The karyotypes of most species of crocodilians were studied using conventional and molecular cytogenetics. These provided an important contribution of chromosomal rearrangements for the evolutionary processes of Crocodylia and Sauropsida (birds and reptiles). The karyotypic features of crocodilians contain small diploid chromosome numbers (30~42), with little interspecific variation of the chromosome arm number (fundamental number) among crocodiles (56~60). This suggested that centric fusion and/or fission events occurred in the lineage, leading to crocodilian evolution and diversity. The chromosome numbers of Alligator, Caiman, Melanosuchus, Paleosuchus, Gavialis, Tomistoma, Mecistops, and Osteolaemus were stable within each genus, whereas those of Crocodylus (crocodylians) varied within the taxa. This agreed with molecular phylogeny that suggested a highly recent radiation of Crocodylus species. Karyotype analysis also suggests the direction of molecular phylogenetic placement among Crocodylus species and their migration from the Indo-Pacific to Africa and The New World. Crocodylus species originated from an ancestor in the Indo-Pacific around 9~16 million years ago (MYA) in the mid-Miocene, with a rapid radiation and dispersion into Africa 8~12 MYA. This was followed by a trans-Atlantic dispersion to the New World between 4~8 MYA in the Pliocene. The chromosomes provided a better understanding of crocodilian evolution and diversity, which will be useful for further study of the genome evolution in Crocodylia.
Africa ; Alligators and Crocodiles ; Arm ; Cytogenetics ; Diploidy ; Genome ; Karyotype ; Mya ; Phylogeny

The symptom of crocodile tears refers to an abnormal gusto-lacrimal reflex whereby any stimulus causing parotid secretion also induces lacrimation. It is a sequelae lesion of facial nerve, usually after the facial paralysis. The authors found the symptom of crocodile tears in one case after facial paralysis due to herpes zoster oticus and two cases after Bell's palsy.
Alligators and Crocodiles* ; Bell Palsy ; Facial Nerve ; Facial Paralysis* ; Herpes Zoster Oticus ; Reflex ; Tears*

Coil herniation, premature deployment, and fracture are procedure associated complications of endovascular aneurysm embolization that optimally necessitate coil retrieval when feasible. Several published techniques describe different strategies for managing coil complications including various snare retrieval devices, alligator retrieval devices, stent fixation, and open surgical resection of coils when distal blood flow is compromised. We report a novel technique employed to retrieve a prematurely detached coil during an aneurysm embolization using a syringe fixed to the microcatheter to carefully aspirate a loose coil with direct fluoroscopic visualization. This technique can only be utilized in the circumstance where the proximal end of the coil remains in the microcatheter. Conventional techniques of coil retrieval and stenting are discussed and compared to the rational for using the manual aspiration technique.
Alligators and Crocodiles ; Aneurysm ; Embolization, Therapeutic ; Intracranial Aneurysm* ; SNARE Proteins ; Stents ; Syringes

Perforation after foreign body ingestion is rare. We report a 25-month-old girl who was diagnosed with a stomach perforation with secondary localized peritonitis caused by long, sharp bamboo. On admission, she had abdominal pain and fever. Simple abdominal erect & supine X-ray, abdominal ultrasonogram and computed tomography scan were normal. On the 6 th hospital day, gastrofiberoscopy was performed because a sharp mass was palpated by doctor on abdominal examination. Endoscopic findings revealed a 8 cm-long sharp bamboo tip was pierced to the posterior wall of antrum. This foreign body was removed with Olympus FG-8L alligator forcep. She was managed with NPO and prompt intravenous antibiotics and discharged with clinical improvement.
Abdominal Pain ; Alligators and Crocodiles ; Anti-Bacterial Agents ; Child, Preschool ; Eating ; Female ; Fever ; Foreign Bodies ; Humans ; Peritonitis* ; Stomach* ; Surgical Instruments ; Ultrasonography

Toothpicks are not uncommonly swallowed, and subsequently, may be impacted into gastrointestinal wall and cause morbidities, and even mortality. Therefore, the early diagnosis and immediate retrieval of an ingested toothpick is important. In many cases, endoscopic removal is attempted initially, but if this fails or a complication is encountered, surgery should be considered. The authors experienced a case of ingested toothpick penetrating the gastric wall. A 51-year-old woman visited our hospital with epigastric pain of one-week duration. Upper endoscopy revealed that the sharp end of a toothpick had been impacted into the distal antrum. Endoscopic removal using an alligator jaw forceps failed because the toothpick broke during removal and our continued attempts to extract the remnant resulted in it becoming more embedded in the stomach wall. In such circumstances, surgical treatment should be considered. However, we incised the mucosa to expose the remnant toothpick, and fortunately, we were then able to grasp and remove the toothpick using an alligator jaw forceps. We report this unusual case of a toothpick impacted in the gastric wall that was resolved endoscopically by mucosal incision.
Alligators and Crocodiles ; Early Diagnosis ; Endoscopy ; Female ; Foreign Bodies ; Hand Strength ; Humans ; Jaw ; Middle Aged ; Mucous Membrane ; Stomach ; Surgical Instruments

Toothpicks are not uncommonly swallowed, and subsequently, may be impacted into gastrointestinal wall and cause morbidities, and even mortality. Therefore, the early diagnosis and immediate retrieval of an ingested toothpick is important. In many cases, endoscopic removal is attempted initially, but if this fails or a complication is encountered, surgery should be considered. The authors experienced a case of ingested toothpick penetrating the gastric wall. A 51-year-old woman visited our hospital with epigastric pain of one-week duration. Upper endoscopy revealed that the sharp end of a toothpick had been impacted into the distal antrum. Endoscopic removal using an alligator jaw forceps failed because the toothpick broke during removal and our continued attempts to extract the remnant resulted in it becoming more embedded in the stomach wall. In such circumstances, surgical treatment should be considered. However, we incised the mucosa to expose the remnant toothpick, and fortunately, we were then able to grasp and remove the toothpick using an alligator jaw forceps. We report this unusual case of a toothpick impacted in the gastric wall that was resolved endoscopically by mucosal incision.
Alligators and Crocodiles ; Early Diagnosis ; Endoscopy ; Female ; Foreign Bodies ; Hand Strength ; Humans ; Jaw ; Middle Aged ; Mucous Membrane ; Stomach ; Surgical Instruments

Foreign body ingestion is common in children. About 80% of ingested foreign bodies spontaneously pass through gastrointestinal tract. The management of an ingested magnet depends on its size, the same as for other foreign bodies. However, it has been reported that magnetic foreign body ingestion can lead to gastrointestinal fistula. We report here on the case of a 13-month-old boy who ingested two magnet bars that attracted to each other, and they were holding the gastric mucosa. A simple abdomen X-ray revealed that the location of two magnet bars was not changed according to the patient's positional change. The magnet bars were removed with an alligator forcep under gastroduodenal endoscopy.
Abdomen ; Alligators and Crocodiles ; Child ; Eating ; Endoscopy ; Fistula ; Foreign Bodies ; Gastric Mucosa* ; Gastrointestinal Tract ; Humans ; Infant ; Male ; Surgical Instruments

The syndrome of crocodile tear refers to an abnormal gusto-lacrimal reflex where any gustatory stimulation produces excessive tearing as well as salivation. It is a relatively rare syndrome that has mainly been observed after a recovery from a peripheral facial nerve palsy, surgery of the acoustic neuroma or in a congenital syndrome. The most commonly accepted mechanism for the pathogenesis of the crocodile tear syndrome is that of aberrant regeneration of nerve fibers or that of transaxonal transmission. Crocodile tear syndrome may be effectively treated by intraglandular injections of botulinum toxin. Authors experienced a case of crocodile tear syndrome that occurred after the removal of acoustic neuroma; it was treated successfully by injection of botulinum toxin into the lacrimal gland. We report this case with the related literatures.
Alligators and Crocodiles* ; Botulinum Toxins ; Facial Nerve ; Lacrimal Apparatus ; Nerve Fibers ; Neuroma, Acoustic ; Paralysis ; Reflex ; Regeneration ; Salivation ; Tears*

Most ingested foreign bodies pass readily throughout intestinal tract if they reach the stomach. In some cases, foreign bodies may be impacted behind a luminal constriction but are rare in colon. Here, we report the case of a 59-year-old man who did laparoscopic anterior resection due to sigmoid colon cancer 2 years ago and ischemic colitis was repeated on the anastomosis site. He initially presented with symptoms of abdominal pain 3 months before and melena 1 day before admission. Abdomen computerized tomography showed a 3.2 cm segment of luminal narrowing of the proximal colon involving upstream foreign material stasis. Sigmoidoscopic approaches revealed near complete obstruction on the anal verge of 20 cm and scope passing failed. Balloon dilatations were done on the obstruction site four times all and a foreign body impacted above the obstruction site was removed by an alligator without any complications. The foreign body removed looks like plastic or a shell, about 20 mm in size.
Abdomen ; Abdominal Pain ; Alligators and Crocodiles ; Colitis, Ischemic ; Colon* ; Constriction ; Constriction, Pathologic* ; Dilatation* ; Foreign Bodies* ; Humans ; Melena ; Middle Aged ; Phenobarbital ; Plastics ; Sigmoid Neoplasms ; Stomach

BACKGROUND: We wanted to examine the clinical characteristics of adult patients with tracheobronchial foreign bodies (FBs) according to the risk of aspiration and the outcomes of intervention with using a fiberoptic bronchoscope. METHODS: From December 1994 through December 2004 at Kyung Hee Medical Center, we retrospectively analyzed the medical records of 29 adult patients with FBs that were identified by using a fiberoptic bronchoscope. RESULTS: 14 patients were not at risk of aspiration, whereas 15 had cerebrovascular diseases and they were at a high risk of aspiration. No history suggestive of FB aspiration was noted in 7 (24.1%) patients. Respiratory symptom(s) were noted in 22 patients, and these symptoms were cough (62.0%), dyspnea (44.8%), fever (20.7%), wheezing (13.8%), chest pain (10.3%) and hemoptysis (0.4%). Only 60% of those patients at a high risk of aspiration had symptom(s) (92.8% of those patients without a risk of aspiration had symptoms, p=0.005). Those patients at risk for aspiration had a longer duration of symptoms (median: 4 days vs. 2 days for those patients not at risk for aspiration, p=0.007) before diagnosis. Acute respiratory symptom(s) within 3 days after aspiration were more frequent in the patients without a risk of aspiration (9 vs. 4, respectively p=0.048). Chest x-ray revealed radiological abnormalities in 23 patients, and these were opacities suspicious of FB (n=11), pneumonia (n=8), air trapping (n=5) and atelectasis (n=3). There were no differences in radiological findings according to the risk of aspiration. FB aspiration developed most commonly during medical procedures (57.1% for the patients at risk) and during eating (35.7% for the patients without risk). The most common FB materials were teeth (n = 11). Alligator jaw biopsy forceps (n = 23) was the most commonly used equipment. All of the FBs were removed without significant complications. CONCLUSION: This study underlines that a tracheobronchial FB in the patients who are at a high risk of aspiration are more likely to overlooked because of the more gradual onset of symptoms and the symptoms develop iatrogenically in many cases.
Adult ; Alligators and Crocodiles ; Biopsy ; Bronchoscopes ; Chest Pain ; Cough ; Dyspnea ; Eating ; Fever ; Foreign Bodies ; Hemoptysis ; Humans ; Jaw ; Medical Records ; Pneumonia ; Pulmonary Atelectasis ; Respiratory Sounds ; Retrospective Studies ; Surgical Instruments ; Thorax ; Tooth