Virtual reality may reduce anxiety and enhance surgical experience during wide-awake local anaesthesia no tourniquet surgery: A report of two cases.

Virtual reality is an immersive experience that has been gaining acceptance in the field of medicine as a tool for reducing patient anxiety. We recently observed the effectiveness of this technology in wide-awake local anaesthesia no tourniquet (WALANT) surgeries. Here we report two cases of patients who used a virtual reality device during hand surgery using the WALANT technique. Both patients reported that the use of VR technology reduced their anxiety and improved their overall experience during surgery. This case report highlights the novel use of virtual reality during hand surgeries where the patients were awake. Based on these two cases, virtual reality may have the potential to reduce anxiety during the perioperative period and enhance a patient's overall experience in WALANT surgeries.

Analyzing the predictability of the Kwok and Caton periodontal prognosis system: A retrospective study.

BACKGROUND: The aim of this study was to analyze the predictability of the Kwok and Caton periodontal prognosis system by investigating tooth survival within a 64-month period and to compare this to other well-established prognosis systems. METHODS: This retrospective study included the records of patients who had a minimum of two dental exams at least 12 months apart at a single University-affiliated Dental Center. Data including patients' age, sex, length of follow-up period, initial tooth prognosis, revised tooth prognosis, tooth type, and number of teeth lost at the latest exam were recorded. Descriptive analysis was used for data interpretation. RESULTS: A total of 4,046 teeth from 174 patients qualified for the study. Teeth with initial poorer prognosis had a higher chance of being extracted compared with those with a better initial prognosis. Tooth survival rate at the latest follow-up for those with an initial favorable, questionable, unfavorable, and hopeless prognosis was 97.9%, 90.7%, 62.5%, and 17.7%, respectively. Teeth initially assigned to a poorer prognosis category had a higher proportion that changed to a worse prognosis at the latest periodontal exam. CONCLUSIONS: The Kwok and Caton prognosis system can predictably determine tooth survivability within a 5-year period. The defined categories of this prognosis system are more reliable than that of other systems in the short-term. However, long-term (>5 years) prediction accuracy of this prognosis system needs further investigation.

Differential mTOR pathway profiles in bladder cancer cell line subtypes to predict sensitivity to mTOR inhibition.

BACKGROUND: Molecular classification of bladder cancer has been increasingly proposed as a potential tool to predict clinical outcomes and responses to chemotherapy. Here we focused on mechanistic target of rapamycin (mTOR) inhibition as a chemotherapeutic strategy and characterized the expression profile of mTOR signaling targets in representative bladder cancer cell lines from basal, luminal, and either basal/luminal ("non-type") molecular subtypes. MATERIALS AND METHODS: Protein and mRNA expression of mTOR signaling components from representative luminal (RT4 and RT112), basal (SCaBER and 5637), and nontype (T24 and J82) bladder cancer cell line subtypes were determined by Western blot and database mining analysis of the Cancer Cell Line Encyclopedia. Cell viability following treatment with either, Torin-2 or KU-0063794, 2 dual mTOR complex 1/2 inhibitors, was determined by MTT assay. Immunoblot analysis of cells treated with Torin-2 or KU-0063794 was performed to determine the effects of mTOR inhibition on expression and phosphorylation status of mTOR signaling components, Akt, 4E-BP1, and ribosomal protein S6. RESULTS: Molecular subtypes of bladder cancer cell lines each exhibited a distinct pattern of expression of mTOR-associated genes and baseline phosphorylation level of Akt and 4E-BP1. Cells with low levels of Akt Ser-473 phosphorylation were more resistant to the cytotoxic effects of mTOR inhibition with Torin-2, but not KU-0063794. Exposure to Torin-2 and KU-0063794 both potently and rapidly inhibited phosphorylation of Akt Ser-473 and Thr-308, and 4E-BP1 T37/46 in cell lines that included basal and nontype subtypes. CONCLUSIONS: Differential gene expression and protein activity associated with mTOR signaling is observed among bladder cancer cell lines stratified into basal, luminal, and nontype subtypes. Urothelial carcinomas characterized by high baseline Akt Ser-473 phosphorylation may be best suited for targeted mTOR therapies.