Use of immobilisation bra for daily setup of patients with pendulous breasts undergoing radiotherapy.

PURPOSE: A feasibility study to evaluate the Chabner XRT® Radiation Bra (CIVCO Radiotherapy & Qfix, Coralville, IA, USA) as a customised immobilisation device for patients with pendulous breasts undergoing radiotherapy was conducted. METHODS: A total of 34 patients with large pendulous breasts were fitted with the Chabner XRT® Radiation Bra during RT. A mixed-method questionnaire was administered to both radiation therapists (RTTs) and patients. RTTs evaluated the effectiveness of the bra in setup. Patients appraised its comfort level and ease of wearing. Setup reproducibility was evaluated based on a departmental imaging protocol. Acute skin side effects were documented with photos and assessed using the Radiation Therapy Oncology Group (RTOG) classification. RESULTS: Of the patients, 27 (79.4%) completed the questionnaire. 23 patients felt comfortable wearing the bra while 20 felt less exposed during treatment. Reproducibility was acceptable, with a median (range) setup error (isocentre) of 0.0 cm (-0.6 to 0.7 cm; left/right), -0.1 cm (-0.5 to 1.2 cm; posterior) and 0.2 cm (-0.5 to 0.9 cm; inferior) achieved based on matched field borders on skin. However, repeated setups and imaging were required for 3 patients due to large breast size (cups D-G; size 4-5). Minimal skin toxicity (grade 0-1) was observed. No grade ≥ 2 was reported. 10 RTTs completed the survey. Male RTTs (n = 4) were not confident in assisting patients with bra fitting. 8 RTTs agreed that although it was difficult to reproduce the breast tissue for treatment, it helped patients to maintain the treatment position. CONCLUSION: Our study demonstrated the feasibility of using a customised bra which provided optimal setup reproducibility while maintaining minimal skin toxicity and patient comfort, especially the value-added modesty felt among Asian women during their breast cancer radiotherapy.

The implementation of an advanced practice radiation therapy (APRT) program in Singapore.

BACKGROUND: The exploration of Advanced Practiced Radiation Therapists (APRTs) development in Singapore started in 2011. This study aims to provide an overview of the development of the APRT roles, and to discuss the approaches used to develop and implement these roles in Singapore. MATERIALS AND METHODS: A mixed methods approach was used in the development of the APRT program. A literature review was carried out to define the APRT scope of practice and core responsibilities. A competency and assessment framework were setup to assess the core competency areas. With this framework, a structured 1-year residency training program was developed. RESULTS: The scope of practice and core responsibilities of APRTs were defined with five proposed advanced practice profiles being successfully validated. A competency framework was set up to assess the core competency domains: clinical, technical and professional competencies, research, education and leadership. A 4-point scoring system was developed for the competency assessment based on two criteria; the frequency with which RTTs would demonstrate competency, and the ability of performing the task competently. A 1-year structured APRT residency program was developed and implemented. The programme consisted of structured lectures, and clinical practice-based modules where APRT residents receive structured mentoring under a mentorship program. CONCLUSION: The APRT program in Singapore employed an evidence-based implementation process that tested the feasibility of a new practice model. Multidisciplinary involvements, mentorship and clinical training were important factors for the success of the APRT program.

The role of breath hold intensity modulated proton therapy for a case of left-sided breast cancer with IMN involvement. How protons compare with other conformal techniques?

PURPOSE: To evaluate the dosimetric impact of four different radiotherapy techniques for a case of left-sided breast cancer with Internal Mammary lymph Nodes (IMN) involvement. MATERIALS AND METHODS: To identify the best radiotherapy technique for this patient, four methods were compared: 3D Conformal Radiotherapy (3D-CRT), Volumetric Modulated Arc Therapy (VMAT), Tomotherapy (TOMO) and Intensity Modulated Proton Therapy (IMPT). Patient was treated using deep inspiration breath-hold (DIBH) technique. Prescribed dose was 40.05y in 15 fractions. Plan evaluation was performed on target coverage and dose to the organs-at-risk (OARs) using 3D-CRT as a baseline. RESULTS: TOMO has the most ideal Conformity Index (CI) at 1.139, followed by IMPT at 1.158, VMAT at 0.765, and 3D-CRT at 0.685. Using 3D-CRT as a baseline, VMAT, TOMO and IMPT all showed improved dose coverage. IMPT has the best dose coverage. TOMO has the most ideal homogeneity index (HI) and Conformity Number (CN). Mean heart dose (MHD) is lowest for IMPT at 0.55 Gy and highest for VMAT at 4.79 Gy. V20Gy of left lung is the lowest for IMPT at 11.11%, compared to 17.53% for TOMO, 18.19% for VMAT and 33.33% for 3D-CRT. V5Gy for the contralateral breast ranges from 0.01% in IMPT to 72.32% in TOMO. CONCLUSION: 3D-CRT compromising target coverage but achieving good OAR sparing for the contralateral right breast, left lung and right lung. Overall, IMPT performed best in terms of target coverage and OAR-sparing. Protons delivered superior target dose coverage and sparing of normal structures for this patient. As dose value parameters are expected to correlate with acute and chronic toxicities, proton therapy should be given due consideration as the preferred technique for the treatment of left-sided breast cancers with IMN involvement. Further studies with more patients can be done to evaluate the effectiveness of proton therapy on acute and chronic toxicities.

Influenza A virus enhances its propagation through the modulation of Annexin-A1 dependent endosomal trafficking and apoptosis.

The influenza virus infects millions of people each year and can result in severe complications. Understanding virus recognition and host responses to influenza infection will enable future development of more effective anti-viral therapies. Previous research has revealed diverse yet important roles for the annexin family of proteins in modulating the course of influenza A virus (IAV) infection. However, the role of Annexin-A1 (ANXA1) in IAV infection has not been addressed. Here, we show that ANXA1 deficient mice exhibit a survival advantage, and lower viral titers after infection. This was accompanied with enhanced inflammatory cell infiltration during IAV infection. ANXA1 expression is increased during influenza infection clinically, in vivo and in vitro. The presence of ANXA1 enhances viral replication, influences virus binding, and enhances endosomal trafficking of the virus to the nucleus. ANXA1 colocalizes with early and late endosomes near the nucleus, and enhances nuclear accumulation of viral nucleoprotein. In addition, ANXA1 enhances IAV-mediated apoptosis. Overall, our study demonstrates that ANXA1 plays an important role in influenza virus replication and propagation through various mechanisms and that we predict that the regulation of ANXA1 expression during IAV infection may be a viral strategy to enhance its infectivity.

Gene Microarray Analyses of Daboia russelli russelli Daboiatoxin Treatment of THP-1 Human Macrophages Infected with Burkholderia pseudomallei.

Burkholderia pseudomallei is the causative agent of melioidosis and represents a potential bioterrorism threat. In this study, the transcriptomic responses of B. pseudomallei infection of a human macrophage cell model were investigated using whole-genome microarrays. Gene expression profiles were compared between infected THP-1 human monocytic leukemia cells with or without treatment with Daboia russelli russelli daboiatoxin (DRRDbTx) or ceftazidime (antibiotic control). Microarray analyses of infected and treated cells revealed differential upregulation of various inflammatory genes such as interleukin-1 (IL-1), IL-6, tumor necrosis factor-alpha (TNF-α), cyclooxygenase (COX-2), vascular endothelial growth factor (VEGF), chemokine C-X-C motif ligand 4 (CXCL4), transcription factor p65 (NF-kB); and several genes involved in immune and stress responses, cell cycle, and lipid metabolism. Moreover, following DRR-DbTx treatment of infected cells, there was enhanced expression of the tolllike receptor 2 (TLR-2) mediated signaling pathway involved in recognition and initiation of acute inflammatory responses. Importantly, we observed that highly inflammatory cytokine gene responses were similar in infected cells exposed to DRR-DbTx or ceftazidime after 24 h. Additionally, there were increased transcripts associated with cell death by caspase activation that can promote host tissue injury. In summary, the transcriptional responses during B. pseudomallei infection of macrophages highlight a broad range of innate immune mechanisms that are activated within 24 h post-infection. These data provide insights into the transcriptomic kinetics following DRR-DbTx treatment of human macrophages infected with B. pseudomallei.

Larval development of the pedunculate barnacles Octolasmis angulata Aurivillius 1894 and Octolasmis cor Aurivillius 1892 (Cirripedia: Thoracica: Poecilasmatidae) from the gills of the mud crab, Scylla tranquebarica Fabricius, 1798.

Detailed studies of larval development of Octolasmis angulata and Octolasmis cor are pivotal in understanding the larval morphological evolution as well as enhancing the functional ecology. Six planktotrophic naupliar stages and one non-feeding cyprid stage are documented in details for the first time for the two species of Octolasmis. Morphologically, the larvae of O. angulata and O. cor are similar in body size, setation patterns on the naupliar appendages, labrum, dorsal setae-pores, frontal horns, cyprid carapace, fronto-lateral gland pores, and lattice organs. Numbers of peculiarities were observed on the gnathobases of the antennae and mandible throughout the naupliar life-cycle. The setation pattern on the naupliar appendages are classified based on the segmentation on the naupliar appendages. The nauplius VI of both species undergoes a conspicuous change before metamorphosis into cyprid stage. The cyprid structures begin to form and modify beneath the naupliar body towards the end of stage VI. This study emphasises the importance of the pedunculate barnacle larval developmental studies not only to comprehend the larval morphological evolution but also to fill in the gaps in understanding the modification of the naupliar structures to adapt into the cyprid life-style.

Teraplectanum n. g. (Monogenea: Diplectanidae) from the banded grunter fish, Terapon theraps Cuvier (Perciformes: Terapontidae), off Peninsular Malaysia.

A new genus of the Monogenea, Teraplectanum n. g., is proposed for two new species of diplectanids found on the gills of Terapon theraps Cuvier collected off Carey Island, Peninsular Malaysia. The genus is based on a unique arrangement of the male reproductive system. In the new species spermatozoa stored in the seminal vesicle and secretions stored in the prostatic reservoir are transferred into, and mixed to form semen within, a special sclerotized auxiliary piece (SAP), and not within the copulatory tube as occurs in the majority of monogeneans. Teraplectanum species also possess a unique sclerotized vaginal loop through which the vaginal tube passes en route from the vaginal pore to the seminal receptacle. The two new species are Teraplectanum crassitubus n. sp. (type species) and T. angustitubus n. sp. They differ from each other mainly in the morphology of their copulatory tube: in T. crassitubus, the proximal region of this tube is thicker compared to the slender proximal region in T. angustitubus, although in both cases the tube tapers and twists distally. Of the known diplectanid species, only Diplectanum undulicirrosum Zhang et al., 2000 (currently considered incertae sedis) possesses such sclerotized hard parts, which suggests the same type of arrangement of the male reproductive system. Consequently, D. undulicirrosum is re-assigned to this new genus as Teraplectanum undulicirrosum (Zhang et al., 2000) n. comb. The copulatory tube of T. undulicirrosum is similar to the slender, undulating copulatory tube of T. angustitubus but does not taper distally as in the latter species.

A description of two new species of Ligophorus Euzet & Suriano, (Monogenea: Ancyrocephalidae) from Malaysian mugilid fish using principal component analysis and numerical taxonomy.

Ligophorus belanaki n. sp. and Ligophorus kederai n. sp. are described from Liza subviridis Valenciennes, 1836 and Valamugil buchanani Bleeker, 1854, respectively. Ligophorus kederai n. sp. has fenestrated ventral anchors, while in L. belanaki n. sp. the ventral anchor is not fenestrated. Ligophorus belanaki n. sp. is similar to L. careyensis, one of its coexisting congeners, in the overall shape and size of hard parts, but differs in having a flat median piece in the structure of the AMP (antero-median protuberance of the ventral bar), copulatory organ with non-ornamented initial part and longer vaginal tube, compared to raised median piece in the AMP, ornamented initial part and comparatively shorter vaginal tube in L. careyensis. Ligophorus kederai n. sp. is similar to L. fenestrum, a coexisting congener, in having fenestrated ventral anchors, but differs in having longer points and narrower base. Ligophorus fenestrum, unlike L. kederai n. sp., also possesses fenestrated dorsal anchors. The principal component analysis (PCA) scatterplots indicate that the two new and eight known Ligophorus species from Malaysian mugilids can be differentiated based on the morphometries of their anchors, ventral bars and copulatory organ separately and when combined together. Numerical taxonomy (NT) analyses based on Jaccard's Index of Similarity and neighbour-joining clustering, is used to facilitate comparison of these two new species with the 50 known Ligophorus based on morphological and metric characters. The two new species are different from each other and the other 50 species in the overall shapes and sizes of hard parts, as indicated by the NT analyses.

The life-cycle of Spirometra species from Peninsular Malaysia.

The life-cycle of Malaysian Spirometra spp. was studied under experimental conditions in the laboratory. The Cyclops were reared as the first intermediate host, the hamster as the experimental second intermediate host and cat as the definitive host. Maturation and hatching of eggs took 6 to 12 days by incubation at temperature 30 ºC. The hatched coracidium measured 46 x 34 µm. The Cyclops used were susceptible to the coracidial infection. The procercoid older than 5 days in the Cyclop body cavity had minute spines at the anterior end, calcium corpuscles in the body parenchyma and the cercomer at the posterior end. Procercoids 10 to 14 days old were infective to hamster. The plerocercoids from the hamster after 30 days were long and slender and were infective to cats. The plerocercoids experimentally inoculated to cats developed to adult worms and began to produce eggs between 10 to 60 days. Based on the results that have been obtained, a complete life-cycle was successfully elucidated in the laboratory and hamster was identified to be a good laboratory model for a second intermediate host of Spirometra sp.

Spontaneous superior ophthalmic vein thrombosis: a rare entity with potentially devastating consequences.

PURPOSE: Spontaneous superior ophthalmic vein thrombosis (SOVT) is a rare entity. We describe three patients with spontaneous ophthalmic vein thrombosis, each with various risk factors. PATIENTS AND METHODS: A retrospective review of three patients with a diagnosis of superior ophthalmic vein thrombosis. Clinical characteristics, radiographic features, management techniques and outcomes are described. RESULTS: All patients presented with unilateral painful proptosis. Two patients had intact light perception, whereas one patient presented with absent light perception. All patients had identifiable risk factors for thrombosis, which included sickle cell trait, hereditary hemorrhagic telangectasia and colon cancer with recurrent deep vein thrombosis. Anticoagulation was initiated in two patients. Resolution of proptosis was seen in all patients, with no recovery of vision in one patient. CONCLUSIONS: Risk factors for spontaneous superior ophthalmic vein thrombosis are multifactorial. MRI and MRV confirm the diagnosis of SOVT. Despite urgent intervention devastating visual loss may occur.

Retrospective review of grommet insertions for otitis media with effusion in children in Singapore.

Otitis media with effusion is one of the most common childhood infections, and grommet insertions are done for chronic otitis media which have failed medical therapy. The aims of this study were 1) to determine the patient profile of children needing grommet insertion and 2) to determine if grommet insertion is safe and effective. A retrospective review of 105 children with myringotomy and grommet insertions for chronic otitis media with effusion between 2006 and 2008 was performed. Seventy two percent of patients were younger than 6 years old. Male to female ratio was 4:3. Twelve percent of patients were syndromic. In children with otitis media with effusion, hearing and academic performance improved after grommet insertion. Allergic rhinitis and cleft palate are risk factors for chronic middle ear effusion.

Annexin-1-deficient mice exhibit spontaneous airway hyperresponsiveness and exacerbated allergen-specific antibody responses in a mouse model of asthma.

BACKGROUND: Glucocorticoids are the mainstream drugs used in the treatment and control of inflammatory diseases such as asthma. Annexin-1 (ANXA1) is an anti-inflammatory protein which has been described as an endogenous protein responsible for some anti-inflammatory glucocorticoid effects. Previous studies have identified its importance in other immune diseases such as rheumatoid arthritis and cystic fibrosis. ANXA1-deficient ((-/-)) mice are Th2 biased, and ANXA1 N-terminus peptide exhibits anti-inflammatory activity in a rat model of pulmonary inflammation. OBJECTIVE: ANXA1 protein is found in bronchoalveolar lavage fluid from asthmatics. However, the function of ANXA1 in the pathological development of allergy or asthma is unclear. Thus, in this study we intended to examine the effect of ANXA1 deficiency on allergen-specific antibody responses and airway responses to methacholine (Mch). METHODS: ANXA1(-/-) mice were sensitized with ovalbumin (OVA) and challenged with aerosolized OVA. Airway resistance, lung compliance and enhanced pause (PenH) were measured in naïve, sensitized and saline or allergen-challenged wild-type (WT) and ANXA1(-/-) mice. Total and allergen-specific antibodies were measured in the serum. RESULTS: We show that allergen-specific and total IgE, IgG2a and IgG2b levels were significantly higher in ANXA1(-/-) mice. Furthermore, naïve ANXA1(-/-) mice displayed higher airway hypersensitivity to inhaled Mch, and significant differences were also observed in allergen-sensitized and allergen-challenged ANXA1(-/-) mice compared with WT mice. CONCLUSIONS: In conclusion, ANXA1(-/-) mice possess multiple features characteristic to allergic asthma, such as airway hyperresponsiveness and enhanced antibody responses, suggesting that ANXA1 plays a critical regulatory role in the development of asthma. CLINICAL RELEVANCE: We postulate that ANXA1 is an important regulatory factor in the development of allergic disease and dysregulation of its expression can lead to pathological changes which may affect disease progression.

Annexin-1 interacts with NEMO and RIP1 to constitutively activate IKK complex and NF-κB: implication in breast cancer metastasis.

The molecular mechanisms underlying constitutive nuclear factor-κB (NF-κB) activation in solid tumors has not been elucidated. We show that Annexin-1 (ANXA1) is involved in this process, and suppression of ANXA1 in highly metastatic breast cancer cells impedes migration and metastasis capabilities in vitro and in vivo. ANXA1 expression correlates with NF-κB activity, suggesting that ANXA1 may be required for the constitutive activity of IκB kinase (IKK) and NF-κB in highly metatstatic breast cancer. Gel-filtration analysis demonstrated that ANXA1 co-elutes with the members of the IKK complex and NF-κB signaling pathway, and immunoprecipitation confirmed that ANXA1 can bind to and interact with IKKγ or NEMO, but not IKKα or IKKß. Importantly, silencing of ANXA1 prevents the interaction of NEMO and RIP1, which indicates that ANXA1 is required for the recruitment of RIP1 to the IKK complex, which may be important for the activation of NF-κB. Downstream targets of NF-κB include uPA and CXCR4, which can be modulated by ANXA1 silencing. CXCR4-mediated migration of breast cancer cell lines in response to CXCL12 was significantly modulated by ANXA1, indicating its importance in the tissue-specific migration of breast cancer cells. Chromatin immunoprecipitation experiments confirmed that in ANXA1 overexpressed cells, NF-κB was recruited to CXCR4 promoter without external stimulation, indicating that ANXA1 is critical for the constitutive activation of NF-κB in breast cancer to promote metastasis. Finally, we show that ANXA1 overexpression enhances metastasis and reduces survival in an intracardiac metastasis model, while ANXA1-deficient mice crossed with MMTV-PyMT mice display significantly less metastasis than their heterozygous littermates, indicating that ANXA1 is an important gene in breast cancer metastasis. Our data reveal that ANXA1 can constitutively activate NF-κB in breast cancer cells through the interaction with the IKK complex, and suggests that modulating ANXA1 levels has therapeutic potential to suppress breast cancer metastasis.

Two new species of ancyrocephalid monogeneans from Lethrinus rubrioperculatus Sato (Perciformes: Lethrinidae) off New Caledonia, with the proposal of Lethrinitrema n. g.

Lethrinitrema gibbus n. g., n. sp. and L. dossenus n. sp. are described from the fish Lethrinus rubrioperculatus Sato collected off New Caledonia, South Pacific. Members of Lethrinitrema n. g. (Ancyrocephalidae) are characterised by having two pyriform haptoral reservoirs and ventral anchors with lateral grooves. The elongate tubular distal end of each reservoir bifurcates, draining into a superficial lateral groove on each side of the ventral anchors. The haptoral reservoirs are postulated to store secretory products which assist in attachment to the host. Lethrinitrema spp. also possess tandem gonads, a male copulatory organ without an accessory piece or with thinly sclerotised accessory piece, and a dextrolateral, non-sclerotised vaginal bulb. The two new species have small, poorly demarcated haptors with small haptoral armament and a crown-like piece on the tip of the inner root of the ventral anchors. They differ from each other in the shape and size of the ventral bar and male copulatory organ (40-45 µm in length in L. gibbus vs 24-30 µm in L. dossenus). Three other species, previously included in Haliotrema Johnston & Tiegs, 1922, are transferred to Lethrinitrema, i.e. L. chrysostomi (Young, 1968) n. comb., L. fleti (Young, 1968) n. comb. (both briefly redescribed from paratypes) and L. lethrini (Yamaguti, 1937) n. comb. All species of Lethrinitrema parasitise Lethrinus spp. (Lethrinidae), and there is evidence for the existence of further Lethrinitrema spp. on Lethrinus spp. in the Indo-Pacific region.

A novel alternative method for 3D visualisation in Parasitology: the construction of a 3D model of a parasite from 2D illustrations.

Three-dimensional (3D) models of the marginal hooks, dorsal and ventral anchors, bars and haptoral reservoirs of a parasite, Sundatrema langkawiense Lim & Gibson, 2009 (Monogenea) were developed using the polygonal modelling method in Autodesk 3ds Max (Version 9) based on two-dimensional (2D) illustrations. Maxscripts were written to rotate the modelled 3D structures. Appropriately orientated 3D haptoral hard-parts were then selected and positioned within the transparent 3D outline of the haptor and grouped together to form a complete 3D haptoral entity. This technique is an inexpensive tool for constructing 3D models from 2D illustrations for 3D visualisation of the spatial relationships between the different structural parts within organisms.

Influenza and seasonal influenza vaccination among diabetics in Singapore: knowledge, attitudes and practices.

INTRODUCTION: Seasonal influenza vaccination is recommended for diabetics; however, the vaccination uptake rate among diabetics remains low. This study explored the knowledge, attitudes and practices among diabetics in Singapore with regard to influenza and influenza vaccination. METHODS: A survey was conducted among type 1 and 2 diabetes mellitus patients who attended three management centres of the Diabetic Society of Singapore in January 2007. The pilot-tested questionnaire covered influenza and influenza vaccination in terms of the patient demographics, medical history and knowledge, attitudes and practices. RESULTS: A total of 307 diabetics participated in the study. Of these, 139 (45.3 percent) claimed to know the difference between influenza and the common cold, while 98 (31.9 percent) and 18 (5.9 percent) participants thought that influenza vaccines protected against all influenza strains and provided lifelong immunity, respectively. 247 (80.4 percent) participants were aware that they were at a moderate or higher risk for influenza-related complications, while 181 (58.9 percent) considered vaccination to be effective in preventing influenza and its complications. Only 94 (30.6 percent) participants were previously vaccinated. Among those unvaccinated, 117 (54.9 percent) did not think vaccination was necessary, while 104 (48.8 percent) had never considered it. As observed from the multivariate analysis, income was a key predictor of influenza vaccination. While 241 (78.5 percent) participants cited healthcare professional advice as the main guiding factor for getting vaccinated, 199 (64.8 percent) had never been advised on influenza vaccination. Of the 108 (35.1 percent) participants who had received previous advice on influenza vaccination, the majority had received it from their healthcare professionals. CONCLUSION: Uptake of influenza vaccination among diabetics in Singapore is low, and the key predictor is income. Perception and knowledge are the main barriers, and hence, healthcare professionals should educate and encourage vaccination among diabetics.

Species of Neohaliotrema Yamaguti, 1965 (Monogenea: Ancyrocephalidae) from the pomacentrid Abudefduf vaigensis (Quoy & Gaimard) off Pulau Langkawi, Malaysia, with a revised diagnosis of the genus and a key to its species.

Four new and one unidentified species of Neohaliotrema Yamaguti, 1965 were obtained from the gills of the Indo-Pacific sergeant Abudefduf vaigensis (Quoy & Gaimard) off Pulau Langkawi, Malaysia. The five species, N. malayense n. sp., N. bombini n. sp., N. andamanense n. sp., N. parvum n. sp. and an unidentified Neohaliotrema sp. (similar to N. macracanthum Zhukov, 1976), are described and distinguished based mainly on features of the haptor. Species of this genus are divisible into two groups, the 'maomao group', with two pairs of morphometrically modified 'marginal' hooks and a fenestrated haptor, and the 'gracile group', with morphologically similar marginal hooks and an entire haptor. With the exception of N. bombini n. sp., the species described fit within the 'maomao group'. It is suggested that the more complex Neohaliotrema species of the 'maomao group' have modified hooks 1 and 2 on a haptoral 'isthmus' between two large apertures, i.e. 'windows', whereas the less complex species lacking these features are those of the 'gracile group'. Neohaliotrema spp. have only a single pair of pigmented eye-spots. A fenestrated haptor is unique to the Neohaliotrema spp. of the 'maomao group'. The generic diagnosis of Neohaliotrema is amended to include new data and a key to its known species is presented.

Description of Sinodiplectanotrema malayanum n. sp. (Monogenea: Diplectanidae), with comments on the taxonomic position of the genus.

Monogeneans identified as Sinodiplectanotrema malayanum n. sp. were collected from the fish Pennahia anea (Sciaenidae) off the west coast of Peninsular Malaysia. The new species is recognised on the basis of morphometrical differences in the anchors, marginal hooks and eggs and apparent differences in the 28S rDNA sequence data. The new species possesses features (ovary looping the intestinal caecum, body spines, a vagina and haptoral reservoirs) not noted in the original description of the type and only other species of the genus, S. argyrosomus Zhang, 2001, necessitating the re-assignment of the genus to the Diplectanidae Monticelli, 1903, a move which is supported by 28S rDNA evidence. Sinodiplectanotrema is redefined on the basis of the observation of several features not included in the original diagnosis.

Trianchoratus longianchoratus sp. n. (Monogenea: Ancyrocephalidae: Heteronchocleidinae) from Channa lucius (Osteichthyes: Channidae) in Peninsular Malaysia.

One new and three previously described species of Trianchoratus Price et Berry, 1966 were collected from the gills of Channa lucius (Cuvier) and Channa striata (Bloch) from the Bukit Merah Reservoir, Perak and Endau-Rompin, Pahang, Peninsular Malaysia. They are Trianchoratus longianchoratus sp.n., T. malayensis Lim, 1986 and T. pahangensis Lim, 1986 from C. lucius, and T. ophicephali Lim, 1986 from C. striata. The new species differs from the Trianchoratus species hitherto described from channids and anabantoids in having two ventral anchors with a long curved inner root and one dorsal anchor with a curved inner root and lacking an outer root. A table summarizing the known species of heteronchocleidins (Trianchoratus, Eutrianchoratus and Heteronchocleidus) and Sundanonchus reported from fish hosts of different families (Channidae, Helostomatidae, Anabantidae and Osphronemidae) is provided.

A new monogenean genus from an ephippid fish off Peninsular Malaysia.

Sundatrema langkawiense n. g., n. sp. (Monogenea: Ancyrocephalidae) is described from the gills of the orbfish Ephippus orbis (Bloch) (Ephippidae) off the Island of Langkawi, Malaysia, in the Andaman Sea. This new genus has the ancyrocephalid characteristics of four anchors, 14 marginal hooks and two bars, but differs from other four-anchored monogenean genera, and notably from Parancylodiscoides Caballero & Bravo Hollis, 1961 (found on the ephippids Chaetodipterus spp. off Central and South America), by having a unique combination of features. These include a muscular genital sucker and a vas deferens and vagina on the same (sinistral) side of the body. It is similar to Parancylodiscoides in having four haptoral reservoirs opening at the anchoral apertures, four anchors, similar connecting bars and small marginal hooks. The new species is characterised by the above generic features and by possessing a small, short copulatory organ lacking an accessory piece. Diplectanum longiphallus MacCallum, 1915 (previously attributed to Ancyrocephalus Creplin, 1839, Tetrancistrum Goto & Kikuchi, 1917 and Pseudohaliotrema Yamaguti, 1953) is transferred to Parancylodiscoides as P. longiphallus (MacCallum, 1915) n. comb.