A label-free optical imaging approach would be well suited for this purpose as it would be easy to integrate with white light laparoscopy, which is the current standard of care. For abdominal cancers, this would particularly involve the peritoneal cavity. It is therefore desirable to develop an imaging system that will enhance the visibility of these occult and presumed small distant metastases, i.e. Despite careful preoperative radiographic and intra-operative evaluation, the accuracy of staging for distant metastases remains poor, as demonstrated by a significant rate of early cancer recurrence in patients who underwent a “complete” operative resection for many types of cancers 2. The appropriateness of surgical resection is typically determined by the extent of the cancer (i.e. Surgical resection is a common treatment modality for various cancers and is clinically utilized in almost half of all cancer patients 1. Successful treatment of cancers requires optimal selection of treatment modalities. When controlling for the degree of illumination, image analysis suggested a potential for mPEL to provide improved visualization of metastases. In conclusion, PEL appears safe and easy to integrate into the operating room. Further, enhancements in the discrimination between malignant and benign lesions were achieved by exploiting the PEL color contrast to enhance sensitivity to tissue scattering, influenced primarily by collagen. When controlling for such effects through direct comparisons of integrated (WLL) vs differential (PEL) polarization laparoscopy images, we found that PEL imaging yielded an over twofold Weber contrast enhancement over WLL. However, this was likely due to reduced illumination under PEL. While most lesions were visible under human examination of both SSL and PEL videos, more lesions were apparent using SSL. Sixty-five lesions (56 presumed benign and 9 presumed malignant) from 3 patients represented the study sample. The prototype performed safely, yet with limitations in illumination, fogging of the distal window, and image co-registration. Using Monte Carlo simulations, contrast enhancement based on the color dependence of PEL (mPEL) was assessed. Image frames of all detectable peritoneal lesions underwent analysis. This is a first-in-human feasibility study, including 10 adult patients who underwent standard staging laparoscopy (SSL) for gastrointestinal malignancy along with PEL. This study evaluates a polarization-enhanced laparoscopy (PEL) prototype and assesses its potential for label-free contrast enhancement of peritoneal metastases. 12v–13r.Despite careful staging, the accuracy for preoperative detection of small distant metastases remains poor, creating a clinical need for enhanced operative staging to detect occult peritoneal metastases. Gallois, so-called Naives Hours, 1839 – 42, Paris. Heures françoises et latines pour Madame L. The Naives book of hours, on the other hand, was commissioned by Jules Gallois, Count of Naives, for his wife, as a devotional work, though also supporting his claim to descend from noble medieval ancestors. The Missal was presented in 1844 to the Count of Chambord, then head of the House of Bourbon, by the Legitimist Ladies of France, who were in favour of a return to monarchy. Two high-end French manuscripts stand out as relatively recent acquisitions: the Naives Hours and the politically-charged Chambord Missal. Pugin and Phoebe Traquair are present in the library, but also some manuscripts reflecting the popular taste for illumination in Victorian England, such as illuminated addresses commissioned for ceremonial occasions, and instances of amateur illumination. Owing to the time and circumstances of its foundation, the museum holds examples of manuscript illumination exemplifying the revival of interest for anything medieval in the 19th century.
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