Crohn's disease may affect any segment of the gastrointestinal tract; however, isolated duodenal involvement is rather rare. It still remains a complex clinical entity with a controversial management of the disease. Initially, patients with duodenal Crohn' s disease (DCD) are managed with a combination of antiacid and immunosuppressive therapy. However, medical treatment fails in the majority of DCD patients, and surgical intervention is required in case of complicated disease. Options for surgical management of complicated DCD include bypass, resection, or stricturoplasty procedures. In this paper, we reported a 33-year-old male patient, who was diagnosed with isolated duodenal Crohn’s diseases, and reviewed the surgical options in the literature.

A method of extracting information in estimating heading angle of vision system is presented. Integration of grey-level cooccurrence matrix (GLCM) in an area of interest selection is carried out to choose a suitable region that is feasible for optical flow generation. The selected area is employed for optical flow generation by using Horn-Schunck method. From the generated optical flow, heading angle is estimated and enhanced via moving median filter (MMF). In order to ascertain the effectiveness of GLCM, we compared the result with a different estimation method of optical flow which is generated directly from untouched greyscale images. The performance of GLCM is compared to the true heading, and the error is evaluated through mean absolute deviation (MAE). The result ensured that GLCM can improve the estimation result of the heading angle of vision system significantly.

This paper gives a novel explanation of the integral equation of Abel’s type from the point of view of Mikusinski’s operational calculus. The concept of the inverse of Mikusinski’s operator of fractional order is introduced for constructing a representation of the solution to the integral equation of Abel’s type. The proof of the existence of the inverse of the fractional Mikusinski operator is presented, providing an alternative method of treating the integral equation of Abel’s type.

Pedunculated lipomas arising from the peritoneal wall are a rare finding during abdominal surgery. These benign tumours of mesenchymal origin can arise anywhere in the body and are usually asymptomatic. We present a case of a torted, pedunculated parietal wall lipoma in the right iliac fossa that gave rise to a clinical diagnosis of appendicitis. To our knowledge, such a case has never been reported in the literature previously. We suggest that torsion of a pedunculated parietal lipoma is a rare differential of acute abdominal pain.

We report a dramatic case of a 19-year-old man with crack cocaine overdose with important clinical complications as cardiac arrest due to ventricular fibrillation and epileptics status. During this intoxication, electrocardiographic abnormalities similar to those found in tricyclic antidepressant poisoning were observed, and they were reversed by intravenous sodium bicarbonate infusion.

The performance of pulse-switching vibration control technique is investigated using a new method for switching sequence, in order to enhance the vibration damping. The control law in this method which was developed in the field of piezoelectric damping is based on triggering the inverting switch on each extremum of the produced voltage (or displacement); however, its efficiency in the case of random excitation is arguable because of the local extremum detection process. The new proposed method for switching sequence is only based on the fact that the triggering voltage level was determined using windowed statistical examination of the deflection signal. Results for a cantilever beam excited by different excitation forces, such as stationary and nonstationary random samples, and pulse forces are presented. A significant decrease in vibration energy and also the robustness of this method are demonstrated.

Introduction. In case of thrombopenia and/or thrombopathy, epistaxes are very difficult to manage. Case Series. Two patients, one with a thrombocytopenia, the other with a thrombopathy, were hospitalized because of repeated active epistaxes after failure of packing. Both patients were successfully treated with an application of Surgiflo without side effects and left the hospital without recurrence of epistaxis. Discussion. Being a subject of many studies dealing with epistaxis, Surgiflo is a simple treatment that seems to be very effective and without side effects to treat acute epistaxis in fragile patients with coagulation disorders. Prospective studies of tolerance and efficiency in such situations should be performed.

Occult spinal dysraphism is defined as a group of dystrophic conditions below an intact cover of dermis and epidermis. Ultrasonography using linear transducers is a fast, inexpensive, and effective method that makes it possible to view the content of the vertebral canal and bone structures. Magnetic resonance imaging (MRI) is reserved for elucidating the type of dysraphism and for planning corrective surgery. We present a case of a five-day-old female neonate who presented cutaneous stigmas (in the lumbar region, hands, and feet), in whom ultrasonography demonstrated dysraphism in the lumbar region. MRI confirmed the type of dysraphism and enabled surgical planning.

We present the case of a penile fracture involving the proximal corpus cavernosum, presenting as a hematoma extending into the scrotum. The presentation, diagnosis, and surgical approach, which differ from the more typical penile shaft fracture, are delineated.

Sacral fatigue fractures represent a frequently overlooked cause of low-back and buttock pain in athletes. A high index of clinical suspicion and MRI utilization can provide the accurate diagnosis. A 38-year-old male amateur, midfielder, soccer player presented to our department with aggravating right buttock pain during the previous month, following an increase in training intensity and frequency on an artificial turf field. A point of maximal tenderness was demonstrated over the area of the right sacroiliac joint. No radiographic abnormalities were observed. MRI of the pelvis revealed the presence of a stress fracture in the right sacral ala. The patient underwent conservative treatment and resumed playing soccer 12 weeks later, with no residual or recurrent clinical complaints. Apart from the recent change in training regimen, decreased shock absorption related to the physical properties of old generation artificial turf may have also been involved in this case.

A 59-year-old woman presented at the emergency department with cough and weakness that started a few days before. She had a history of breast cancer treated with mastectomy with negative followup. Physical examination revealed tachycardia and tachypnea, normal blood pressure, lower lobe crackles bilaterally, and jugular venous distention. Laboratory data underlined neutrophilic leukocytosis, mild renal failure, and high procalcitonin. Chest radiography revealed bilateral nodular lesions, presumably secondary. Patient was treated with fluid therapy and broad-spectrum antibiotic therapy because of suspected sepsis. In clinical revaluation patient showed systolic hypotension unresponsive to fluid resuscitation. Because of suspected pulmonary embolism an echocardiography was performed revealing normal dimensions of right ventricle with presence of a hypoechoic mass involving tricuspid annulus and obstructing the opening of anterior tricuspid flap; inferior vena cava appeared dilated and not collapsible. Subsequently, chest ultrasonography was performed, confirming multiple rounded lesions involving the pleura bilaterally, compatible with metastasis, and absence of interstitial syndrome. Finally a computed tomography scan of chest excluded pulmonary embolism and confirmed the presence of the obstructive mass responsible for hemodynamic instability together with pulmonary sepsis.

Objective. To present a case of otic Langerhans' cell histiocytosis in an adult. Also included the diagnosis and management of the condition and a review of the relevant literature. Case Report. We report a case of a 41-year-old man with a history of persistent unilateral ear discharge associated with an aural polyp. Radiological imaging showed bony lesions of the skull and a soft-tissue mass within the middle ear. Histological analysis of the polyp demonstrated Langerhans' cell histiocytosis. His otological symptoms were completely resolved with the systemic therapy. Conclusions. Otic Langerhans' cell histiocytosis can present in adults. Persistent ear symptoms along with evidence of soft-tissue masses within the ear and bony lesions of the skull or elsewhere should prompt the otolaryngologists to include Langerhans' cell histiocytosis in their differential diagnosis. Management should be with systemic therapy rather than local surgical treatment.

Geschwind syndrome has been described in patients with temporal lobe epilepsy and is characterized by sexual behavioural disorders, hyperreligiosity, hypergraphia, and viscosity. Presented here is a case of a 53-year-old man with clinical findings consistent with Geschwind syndrome in the setting of a known diagnosis of schizoaffective disorder, with no identifiable comorbid illness of temporal lobe epilepsy or frontotemporal dementia. Brain MRI showed bilateral temporal lobe atrophy greater than would be expected for age and more prominent on the left side than the right. It is likely that these structural abnormalities may be related to this patient’s clinical presentation of Geschwind syndrome. To our knowledge, this is the first reporting of a case of Geschwind syndrome in the setting of schizoaffective disorder. These symptoms of Geschwind syndrome were present irrespective of mental state status. The report highlights the importance in correct identification of underlying cause and differentiation between Geschwind syndrome and schizoaffective disorder in order to avoid mistreatment and consequent iatrogenic adverse events.

Introduction. Von Hippel-Lindau (VHL) syndrome is a pathological condition that causes various clinical symptoms and is difficult to diagnose. The most common pathological lesions are hemangioblastomas of the central nervous system, retinal angiomas, renal clear cell carcinomas, and pheochromocytomas. Case Report. A 23-year-old female had a syncope episode in 2008. Magnetic resonance imaging (MRI) revealed a right temporal hemangioblastoma, which was treated surgically. Genetic screening identified a VHL gene mutation, and computed tomography (CT) revealed a left adrenal mass. Since it was unclear whether the mass was a pheochromocytoma, or another benign or malignant tumors, laparoscopic adrenalectomy was performed. A month after surgery, the patient complained of general fatigue, poor concentration, loss of appetite, and insomnia. After careful clinical investigation, the patient was referred to a psychiatrist due to suspected depression, which was confirmed. Conclusions. VHL genetic screening should be performed in cases of hemangioblastoma. In VHL syndrome cases, pheochromocytoma cannot always be diagnosed by biochemical catecholamine analyses; therefore, CT or MRI scanning of the abdomen must be performed. Due to the long treatment period, some patients may develop episodes of depression, which can simulate VHL syndrome.

The utilization of whole grains in food formulations is nowadays recommended. Extrusion cooking allows obtaining precooked cereal products and a wide range of ready-to-eat foods. Two rice varieties having different amylose content (Fortuna 16% and Paso 144, 27%) were extruded using a Brabender single screw extruder. Factorial experimental design was used to study the effects of extrusion temperature (160, 175, and 190°C) and grits moisture content (14%, 16.5%, and 19%) on extrudate properties. Specific mechanical energy consumption (SMEC), radial expansion (), specific volume (SV), water absorption (WA), and solubility () were determined on each extrudate sample. In general, Fortuna variety showed higher values of SMEC and (703–409 versus 637–407 J/g; 33.0–21.0 versus 20.1–11.0%, resp.) than those of Paso 144; on the contrary SV (8.64–3.47 versus 8.27–4.53 mL/g) and WA tended to be lower (7.7–5.1 versus 8.4–6.6 mL/g). Both varieties showed similar values of expansion rate (3.60–2.18). Physical characteristics depended on extrusion conditions and rice variety used. The degree of cooking reached by Paso rice samples was lower than that obtained for Fortuna. It is suggested that the presence of germ and bran interfered with the cooking process, decreasing friction level and broadening residence time distribution.

Intestinal obstruction is an uncommon surgical emergency during pregnancy that affects seriously the prognosis of gestation. The underlying cause can be identified in the majority of cases and usually consists of adhesions secondary to previous abdominal or pelvic surgery, followed in order of frequency by intestinal volvuli. In recent years there have been no reports in which the gravid uterus has been the cause of intestinal obstruction. We report the case of a woman in week 33 + 4 of pregnancy who developed extrinsic compression of the colon secondary to uterine rotation and pelvic impaction of the head of the fetus.

Introduction. Malaria had been eliminated in Tunisia since 1979, but there are currently 40 to 50 imported cases annually. Soldiers are no exception as the incidence of imported malaria is increasing in Tunisian military personnel after returning from malaria-endemic area, often in Sub-Saharan Africa. Methods. We retrospectively analyzed the clinical and biological presentations, treatment, and outcomes of 37 Tunisian military personnel hospitalized at the Department of Internal Medicine, the Military Hospital of Tunis, between January 1993 and January 2011, for imported malaria. The clinical and laboratory features were obtained from the medical records and a questionnaire was filled by the patients about the compliance of malaria prophylaxis. Results. Thirty-seven male patients, with a mean age of 41 years, were treated for malaria infection. Twenty-two were due to Plasmodium falciparum. The outcome was favourable for all patients, despite two severe access. The long-term use of chemoprophylaxis has been adopted by only 21 (51%) of expatriate military for daily stresses. Moreover, poor adherence was found in 32 patients. Conclusion. The risk of acquiring malaria infection in Tunisian military personnel can largely be prevented by the regular use of chemoprophylactic drugs combined with protective measures against mosquito bites.

Aortic root abscess in patients with aortic endocarditis is not uncommon. Aortic root abscess may cause persistent sepsis, worsening heart failure, conduction abnormalities, fistula formation, and an increased need for surgery. We present a young patient with aortic root abscess presenting as pyrexia of unknown origin. She had acute severe aortic and mitral regurgitation which produced very soft murmurs that were easily missed. This report reiterates that a high index of suspicion is needed in suspecting valvular endocarditis as well as a comprehensive transthoracic and transesophageal echocardiographic examination to diagnose complications like aortic root abscess.

Primary cutaneous mantle cell lymphoma (MCL) is a rare cutaneous proliferation of naive pregerminal CD-5 positive B cells in the skin with no extracutaneous involvement. Overexpression of cyclin D1 is pathognomonic of this condition, and surgery and radiation therapy are the most common therapeutic options. In this case, we describe the clinical, histopathological, immunohistochemical, and molecular characteristics of a new case of primary cutaneous MCL.