Charged Particles Transverse Momentum and Pseudorapidity Distribution in Hadronic Collisions at LHC Energies.

We present an analysis of the pseudorapidity η and transverse momentum pT distributions of charged hadrons in pp collisions for the kinematic range of 01 GeV/c at 0.9 and 2.36 TeV within the experimental errors, while Dire overshoots and Vicia undershoots the data by 50% each. At 7 TeV, the Dire module presents a good prediction, whereas the Simple and Vincia modules underestimate the data within 30% and 50%. Comparing the Simple module of the Pythia model and the predictions of the CRMC models with the experimental data shows that at 0.9 TeV, EPOS-LHC has better results than the others. At 2.36 GeV, the cosmic rays Monte Carlo (CRMC) models have better prediction than the Simple module of Pythia at low pT, while QGSJETII-04 predicts well at high pT. QGSJETII-04 and EPOS-LHC have closer results than the Pythia-Simple and Sibyll2.3d at 7 TeV. In the case of the pseudorapidity distributions, only the Pythia-Simple reproduced the experimental measurements at all energies. The Dire module overestimates, while Vincia underestimates the data in decreasing order of discrepancy (20%, 12%, 5%) with energy. All CRMC models underestimate the data over the entire η range at all energies by 20%. The angular ordering of partons and the parton fragmentation could be possible reasons for this deviation. Furthermore, we used the two-component standard distribution to fit the pT spectra to the experimental data and extracted the effective temperature (Teff) and the multiplicity parameter (N0). It is observed that Teff increases with the increase in the center of mass energy. The fit yielded 0.20368±0.01, 0.22348±0.011, and 0.24128±0.012 GeV for 0.9, 2.36, and 7 TeV, respectively. This shows that the system at higher energies freezes out earlier than lower ones because they quickly attain the equilibrium state.

Study of Kinetic Freeze-Out Parameters as a Function of Rapidity in pp Collisions at CERN SPS Energies.

We used the blast wave model with the Boltzmann-Gibbs statistics and analyzed the experimental data measured by the NA61/SHINE Collaboration in inelastic (INEL) proton-proton collisions at different rapidity slices at different center-of-mass energies. The particles used in this study were π+, π-, K+, K-, and p¯. We extracted the kinetic freeze-out temperature, transverse flow velocity, and kinetic freeze-out volume from the transverse momentum spectra of the particles. We observed that the kinetic freeze-out temperature is rapidity and energy dependent, while the transverse flow velocity does not depend on them. Furthermore, we observed that the kinetic freeze-out volume is energy dependent, but it remains constant with changing the rapidity. We also observed that all three parameters are mass dependent. In addition, with the increase of mass, the kinetic freeze-out temperature increases, and the transverse flow velocity, as well as kinetic freeze-out volume decrease.

Acute intestinal obstruction: What if it is instead colonic tuberculosis? What diagnostic and management dilemmas are there?

INTRODUCTION AND IMPORTANCE: Colonic tuberculosis is rare. Clinical, biologic endoscopic and radiological features are not unequivocal. A multitude of differential diagnoses interfere, including Crohn's disease and cancer. CASE PRESENTATION: we present a case of a 48-year-old Tunisian female who complained from occlusive syndrome. For whom none of the various elements of the medical record, the clinical, endoscopic and radiological investigations had enabled a decision to be reached in favor of one diagnosis over the other. Several diagnoses were suggested, including Crohn's disease, neoplastic diseases and, ultimately, colonic tuberculosis, since our country was endemic for this pathology. The collegial decision of the medical staff involved in the management was to operate on the patient. Surgery was required with the intention to treat and mainly to provide histological proof of the disease. A right colectomy allowed histological examination and a diagnosis of colonic tuberculosis. DISCUSSION: The diagnosis should be discussed in patient from endemic countries, who complain chronic abdominal pain, vesperal fever and weight loss for who endoscopy shows the presence of nodules or ulcers. The diagnosis is retained on the basis of pathological findings. CONCLUSIONS: Because of a nonspecific clinical and endoscopic presentations, multiples biopsies even surgical resection are mandatory to rule out differential diagnosis and to confirm the diagnoses of colonic tuberculosis.

Pseudorapidity dependence of the bulk properties of hadronic medium in pp collisions at 7 TeV.

The measured charged particle [Formula: see text] spectra in proton-proton collisions obtained by the CMS experiment at CERN is compared with the simulation results of EPOS-LHC and Pythia8.24 models at 7 TeV center-of-mass energy. The Pythia8.24 model describes the experimental data very well, particularly in the high [Formula: see text] region. The model also predicts the [Formula: see text] spectra for [Formula: see text] [Formula: see text] [Formula: see text] < 2.4 at 0 [Formula: see text] [Formula: see text] [Formula: see text] 6 [Formula: see text]. The EPOS-LHC model underpredicts the [Formula: see text] spectra from 0.1 to 2 [Formula: see text] in all [Formula: see text] bins for about 20% and the [Formula: see text] spectrum from 0.1 to 4.2 [Formula: see text] for [Formula: see text] [Formula: see text] [Formula: see text] < 2.4 by about 15% while reasonably predicts well for [Formula: see text] > 4.2 [Formula: see text] within the experimental errors. Furthermore, to get information about collective properties of the hadronic matter, modified Hagedorn function with embedded transverse flow velocity and thermodynamically consistent Tsallis distribution functions are used to fit the experimental data and simulated results. The values of [Formula: see text] show that the functions fit the data and simulation results well. The parameter extracted by the functions: [Formula: see text], [Formula: see text], and [Formula: see text] decreases with increasing [Formula: see text]. The decrease in [Formula: see text] with increasing [Formula: see text] is due to the large energy deposition in lower rapidity bins producing rapid expansion due to large pressure gradient resulting quick expansion of the fireball. Similarly, large energy transfer in the lower pseudo-rapidity bin results in higher degree of excitation of the system which results larger values of [Formula: see text] and [Formula: see text]. The values of the fit constant [Formula: see text] increase with [Formula: see text] where the values of [Formula: see text] extracted from Pythia8.24 are closer to the data than the EPOS-LHC model. The Pythia8.24 model has better prediction than the EPOS-LHC model which might be connected to its flow-like features and color re-connections resulting from different Parton interactions in the initial and final state.

Clinicopathological and prognostic significance of DNA mismatch-repair protein expression in gastric adenocarcinoma

Although the significance of DNA mismatch repair (MMR) protein expression in colorectal cancer is well-established, it remains contentious in extra-colorectal cancers and mainly in gastric adenocarcinoma. Data from Africa and Arab world remain limited. This study explored the MMR expression in gastric adenocarcinoma and evaluated its clinicopathological and prognostic signification among Tunisian patients. A retrospective study of 72 gastric adenocarcinomas was carried out. Clinicopathological particularities and patient outcomes were recorded. MMR expression was determined by immunohistochemistry on whole sections of archived material. Survival analysis was realized utilizing the Kaplan-Meier estimates and Log-Rank test. Expression of MMR proteins was observed in 84.7% of gastric adenocarcinoma samples. The 11 remaining samples (15.3%) exhibited an altered pattern of MMR protein. A significant association was identified between deficient MMR expression and advanced age (p = 0.03), intestinal type (p = 0.04) and lymph node metastases (p = 0.04). No other significant relationship was observed with the remaining selected tumor features. Patient survival was significantly associated with lymph node invasion (p = 0.002), distant metastases (p = 0.02) and tumor differentiation (p = 0.03), but not with MMR status (p = 0.83). MMR deficiency was related to advanced-age, intestinal type and nodal metastasis, but not to survival of Tunisian patients with gastric adenocarcinoma. Larger multicenter studies with additional molecular investigation are required to more explore these tumors.

Bien que l'importance de l'expression des protéines de réparation des mésappariements de l'ADN (MMR) dans le cancer colorectal soit bien établie, elle reste controversée dans les cancers extra-colorectaux et principalement dans l'adénocarcinome gastrique. Les données de l'Afrique et du monde arabe restent limitées. Cette étude a exploré l'expression des protéines MMR dans l'adénocarcinome gastrique et a évalué sa signification clinicopathologique et pronostique chez les patients tunisiens. Une étude rétrospective de 72 adénocarcinomes gastriques a été réalisée. Les particularités clinicopathologiques et pronostiques des patients ont été enregistrées. L'expression des protéines MMR a été déterminée par immunohistochimie. L'analyse de survie a été réalisée en utilisant la méthode de Kaplan-Meier et le test Log-Rank. L'expression des protéines MMR a été observée dans 84,7 % des échantillons d'adénocarcinome gastrique. Les 11 cas restants (15,3 %) présentaient un profil d'expression altérée des protéines MMR. Une association significative a été identifiée entre l'expression déficiente de MMR et l'âge avancé (p = 0,03), le type intestinal (p = 0,04) et les métastases ganglionnaires (p = 0,04). Aucune autre relation significative n'a été observée avec les autres caractéristiques tumorales sélectionnées. La survie des patients était significativement associée à l'envahissement des ganglions lymphatiques (Log Rank, p = 0,002), aux métastases à distance (Log Rank, p = 0,02) et à la différenciation tumorale (Log Rank, p = 0,03), mais pas à l'expression de MMR (Log Rank, p = 0,03). Rang, p = 0,83). Le déficit de l'expression des protéines MMR était lié à l'âge avancé, au type intestinal et aux métastases ganglionnaires, mais pas à la survie des patients tunisiens ayant un adénocarcinome gastrique. Des études multicentriques avec des investigations moléculaires supplémentaires sont nécessaires pour explorer davantage le cancer gastrique avec expression déficiente des protéines MMR.

Dacryops of the lacrimal gland in an elderly woman: A case report.

INTRODUCTION: Dacryops is a rare benign cystic lesion of the lacrimal gland often developing in the palpebral gland. The exact etiology of dacryops remains unclear. Diagnosis could be suspected clinically and established histopathologically. Treatment is commonly surgical. PRESENTATION OF CASE: We report the case of a 75-year-old woman with past history of total conservative parotidectomy for a benign tumor 10 years ago. She presented to the Ophtalmology Department at Farhat Hached University Hospital of Sousse with a painful swelling of the left supero-external orbital angle. The patient underwent complete excision of the cyst using the conjunctival approach. Histopathological examination showed characteristic features of dacryops with foci of chronic inflammatory cell infiltrates. DISCUSSION: Dacryops is commonly seen in young adults or middle-aged individuals with a slight female preponderance. In some cases, cystic enlargement of dacryops can lead to mechanical ptosis, dystopia, limitation of extraocular movements, diplopia, and, in rare cases, blepharoptosis. However in this case, the patient was an elderly woman presenting a painless mass without ptosis. As in our case, excision using the conjunctival approach under microscope has excellent results without complications. Histopathological examination confirms the diagnosis and helps to rule out differential diagnoses. CONCLUSION: As reported in the present case, histopathological examination confirms clinically recognized or suspected dacryops. If untreated, dacryops may lead to ptosis, proptosis and/or dystopia. Complete excision of the cyst is often curative.

Adenocarcinoma of intestinal type arising in mature cystic teratoma of ovary: A diagnostic dilemma.

Adenocarcinomas of intestinal type arising in mature cystic teratoma of ovary (MCT) are extremely rare and remain a diagnostic dilemma because of its similarities with MCT. Serum tumor markers CEA and SCC and also MRI may help in the preoperative diagnosis. Pathologist experience helps in intraoperative diagnosis.

Anemia revealing a collagenous gastritis in a young Tunisian man.

Collagenous gastritis is a rare entity, characterized by the deposition of a subepithelial collagenous band with an inflammatory infiltrate in the mucosa. We report the first Tunisian case revealed by severe anemia. Lesions were limited to the stomach and remained unchanged on 3 series biopsies during a 24 month follow up despite treatment with corticosteroids. The cause of the disease remains unknown; our findings suggest that lesions of collagenous gastritis may result from a local immune process.

Colonic intussusception caused by a sigmoidal lipoma: A case report.

INTRODUCTION: Intussusception is a relatively common condition seen in children. In comparison, adult intussusception is rare and is often secondary to inflammatory diseases, benign or malignant tumors and motility disorders. Being a benign cause, lipomas appear as a particularly rare gastrointestinal tumor. PRESENTATION OF CASE: We present a case of colo-colonic intussusception secondary to a sigmoidal lipoma, in a 40-year-old man. We describe the different aspects of diagnosis and management of this rare complication. DISCUSSION: Adult intussusception is the cause of symptomatic bowel obstruction in 1% of cases and its colo-colonic occurrence represents 17% of all intestinal intussusceptions. The case that we describe is particularly unique because apart from being an example of intussusception in adults, it occurred in the sigmoid colon and was not associated with a malignant lesion. The treatment of intussusception in adults is surgical resection because of the high incidence of underlying malignancy. Colonoscopy is a modality which allows direct visualization of the lipoma. However, intraluminal reduction via colonoscopy is not recommended. CONCLUSION: Colo-colonic intussusception is a very rare complication of lipoma. It is determined that the treatment is surgical due to the risk of malignancy.

p16INK4A overexpression and HPV infection in uterine cervix adenocarcinoma.

Human papillomaviruses (HPVs) are causally involved in the genesis of cervical carcinomas and their precursors, and there is a strong relationship between the cyclin-dependant kinase inhibitor p16INK4A and HPV infection. This study was carried out to assess the correlations between p16INK4A expression as an early biomarker of the endocervical adenocarcinoma and HPV infection. p16INK4A expression and HPV typing were performed on 46 samples including 5 normal endocervix, 9 benign lesions of the endocervix, 25 endocervical adenocarcinomas, and 7 endometrioid adenocarcinomas of the uterine corpus. A semiquantification of the p16INK4A immunostaining was realized (using both the staining intensity and the percentage of positive cells) and was graded from 0 to 15. All of the 25 endocervical adenocarcinomas overexpressed p16INK4A; the adjacent epithelium and the connective tissue were strictly negative. No p16INK4A was detected in nine benign endocervical lesions and in five normal endocervix. Few endometrioid adenocarcinomas of the uterine corpus that infiltrate the endocervix exhibited a low immunoreactivity (score 0/15 or 1/15). This pattern of expression is significantly associated with HPV infection (p<10(-3)), mainly high-risk HPV types (p=0.02). Our results suggest that p16INK4A is a putative molecular biomarker that consistently discriminates uterine cervix adenocarcinomas from benign lesions and from endometrioid adenocarcinomas of the uterine corpus.

Colorectal cancer in Central Tunisia: increasing incidence trends over a 15-year period.

INTRODUCTION: Significant variation in colorectal cancer incidence rates and trends has been observed across countries. Data from Tunisia are sparse. In this paper, we analyzed trends in incidence rates of the colorectal cancer over a 15-year period, 1993-2007, in Central Tunisia. DESIGN: Five-year age-specific rates, crude incidence rates, world age-standardized rates, and annual percent change were calculated using annual data on population size and its estimated age structure. RESULTS: A total of 1,443 incident cases of colorectal cancer were registered, with a male to-female sex ratio of 1.1:1. The world age-standardized rate was 10.0 per 100,000 among females and 11.7 among males. Over time, there were significant increasing trends by +2.6% (95% CI: 0.1%, 5.1%) and +5.3% (95% CI: 2.7%, 7.9%) for females and males, respectively. CONCLUSION: The absence of a screening program for colorectal cancer could explain the increasing trends observed among males and females in Central Tunisia. Our findings point the need to plan and develop effective programs aimed at the control and prevention of the spread of colorectal cancer in Tunisia.

Breast cancer in Tunisia: clinical and pathological findings.

INTRODUCTION: The aim of this study was to survey the clinical and pathological features of breast cancer in the Center of Tunisia. DESIGN: Characteristics of all breast cancer cases diagnosed in the Pathology Department, Farhet Hached Hospital, Sousse, Tunisia during a 15-year period (1993-2007) were analyzed. RESULTS: A total of 2,404 new cases of breast cancer were recorded, only 48 being diagnosed in men. The age-standardized incidence rate was 0.7 and 29.2 per 100,000 in men and women, respectively, with median ages of 48.0 and 64.5 years. Invasive ductal carcinoma was the most common (2,012 cases). Stage II was the most frequent (47.7%) followed by advanced stages (Stage III and IV, 41%). CONCLUSION: Cancer of the breast remains the most common cancer in the absence of specific screening measures among Tunisian women. Our study justifies the need to plan and develop effective programs aiming at the control and prevention of the spread of breast cancer in Tunisia.

Cancer of corpus uteri in Tunisia: epidemiological and clinicopathological features.

INTRODUCTION: The aim of this study was to survey for the first time the burden and characteristics of corpus uteri cancers in Central Tunisia. DESIGN: Characteristics of all cancer cases diagnosed during a 15-year period were analyzed based on the data of the Cancer Registry of the Center of Tunisia. Five-year age-specific rates, crude incidence rates, world age-standardized rates (ASR), and annual percent change (APC) were calculated using annual data on population size and its estimated age structure. RESULTS: A total of 218 new cases of corpus uteri cancer were recorded. The ASR was 3.1 per 100,000 with a significant increase over time (APC: +7.1%; 95% CI: 3.1%, 11.1%). The median age at diagnosis was 60 years and only 20.6% of patients were less than 50 years old. The tumor size was higher than 2 cm in 83.5% of cases. Stage I was the most frequent (59.9%) followed by advanced stages (23.2%). Endometrial adenocarcinoma was the most frequent histological type (62.8%) with grade II accounting for 48.5% of cases. CONCLUSION: Corpus uteri cancer is an important female cancer with increasing trend over time. These findings justify the need to plan and develop effective programs aiming at the control of the spread of cancer in Tunisia.

Childhood cancer frequency in the center of Tunisia.

OBJECTIVE: In this paper, we analyzed the frequency of childhood cancer in the Center of Tunisia during 1993-2006. DESIGN: The different types of cancer were grouped according to the International Classification for Cancer in Children. The general and specific frequencies by age and by sex were analyzed. RESULTS: A total of 727 new cases of childhood cancer were registered, with a male to-female sex ratio of 1.7/1. Leukemias had the highest frequency (27%) and, of these, lymphoid leukemias were the most prevalent (73.5%). Thereafter, in descending order of frequency, were lymphomas (25.7%), tumors of the central nervous system (CNS, 9.2%), neuroblastomas (7.7%), sarcomas (6.9%), carcinomas (6.3%), bone tumors (5.8%), nephroblastomas (5.5%), and germinal cell tumors (2.6%). The highest frequency of cancer was found at age 10-14 years (34.9%). Leukemias were the most frequent in age groups 1-4 and 5-9 years, whereas, neuroblastomas and lymphomas were the most frequent at age under one year and 10-14 years, respectively. Of those cases of solid tumors, 55.8% were diagnosed as having advanced stages of the disease. CONCLUSION: Leukemias, lymphomas, and CNS tumors were the principal cancers in the Center of Tunisia. A childhood cancer registry with high-resolution data collection is advocated for in-depth analysis of pediatric malignancies.

Pediatric rhabdomyosarcomas in Tunisia.

INTRODUCTION: Rhabdomyosarcoma is the most common soft tissue sarcoma in the first two decades of life. Since there is a paucity of reports on the pattern of its occurrence in Tunisia, we here analysed the epidemiological pattern, clinical features, and pathology. DESIGN: We retrospectively studied 30 consecutive cases of histologically proven rhabdomyosarcoma in children aged 0-15 years extracted from the database of the Cancer Registry of the Center of Tunisia for the period 1993-2007. RESULTS: Rhabdomyosarcomas represented 53.6% of soft tissue sarcomas and 3.8% of all children cancer cases registered during this period. The male/female ratio was 2.7 with a mean age at diagnosis of 5.9 years. The embryonal subtype was the most frequent (60%) and the two most common sites of disease were the head and neck (50%) and genito-urinary tract(23.3%). Chemotherapy was used in 90% of patients; 43.3% of patients had radical surgery and 26.7% of patients received radiation therapy. CONCLUSION: The epidemiology, pathology and clinical features of rhabdomyosarcoma in Tunisian children are close to those reported from other countries.

Synchronous Bilateral Benign Phyllodes Tumor of the Breast in a 32-year-old Woman.

Bilateral phyllodes tumors are distinctly uncommon. As some previous reports have described, most of them are malignant and asynchronous. We report a new case of bilateral synchronous phyllodes tumor in a 32-year-old women. Both tumors were classified as benign after large bilateral excision. No tumor recurrence was noted during the 10 months follow-up.

Clinicopathological patterns of colorectal cancer in Tunisia.

INTRODUCTION: Colorectal cancer is the third most commonly diagnosed cancer worldwide. DESIGN: In order to review the clinical and pathological features of colorectal cancer in Tunisia, a retrospective study was carried out on 1,443 cancer cases diagnosed in the Pathology Department, Farhet Hached University Hospital of Sousse, for a 15-year period (1993-2007). RESULTS: The median age was 61 years. Adenocarcinoma was the most frequent (90.9%) with moderately differentiated tumors accounting for 76.7% of cases. Only eighty patients were identified as being in early stages (0 and A) and 85.8% in advanced stages (B-D). Over time, we observed a significant decrease of stage B (p=0.02) and a significant increase of stage D (p=0.002). The tumor size was larger than 5 cm in 67.5% of cases. CONCLUSION: The large proportion of patients presented at advanced stages, compared to only 5.5% of patients at early stages, emphasizes the need to plan and develop a screening program for the early detection of this cancer and its precursor lesions in Tunisia.

A case of primary biliary cirrhosis associated with pernicious anemia: a case report.

Primary biliary cirrhosis is often associated with autoimmune diseases. However, its association with pernicious anemia has rarely been reported.We report a case of a 68-year-old woman who presented jaundice and pruritus. Mildly elevated serum levels of alkaline phosphatase and gamma-glutamyl transpeptidase were detected. The titer of anti-mitochondrial M(2 )anti-body was elevated. Histology of liver biopsy showed features of primary biliary cirrhosis. In addition, aregenerative macrocytic anemia was found in the full blood count. The diagnosis of pernicious anemia was established by megaloblastosis in bone marrow, atrophic gastritis without Helicobacter pylori, low level of vitamin B(12 )and good response to treatment regimen of vitamin B(12). The association of primary biliary cirrhosis and pernicious anemia is unlikely to be casual and may be explained by autoimmune mechanism commonly shared by the diseases.