Introduction / Purpose: Retinoblastoma is the most common intra-ocular tumour of childhood. Radiotherapy and chemotherapy has improved survival for the disease over the last 40 years. Looking for prognostic criteria is one of the major research areas that inspires disease management teams all-over the world. Many protocols were designed over the years to correlate the presence of certain pathological and/or molecular features and prognosis of the disease. Children’s Cancer Hospital Egypt 57357 (CCHE) is a new cancer center in Egypt that serves about 25-40% of the pediatric oncology population in the country. The aim of this study is to present the histopathological findings in Egypt leading pediatric oncology center and impact of implementing CAP protocol on the improvement of patient care. Materials & Methods: CCHE Retinoblastoma study team implemented College of American Pathologist (CAP) protocol of Retinoblastoma version 3.0 (Based on AJCC/UICC TNM, 7th edition) for examining enucleation specimens. Pathology team has conducted an internal training for pathologists. New electronic case report forms (eCRFs) were designed for reporting the progress. Real-time online statistical analysis system was integrated with eCRFs. Implementation included prospective processing and data entry of new specimens properties beside revising of all specimens prior to the implementation of the protocol. Healthcare quality measures included required time for releasing the reports. Results: Between July 2007 and May 2013 we’ve examined 198 enucleation specimens. Mean of all ocular diameters was 22.2 mm. Mean Optic nerve stump length was 6.35 mm. Invaded structures included Cornea (5.3%), Anterior chamber (15.4%), Iris (8.3%), Lens (5.9%), Ciliary body (18.3%), Choroid, (72.2%), Sclera (17.2%), and Orbital tissue (7.1%). Any degree of Optic Nerve invasion was noted in 51% of specimens while surgical margin was involved in 10.8%. Validation rules in eCRFs helped the team to complete missing data and provide systematic reporting. Integrated online analysis system provided a real-time reporting facility for detecting protocol implementation progress. Conclusions / Significance: Implementing CAP retinoblastoma protocol resembled a roadmap for improving patients’ care. It supported the systematic reporting of cases, decreasing errors and missing data and provided research informatics team with a blueprint for developing a real-time monitoring system. This system can be integrated in the practice of emerging teams to ensure adherence to quality measures.

Introduction: Extraocular Retinoblastoma is a disease of developing countries. It represents a challenge for oncologists with its poor prognosis and resistance to chemotherapy. There is a major discrepancy in reporting its incidence between developing and developed world. Egypt represents the third most populous African country, hence, establishing Childrenâ?Ts Cancer Hospital Egypt 57357 (CCHE) -­a non for profit institute-­ represents a hope for childhood cancer patients in Egypt and the middle-­east. The aim of this paper is to report the magnitude of the disease and presenting features of extraocular retinoblastoma in Egypt over the last 6 years. Materials & Methods: We reviewed all the cases that were presented with extraocular retinoblastoma to our center between July 2007 and December 2012. This included ISGEDR 2013 72 reviewing clinical, radiological and pathological investigations. Cases were classified based on international staging of Retinoblastoma and milestone of diagnosing the disease. Results: Between July 2007 and December 2012 our team has diagnosed 48 cases of metastatic disease accounting for 18.3% of all cases with retinoblastoma. Mean age of presentation was 27.3 months and duration of prior symptoms was 17 months. 40% of the cases presented initially with extra-­ocular retinoblastoma while 49% was diagnosed after enucleation and about 9% of the cases ignored followup sessions and came later with metastases. Stage II represented 32.4% of the cases while Stage III was 26.4% and Stage IV accounted for 42.2 % of the cases. Conclusions: Extraocular retinoblastoma is still an under-­studied field due to the few diagnosed cases in developed world. But in the settings of developing countries it represents a real nightmare specially with the increasing number of advanced intra-­ ocular retinoblastoma patients and lack of access to healthcare services.

This work presents experimental investigation of turbulent partially premixed flames (PPF’s) stabilized within a concentric flow conical nozzle (CFCN) burner with a turbulence generator. The burner stability limit is investigated. In addition, the flow and temperature fields are measured above the conical nozzle exit using 2D PIV and fine wire thermocouple, respectively. The turbulence generator is used to increase the turbulence level as compared to previous measurements. Six turbulent partially premixed natural gas (NG) flames are investigated to study the effect of the level of partial premixing, jet equivalence ratio and Reynolds number. The Reynolds numbers varies between 5.9×103 and 8.9×103 while the jet equivalence ratio varies between 3 and 4.5. The effects of heat release on the flow structure are investigated. The results show that the change of turbulence level has a limited effect on the flame stability. However, the turbulence affects the mixing and hence the best stabilization is achieved at smaller mixing length as compared to the original burner. The flow field shows flow divergence that leads to high flame stability. The centerline axial velocity increases in reactive case by a factor of 1.5-4 higher than that of the non-reactive case. Moreover, the reactive case reaches a reduction in the local Reynolds number by a factor of 4-5.5. The centerline normalized standard deviation increases in the reactive case by a factor of 2-9 higher than that of the nonreactive case.