Customised joystick-making and training service of power wheelchair using rapid prototyping in rehabilitation centre for people with cervical spinal cord injury: findings from two case studies.

PURPOSE: This study aimed to evaluate the clinical applicability of a customised power wheelchair joystick using rapid prototyping with 3D modeling and printing technology within a rehabilitation centre for patients with cervical spinal cord injury. MATERIALS AND METHODS: Two male participants with tetraplegia following cervical-level spinal cord injury who had difficulty operating a powered wheelchair were recruited. The procedure of the joystick-making and training service consists of four steps: (1) driving evaluation; (2) digital fabrication; (3) functional test; and (4) driving training. K-QUEST 2.0 (Korean-Quebec User Evaluation of Satisfaction version 2.0) was used to measure the usability of the off-the-shelf and customised joystick. RESULTS: During the application process, several redesign stages were required to obtain the final customised joystick. After participants attended a 30-min driving training five times per week for 8 weeks, the usability of the customised joystick was higher than that of the off-the-shelf one. CONCLUSION: Providing the customised joystick-making and training service can be used in hospitalised rehabilitation centre before the hospital discharge of patients and returns to their everyday lives.

3D printing technology in rehabilitation clinics can provide new benefits, including cost-effectiveness, customisation of assistive devices, higher productivity, and enhanced collaboration with clients. More specifically, the entire intervention process, from medical evaluation, designing and manufacturing the devices, and training the client, can be performed efficiently and quickly by rehabilitation practitioners who best understand the client's characteristics.This study aimed to confirm the clinical applicability of a quick and efficient service for a customised power wheelchair joystick using 3D modelling and printing technology in rehabilitation centres for patients with cervical spinal cord injury. This study is expected to provide clinical support for connecting potential users and practitioners with technological advancements.

Comparison of oncologic outcomes between open and laparoscopic distal pancreatectomy for pancreatic ductal adenocarcinoma using data from the KOTUS-BP national database: overcoming selection bias and the necessity of definite indications.

BACKGROUND: Despite the lack of high-level evidence, laparoscopic distal pancreatectomy (LDP) is frequently performed in patients with pancreatic ductal adenocarcinoma (PDAC) owing to advancements in surgical techniques. The aim of this study was to investigate the long-term oncologic outcomes of LDP in patients with PDAC via propensity score matching (PSM) analysis using data from a large-scale national database. METHODS: A total of 1202 patients who were treated for PDAC via distal pancreatectomy across 16 hospitals were included in the Korean Tumor Registry System-Biliary Pancreas. The 5-year overall (5YOSR) and disease-free (5YDFSR) survival rates were compared between LDP and open DP (ODP). RESULTS: ODP and LDP were performed in 846 and 356 patients, respectively. The ODP group included more aggressive surgeries with higher pathologic stage, R0 resection rate, and number of retrieved lymph nodes. After PSM, the 5YOSRs for ODP and LDP were 37.3% and 41.4% (p = 0.150), while the 5YDFSRs were 23.4% and 27.2% (p = 0.332), respectively. Prognostic factors for 5YOSR included R status, T stage, N stage, differentiation, and lymphovascular invasion. CONCLUSION: LDP was performed in a selected group of patients with PDAC. Within this group, long-term oncologic outcomes were comparable to those observed following ODP.

Missing effect of glutamine supplementation on the surgical outcome after pancreaticoduodenectomy for periampullary tumors: a prospective, randomized, double-blind, controlled clinical trial.

BACKGROUND: The effect of glutamine (Gln) supplementation in patients undergoing a major operation has not been conclusively established. This study was designed to elucidate the effect of Gln supplementation on the surgical outcome after a pancreaticoduodenectomy (PD) for periampullary tumors. METHODS: A prospective, randomized, double-blind, and controlled clinical trial was undertaken for patients who underwent a classical PD or a pylorus-preserving PD for periampullary tumors. The Gln and control groups received isonitrogenous amino acid, with a 0.2 g/kg per day Gln regimen administered to the Gln group. The surgical outcome was compared in light of length of postoperative hospital stay, nutritional and chemical profiles, and complication rate between the Gln and control groups. RESULTS: Sixty of the consecutive 143 patients who were admitted to undergo operation for periampullary tumors were enrolled in our study; 32 were in the Gln group and 28 in the control group. The two groups were comparable prior to and during the operation. The median length of the postoperative hospital stay and the postoperative nutritional and chemical profiles were not different between two groups. The overall and PD-related complication rates of the Gln group (37.5% and 25.0%) and the control group (28.6% and 14.3%) were not statistically different. CONCLUSIONS: No significant beneficial effect of Gln supplementation with a low-dose parenteral regimen was demonstrated on the surgical outcome after a PD for periampullary tumors. Therefore, we should be prudent in using Gln as a routine pharmacologic supplement to the standard nutrition in patients who undergo major operations.