Surgical Treatment and Muscle Protein Analysis of V-pattern Exotropia in Craniosynostosis

Purpose: The purpose of this study was to compare the differences of V-pattern exotropia in craniosynostosis and normal children.Methods: 39 children were included in this study, 19 craniosynostosis and 20 children in control group. They underwent comprehensive ocular examinations and received strabismus surgery. The extraocular muscle samples were analysed.Results: Compared with the control group, craniosynostosis group had larger deviation in primary and up gaze, larger V pattern, and more severe inferior oblique overaction. For 20-40, and 50-60 prism diopter exotropia, the lateral recession in the craniosynostosis group was larger than that in the control group, 7.13±0.44 mm vs 6.71±0.47 mm, 8.90±0.21 mm vs 7.75±0.46 mm (p=0.025, 0.000). The anterior transposition of craniosynostosis group was more anterior than that of control group, posterior 1.03±1.24 vs 2.68±0.94 mm (p=0.000). Compared with the control group, the extraocular muscle abnormality in craniosynostosis was significant, 32% vs 5% (p=0.031). There were 40 proteins in craniosynostosis group, which were different from those in control group.Conclusions: A larger V pattern and larger deviation is common in craniosynostosis children. For the same PD of deviation, it usually needs more recession in craniosynostosis because of the thinner and weaker extraocular muscles.

Post-Operative Assessment of Ulnar Nerve Tension Using Shear-Wave Elastography

Background: Ulnar nerve compression at the elbow level is the second-most common entrapment neuropathy. The aim of this study was to use shear-wave elastography for the quantification of ulnar nerve elasticity in patients after ulnar nerve decompression with anterior transposition and in the contralateral non-operative side. Method: Eleven patients with confirmed diagnosis and ulnar nerve decompression with anterior transposition were included and examinations were performed on an AixplorerTM ultrasound system (Supersonic Imagine, Aix-en-Provence, France). Results: We observed significant differences at 0-degree (p < 0.001), 45-degree (p < 0.05), 90-degree (p < 0.01) and 120-degree (p < 0.001) elbow flexion in the shear elastic modulus of the ulnar nerve in the operative and non-operative sides. There were no statistically significant differences between the elasticity values of the ulnar nerve after transposition at 0-degree elbow flexion and in the non-operative side at 120-degree elbow flexion (p = 0.39), or in the ulnar nerve after transposition at 120-degree elbow flexion and in the non-operative side at 0-degree elbow flexion (p = 0.09). Conclusion: Shear-wave elastography has the potential to be used postoperatively as a method for assessing nerve tension noninvasively by the estimation of mechanical properties, such as the shear elastic modulus.

A Novel Body Plan Alters Diversification of Body Shape and Genitalia in Live-Bearing Fish

Major evolutionary innovations can greatly influence subsequent evolution. While many major transitions occurred in the deep past, male live-bearing fishes (family Poeciliidae) more recently evolved a novel body plan. This group possesses a three-region axial skeleton, with one region—the ano-urogenital region—representing a unique body region accommodating male genitalic structures (gonopodial complex). Here we evaluate several hypotheses for the evolution of diversity in this region and examine its role in the evolution of male body shape. Examining Gambusia fishes, we tested a priori predictions for (1) joint influence of gonopodial-complex traits on mating performance, (2) correlated evolution of gonopodial-complex traits at macro- and microevolutionary scales, and (3) predator-driven evolution of gonopodial-complex traits in a post-Pleistocene radiation of Bahamas mosquitofish. We found the length of the sperm-transfer organ (gonopodium) and its placement along the body (gonopodial anterior transposition) jointly influenced mating success, with correlational selection favoring particular trait combinations. Despite these two traits functionally interacting during mating, we found no evidence for their correlated evolution at macro- or microevolutionary scales. In contrast, we did uncover correlated evolution of modified vertebral hemal spines (part of the novel body region) and gonopodial anterior transposition at both evolutionary scales, matching predictions of developmental connections between these components. Developmental linkages in the ano-urogenital region apparently play key roles in evolutionary trajectories, but multiple selective agents likely act on gonopodium length and cause less predictable evolution. Within Bahamas mosquitofish, evolution of hemal-spine morphology, and gonopodial anterior transposition across predation regimes was quite predictable, with populations evolving under high predation risk showing more modified hemal spines with greater modifications and a more anteriorly positioned gonopodium. These changes in the ano-urogenital vertebral region have facilitated adaptive divergence in swimming abilities and body shape between predation regimes. Gonopodium surface area, but not length, evolved as predicted in Bahamas mosquitofish, consistent with a previously suggested tradeoff between natural and sexual selection on gonopodium size. These results provide insight into how restructured body plans offer novel evolutionary solutions. Here, a novel body region—originally evolved to aid sperm transfer—was apparently co-opted to alter whole-organism performance, facilitating phenotypic diversification.