The Fleur-de-lis DIEP-Introducing a 5th zone for DIEP reconstruction.

We present a case of breast cancer in the massive weight loss patient. In the light of the PIP implant scandal, the patient demanded an autologous reconstructive solution. We describe our surgical approach towards this unique problem and share our experience of performing a DIEP reconstruction using a fleur-de-lis pattern.

Phylogenetic relationships amongst Chloromyxum Mingazzini, 1890 (Myxozoa: Myxosporea), and the description of six novel species from Australian elasmobranchs.

Six novel species of Chloromyxum Mingazzini, 1890 are described using a whole evidence approach combining morphometric and molecular data, together with features of their biology. Elasmobranchs were collected in Australian waters, from the Great Barrier Reef, Queensland, off Lizard and Heron Islands; from Moreton Bay, southeast Queensland; off Hobart, Tasmania; and from the Tamar River, Launceston, Tasmania. The novel species proposed here are: Chloromyxum hemiscyllii n.sp. from Hemiscyllium ocellatum; Chloromyxum kuhlii n.sp. from Neotrygon kuhlii; Chloromyxum lesteri n.sp. from Cephaloscyllium laticeps; Chloromyxum mingazzinii n.sp. from Pristiophorus nudipinnis; Chloromyxum myliobati n.sp. from Myliobatis australis; and Chloromyxum squali n.sp. from Squalus acanthias. A seventh species from Squalus acanthias is also reported but due to limited material is not formally described. Molecular phylogenetic analyses revealed that the genus Chloromyxum is polyphyletic, and species from elasmobranchs form a well-supported sister clade, with the type species Chloromyxum leydigi, to all other congeneric species clustering within the freshwater myxosporean clade. Morphological analysis showed that elasmobranch-infecting species are predominantly pyriform shaped, have clearly thickened spore apex and possess caudal filaments, compared to other Chloromyxum species which are generally spherical or subspherical, and lack caudal filaments. These morphological and phylogenetic data provide further support for the erection of new genera, but we conservatively consider the species described in this study and other elasmobranch-infecting Chloromyxum species as Chloromyxum sensu strictu, whilst the freshwater teleost infecting and amphibian infecting species we will assign as Chloromyxum sensu lato, until more comprehensive data are available.

Wildlife as reservoirs for parasites infecting commercial species: host specificity and a redescription of Kudoa amamiensis from teleost fish in Australia.

Parasites of the genus Kudoa (Phylum Myxozoa) have long been known to cause considerable losses to finfish aquaculture. One such parasite species, Kudoa amamiensis, causes unsightly white cysts in the skeletal muscle of yellowtail kingfish, Seriola quinqueradiata, in Japan rendering the fillets unmarketable. The authors who characterized K. amamiensis, Egusa & Nakajima, 1980, hypothesized that yellowtail kingfish, as non-natives to the area, were accidental hosts of the parasite and that it normally infects native reef fish (damselfish, Family Pomacentridae). Since then, we have found parasites that are consistent with the description of K. amamiensis in two species of damselfish and one species of carangid fish in Australia, and it has been recorded previously in another species of reef-associated fish. Our morphometric, histological and DNA results suggest that these specimens are K. amamiensis, and are new host records for that species. Furthermore, our observations show that reef fish may act as a reservoir of myxozoan infection for commercial species, and as such should be considered an infection pathway for species in aquaculture.

Re-feeding syndrome.

The effect of a therapeutically administered high calorie diet in a severely malnourished patient is discussed in this case report. In patients with advanced head and neck cancer prolonged periods of malnutrition prior to admission are frequently encountered. This case report highlights the need to constantly monitor the electrolyte and vitamin levels during the early stages of instituting enteral or parenteral nutrition. By vigilant monitoring and a high index of suspicion re-feeding syndrome or severe hypophosphataemia and its associated complications can be avoided.

Evidence for an independent radiation of endosymbiotic litostome ciliates within Australian marsupial herbivores.

The recent discovery of isotrichid-like ciliates occurring as endosymbionts in macropodid marsupials posed interesting questions in regard to both their phyletic origin (all previous records confined to eutherian mammals) and their morphological evolution (Australian forms possibly representing missing links between previously described genera). The SSU rRNA gene was sequenced for three species (Dasytricha dehorityi, D. dogieli, and Bitricha tasmaniensis) and aligned against representatives of all major ciliate classes. The Australian species did not group with the other isotrichid species but instead formed an independent radiation. Discrepancies between recent global phylogenies of the phylum Ciliophora were examined by manipulation of the aligned sequence data set. Sources of conflict between these studies did not stem from differences in outgroup choice or phylogenetic reconstruction methods. Differences in the application of confidence limits and primary sequence alignment have probably resulted in the reporting of spurious associations which are not supported by more conservative confidence or alignment methodology. At present, the ciliate subphylum Intramacronucleata is an unresolved polytomy which may be due to deficiencies in the SSU rRNA gene sequence dataset or indicate that the ciliates radiated into their extant classes by rapid burst-like evolution.

The Calicotyle conundrum: do molecules reveal more than morphology?

Partial large subunit 28S rDNA sequences were obtained for specimens of Calicotyle (Monogenea: Monocotylidae) from eight different host species distributed worldwide to test the validity of some species and to address the question of host-specificity in others. Sequences obtained for Calicotyle specimens identified as C. kroyeri based on morphological methods from the type-host Raja radiata (Rajidae) and an additional host R. clavata, both from the North Sea, were identical. However, 'C. kroyeri' from the cloaca of R. naevus from Tunisia, Raja sp. A from Tasmania and R. radula from Tunisia differed from C. kroyeri from R. radiata by five (0.51%), 21 (2.13%) and 39 (3.96%) base pairs, respectively, over 984 sites. Therefore, it is likely that the specimens from Raja sp. A, R. radula and perhaps even from R. naevus are not C. kroyeri. Molecular results determined that the calicotylines from the cloaca of Urolophus cruciatus and U. paucimaculatus (Urolophidae) from southern Tasmania identified previously as C. urolophi are indeed identical. Large subunit 28S rDNA sequences of C. palombi and C. stossichi collected from the cloaca and rectal gland, respectively of Mustelus mustelus (Triakidae) from the coast of Tunisia differ sufficiently for these calicotylines to be considered separate and valid species. Our results indicate that some species of Calicotyle are not strictly host-specific, but that C. kroyeri may not be as widely distributed in rajids as was believed previously. Calicotyle specimens from rajids must be re-examined critically to determine whether there are morphological differences indicative of specific differences that may have been overlooked previously.