterial community members. These models could aid in determining how temporal environmental changes affect community assembly and guide the selection of appropriate statistical models to capture future community responses to environmental change.

Neurological soft signs in autism spectrum disorder

Autism spectrum disorder (ASD) is a phenotypically heterogeneous group of neurodevelopemental syndromes characterized by impairments in social communication and restricted &amp; repetitive behavior. Neurological soft signs (NSS) are minor neurological abnormalities that aren’t a part of any fixed/transient neurological disorders. The most common NSS in ASD are motor incoordination, difficulty sequencing motor tasks &amp; sensory disintegration.22 participants of ASD satisfying the inclusion and exclusion criteria were assessed for NSS, using a semi structured performa &amp; Heidelberg manual for neurological soft signs. The data was tabulated and analysed statistically.The mean age of the participants was 11.63 years with 82% males &amp; 18% females. 100% participants had dysdiadochokinesia (82% -adiadochokinesia), errors in the finger-nose test(71% unable to perform), right-left confusion (39% -making gross errors), difficulty in tandem walking(70% -significant balance problems), difficulty in fist-edge-palm (54% unable to complete task) &amp; ozeretski test (78%- unable to perform). 94% had difficulty in pronation-supination (56%-failed to complete exercise).89% of the participants had difficulty in finger –thumb opposition (63%- unable do it).NSS are present in a significant amount of patients of ASD &amp; such patients should be assessed for the full spectrum of NSS.

Dual migration of organic foreign body in bronchus

The foreign body in the bronchus is one of the most fatal emergencies in the Otorhinolaryngology. Delay in the appropriate treatment may result in acute airway diseases and fatal complications. The aim of this manuscript is to report a clinical case of dual migration of an organic foreign body from left to right and then back to the left bronchus in a 13 months old child. The case was initially diagnosed as left sided severe pneumonia which recurred after initial partial response to medical management and thus raised the suspicion of a foreign body. Computed tomography of the chest revealed a foreign body in the right bronchus contrary to clinical findings on the left side suggesting the first migration. The foreign body was visualized and removed from the left bronchus during bronchoscopy; which was contrary to radiological findings, suggesting the second migration.

Anatomical Variations of the Superior Sagittal, Transverse and Sigmoid Dural Venous Sinuses in the Cerebral MRV Images of Adult Bangladeshis

Background: The understanding of the dural venous sinus anatomy and normal anatomical variations is fundamental for appropriate diagnosis of cerebral venous sinus pathology and also for surgical planning and treatment of neurological diseases. Cerebral MRV (Magnetic Resonance Venography) is an exclusive imaging technique for appropriate identification of the normal anatomical variations as well as pathology of the dural venous sinuses. Most of the variations have been detected in the superior sagittal, transverse and sigmoid venous sinuses. Objectives: To identify and determine the frequencies of some selected anatomical variations- symmetry, hypoplasia and aplasia (as applicable) of the superior sagittal, transverse and sigmoid dural venous sinuses in the cerebral MRV images of adult Bangladeshis. Methods: The research was observational in nature, carried out in the Department of Anatomy, Bangabandhu Sheikh Mujib Medical University (BSMMU) in collaboration with the Department of Neuroradiology &amp; Imaging, National Institute of Neuroscience and Hospital (NINS), Dhaka, from March 2020 to June 2021. A total of 70 adults (35 males and 35 females) Bangladeshi participants were included in this research. The MRV scans were produced by using 3 Tesla magnetic field strength following the routine standard protocols of the institution. By using the Radiant DICOM Viewer software, the MRV images were evaluated by the researcher and the co-investigator independently to identify the selected anatomical variations of the dural venous sinuses. Results: Bilateral symmetrical transverse and sigmoid sinus was found in 38% and 47% of total participants respectively. Among the variations of the transverse sinuses, the left sided hypoplastic transverse sinus was found in 17.1% participants whereas the right sided hypoplasia was found only in 2.9% participants. Regarding sigmoid sinus, hypoplasia and aplasia were found only on the left side respectively in 7.1% and 1.14% participants. ...

Robotic-assisted minimally invasive thymectomy for myasthenia gravis with thymoma.

Robotic-assisted minimally invasive thymectomy for myasthenia gravis with thymoma.

Correlation between Morphological Variations and Morphometry of Scapula and Suprascapular Notch with Its Clinical Significance in South Indian Population

Introduction: The biological profile is one of the most important things that forensic anthropologists accomplish in their work, which includes determination of age, sex, race and stature. These components aid in identification of an individual in forensic context. Since the beginning of the field of physical anthropology, anthropologists and anatomists have studied human remains in order to provide new and more accurate ways of building the biological profile. Aim: To compare the metric difference between right and left scapula, calculate scapular index, and to correlate the morphometry between the scapula and the suprascapular notch. Materials and Method: This study was carried out in 200 dry ossified adult human scapula bones collected from the Department of Anatomy and from the students of 1st year MBBS of Yenepoya Medical College. Study done using vernier calliper and measuring tape. Scapula having gross deformity or any pathological alterations were excluded from the study. Results and Discussion: Out of 100 right and left scapulae, maximal width and projection length of scapular spine and maximal length of coracoid process were more on the right sided scapula. The superior- transverse diameter of suprascapular notch, maximal depth of suprascapular notch, morphological length and width of scapula and scapular index were more on the left sided scapulae. The mean scapular index of right side scapula was 70.11 and left side was 70.26, which shows that the left scapula is slightly shorter than right. Also there were more scapulae with longer superior transverse diameter of suprascapular notch (STD&gt;MD) with 52% than the scapulae with longer maximal depth of suprascapular notch (MD&gt;STD) 24% and STD=MD was 9%. Absent notches were seen in 15% of scapulae. The superior transverse scapular ligament was completely ossified in 12% of cases. Both right and left scapula shows more of ‘U-shaped’ suprascapular notch. There was no statistically significant difference between anthropometric measurements of the group with higher maximal depth and the group with higher superior transverse diameter of the suprascapular notch. Conclusion: The scapular index was more in left scapula, which shows that left scapula is slightly shorter than the right scapula compared to other populations. This may be due to the difference in general built and stature of South Indians compared to other populations. Completely ossified superior transverse scapular ligament can result in entrapment of suprascapular nerve. Keywords: Scapula, Suprascapular notch, Spine of scapula, Coracoid process.

Abstract P3-19-21: Semi-lateral decubitus position using Alexandria left breast board-16. A prospective study regarding dose distribution and reproduciblity

Abstract Purpose: Organs at risk sparing without compromising adequate coverage to the target volumes is the main challenge during left breast cancer adjuvant radiation therapy. Advanced radiotherapy techniques have been investigated to improve the dose distributions and to reduce toxicities. These techniques includes deep inspiration breath hold, accelerated partial-breast irradiation, Intensity Modulated Radiation Therapy. Supine positioning (SP) is the most commonly used and the standard tangent set-up for breast radiotherapy. Our purpose is to compare the Semi-lateral decubitus position(SLDP) versus SP regarding the dose distribution to the left Chest wall/Whole breast (WB), ipsilateral left axilla, contra-lateral breast, thyroid, spinal cord, ipsilateral lung, heart, LAD (Left Anterior Descending Artery), as well as determining the reproducibility of the Alexandria left breast board-16 (ALB-16) by portal image verification. Methods: We invented a new breast board ALB-16 to induce SLDP allowing tilting the patient towards the right side, elevating the patient's left side at a certain angle adjusted according to the patient’s body surface area and the gantry width of the CT simulator. Simulation process was performed in two different positions whilst the patients were freely breathing, the first scan in SLDP and the second in SP. Fifty women with a left sided breast cancer who underwent either mastectomy or lumpectomy were enrolled in this study for dosimetric comparison between the SLDP and the SP. The mean radiotherapy dose to the CW/WB, axilla, thyroid, left lung, heart, LAD, Spinal cord and the contra-lateral right breast in SLDP and the SP for the same patient were compared. Secondly, analysis was conducted on the fifty patients who were treated in SLDP by ALB-16 in comparison with a control group treated in SP to determine ALB-16 reproducibility. Results: On dosimetric analysis of the two positions, SLDP was found to significantly decrease the mean dose to the heart when compared with SP (2.2Gy vs. 2.9Gy respectively), LAD (5.4Gy vs. 7.2Gy) and the Spinal cord Dmax (7.5Gy vs. 12.6Gy) with a (p&amp;lt;0.01), while maintaining a similar coverage to the axillary lymph nodes levels I, II and III and the SCV group (91.13%, 89.9%, 88.9% and 93.9% vs. 91.3%, 90.2%, 89.5% and 94.1% respectively)(p =0.73, 0.37, 0.29 and 0.67) SLDP improved coverage to the target PTV mean dose (95.2% vs. 94.2%, p&amp;lt;0.01). SLDP decreased the mean dose to the contralateral breast (2.27Gy vs. 2.52Gy, p= 0.08). However, it achieved slightly a higher mean dose to the thyroid gland (79.8Gy vs. 16.8Gy, p= 0.56). The mean dose to the ipsilateral lung was slightly higher than SP (22.5% vs. 20.3%) with a statistically significant difference (p&amp;lt;0.01). For the secondary analysis, setup error in lateral (x) direction was higher in SLDP (0.66cm vs.0.49cm, p=0.028), setup error in vertical (y) direction in SLDP was lower than SP (0.39cm vs. 0.55cm, P=0.013). For the changes in longitudinal direction (Z), there was a slight difference between both positions (0.49cm vs. 0.39cm, p= 0.56). The length of deviation vector (3D vector) was (0.95cm in SLPD vs.0.87 in SP), the mean difference between vector lengths was only (0.08 cm) and this difference wasn’t statistically significant (p= 0.441) indicating the overall reproducibility of the ALB-16 breast board in comparison to standard supine breast board. Conclusions: ALB-16 Breast board is considered a reproducible method of setup for patients receiving left breast cancer adjuvant radiotherapy. It is comparable with the conventional supine breast board in regards of setup errors variability. SLDP spared the heart, LAD and the spinal cord, with a better WB/CW PTV coverage. SLDP can be used in patients whom regional nodal irradiation is indicated while maintaining low contralateral breast dose. Citation Format: Omar Saeed Emam, Mohamed Abouegylah, Rasha Elsaka, Amr Munir, Fady Aziz, Abdelsalam Attia Ismail, Amr Abdelaziz Elsaid. Semi-lateral decubitus position using Alexandria left breast board-16. A prospective study regarding dose distribution and reproduciblity [abstract]. In: Proceedings of the 2021 San Antonio Breast Cancer Symposium; 2021 Dec 7-10; San Antonio, TX. Philadelphia (PA): AACR; Cancer Res 2022;82(4 Suppl):Abstract nr P3-19-21.