Effects of Therapeutic Climbing Training on the Balance and Gait Ability in Chronic Stroke Patients

Soin Lee,Mingyun Ko,Seju Park 국제물리치료연구학회 2020 Journal of International Academy of Physical Ther Vol.11 No.3

Background: Therapeutic climbing training, which originated in Germany, is a wall-hanging rock climbing-based therapy to increase the body's coordination through movement of the upper and lower limbs against gravity. However, there are no studies examining the effectiveness of therapeutic climbing training to treat balance and gait ability in patients with chronic stroke. Objectives: To investigate therapeutic climbing training program on balance and gait in patients with chronic stroke. Design: Pretest-posttest control group design. Methods: Fourteen patients with chronic hemiplegic stroke participated. Participants were randomized into the therapeutic climbing training group (TCTG, n=7) and the standard rehabilitation program group (SRPG, n=7) group. All subjects participated in the same standard rehabilitation program consisting of 60 minutes 5 times a week for 6 weeks. TCTG participated additionally in the therapeutic climbing program consisting of 30 minutes sessions 3 times a week for the same 6 weeks. Berg balance scale (BBS), Gaitview Measure, Timed up and go test (TUG) were measured. Results: In the TCTG, revealed a statistical difference in BBS between the groups; in the difference of plantar pressure ratio in the static standing position revealed a statistical difference between the groups after training; the balance ability in the one-leg standing tests increased significantly; the time in TUG decreased significantly after training in both groups; The changes in the difference of dynamic plantar pressure ratio were reduced significantly in the TCTG. Conclusion: Therapeutic climbing training contribute to improve balance and walking function in patients with chronic stroke.

Unprecedented Electromagnetic Shielding Effectiveness of Lightweight Nonwoven Ag/PA66 Fabrics

M. S. Ozen,E. Sancak,N. Soin,T. H. Shah,A. Zarei,E. Siores 한국섬유공학회 2018 Fibers and polymers Vol.19 No.2

Novel, high-performance silver coated polyamide, Ag/PA66, nonwoven fabrics with a density of only 0.04 g/cm3 have been developed using staple fibres of 19 (3.3 dtex) and 27 (6.7 dtex) μm diameter. The obtained nonwoven fabrics with an Ag loading of 12-18 wt% exhibited excellent weight-normalised specific electromagnetic shielding effectiveness of over 1200 dB/(g/cm3) in the 0.015-3 GHz range, which is among the highest reported till date. Moreover, the applied microwave was verified to be absorbed rather than being reflected back making the fabrics highly suitable for shielding applications. It was also observed that nonwoven fabrics made from finer 3.3 dtex Ag/PA66 fibres have higher reflection and lower absorption values than their thicker (6.7 dtex) counterparts. Additionally, we have also explored the use of these nonwoven Ag/PA66 fabrics for personal thermal management via Joule heating with samples showing rapid heating response (up to 0.2 oC/sec) and long-term stability measured over 10,000 seconds. The needle-punched Ag/PA66 nonwoven fabrics, in spite of their low density of the order of 0.04 g/cm2, exhibited high EMSE values of nearly 69-80 dB, leading to excellent weightnormalised specific electromagnetic shielding effectiveness of over 1200 dB/(g/cm3) in the 0.015-3 GHz range. The production of Ag/PA66 needle punched nonwoven fabrics thus offers a facile route to develop multifunctional fabrics for EMI shielding as well as personal thermal management applications.

Robotic-assisted right hepatectomy via anterior approach for intrahepatic cholangiocarcinoma

Sanjay Goja,Manoj K Singh,Rohan Jagat Chaudhary,Arvinder S Soin 한국간담췌외과학회 2017 Annals of hepato-biliary-pancreatic surgery Vol.21 No.2

Major hepatic resection, especially right hepatectomy, has been successfully performed by specialized hepatobiliary centers using the robotic platform with low morbidity, conversion rates and outcomes comparable to laparoscopic and open surgery. The authors report a case of robotic-assisted right hepatectomy done for intrahepatic cholangiocarcinoma using anterior approach, after right portal vein embolisation for future liver remnant volume enhancement.

Push pull microfluidics on a multi-level 3D CD

Thio, T.,Ibrahim, F.,Al-Faqheri, W.,Moebius, J.,Khalid, N.,Soin, N.,Kahar, M.,Madou, M. Royal Society of Chemistry 2013 Lab on a chip Vol.13 No.16

Theoretical development and critical analysis of burst frequency equations for passive valves on centrifugal microfluidic platforms

Thio, Tzer Hwai Gilbert,Soroori, Salar,Ibrahim, Fatimah,Al-Faqheri, Wisam,Soin, Norhayati,Kulinsky, Lawrence,Madou, Marc Springer-Verlag 2013 Medical & biological engineering & computing Vol.51 No.5

Surgical approaches to hepatic hydatidosis ranging from partial cystectomy to liver transplantation

Sanjay Goja,Sujeet Kumar Saha,Sanjay Kumar Yadav,Anisha Tiwari,Arvinder Singh Soin 한국간담췌외과학회 2018 Annals of hepato-biliary-pancreatic surgery Vol.22 No.3

Backgrounds/Aims: A wide range of surgical approaches has been described for hepatic hydatidosis aiming primarily at the reduction of disease recurrence and minimization of postoperative morbidity. Methods: A database analysis of patients with liver hydatidosis who underwent different surgical procedures between March 2010 and May 2016 was performed. Results: A total of 21 patients with cystic echinococcosis (CE) and four cases of alveolar echinococcosis (AED) were detected. Nine patients manifested recurrent disease at presentation. Among CE cases, 5 underwent partial cystectomy (2 laparoscopic and 3 open), 9 cysto-pericystectomy (7 open and 2 robotic) and 7 hepatectomies (1 central, 4 right, 1 left and 1 right trisectionectomy). Living donor liver transplantation was performed in 3 patients with AED and the fourth patient underwent right trisectionectomy with en bloc resection of hepatic flexure and right diaphragm. Seven developed Clavien grade II and three grade III complications. The mean follow-up of CE was 34.19±19.75 months. One patient of laparoscopic partial cystectomy developed disease recurrence at 14 months. No recurrence was detected at a mean follow-up of 34±4.58 months following LDLT and at 24 months following multivisceral resection for AED. Conclusions: The whole spectrum of tailored surgical approaches ranging from minimally invasive to open and extended liver resections represents safe, effective and recurrence-free treatment of hepatic hydatidosis.

Algorithmic Approach for Safe Optimization and Surgical Planning in Hilar Blocks- Single Center Experience

( Rohan Jagat Chaudhary ),( V. Sagar Puppala ),( Thiagarajan S. ),( Prashant Bhangui ),( Amit Rastogi ),( Tarun Piplani ),( S. Baijal ),( V. Vohra ),( Arvinder Singh Soin ) 대한간학회 2020 춘·추계 학술대회 (KASL) Vol.2020 No.1

Aims: To study the outcomes of our algorithmic-approach for safe optimisation and surgical planning in patients with Hilar- Block. Methods: Retrospective-analysis of prospectively-maintained database of patients undergoing surgery for hilar-block from Jan2013-May2019 was done.Our approach includes Imaging, Biliary-decompression, Future-liver-remnant-Volume(FLR)augmentation based on CT-Volumetry and FLR-function assessment. Results: 45cases of hilar-blocks underwent resections.32were Hilar-cholangiocarcinoma,5-Intrahepatic-cholangiocarcinoma, 6-Ca-Gall-Bladder with hilar-block,2-IgG4-sclerosing- cholangitis-presenting as malignant-masquerade. The mean age was57±12years and 30(67%) were males. On MRCP, hilar-blocks types 2,3a,3b,4 were 3,15,17,10 respectively. Pre-operative biliary-decompression of FLR were done in 21cases[19 PTBD(Percutaneous-Transhepatic-biliary-drainage)/ 2 EBD(Endoscopic-biliary-drainage)]. Additional PTBD were done in 2 cases for inadequate fall in SB, and 3 for cholangitis. The mean SB(Serum-Total-Bilirubin) at presentation was 9.57±5.58mg/dl. The rate of fall of S.bilirubin was faster in patients < 50yrs of age and type-3 hilar-blocks than in type-4 hilar- blocks. PVE was performed in 14cases and FLR hypertrophy of 11.3± 3.03%was achieved.The quality of FLR was assessed with LAI(n=39),fibroscan(n=17), ICGR15(n=12), HVPG (n=35), and selective-remnant-biopsy(n=14,if HVPG >10 mm Hg,ICGR15> 15%, or in-suspected steatosis or fibrosis).After optimization, surgical procedures done were Right-Hepatectomy(7), Right-TriSectorectomy(7), Extended-Right-Hepatectomy(9), Left-Hepatectomy(6),Extended-Left-Hepatectomy(5), Left-Trisectorectomy( 8) and Bile-duct-excision-alone(3).Eleven patients required concomitant vascular-resections and reconstructions(- 8portal-vein-resections, 2 hepatic-arterial-resection,1both) to obtain R0. R0 and R1 resections were achieved in 42(93%) and 3 patients. Clavien-Dindo-Grade3/4 complications were 22.2%(n=10). 8(18%)patients had Post-Hepatectomy-Liver- Failure.Overall operative-mortality was 5/45(11.1%). Conclusions: Our algorithmic approach for safe optimization by preoperative-biliary-drainage, FLR-augmentation and FLR-functional- assessment have led to a high rate of R0 major liver resection and good outcomes in patients with hilar-blocks.Augmentation of FLR can also increase resectability in borderline resectable cases.