자발성 척추 경막외 농양의 수술적 치료

이정길,김수한,김은성,김태선,정신,김재휴,강삼석,이제혁,Lee, Jung-Kil,Kim, Soo-Han,Kim, Eun-Seong,Kim, Tae-Sun,Jung, Shin,Kim, Jae-Hyoo,Kang, Sam-Suk,Lee, Je-Hyuk 대한신경외과학회 2000 Journal of Korean neurosurgical society Vol.29 No.8

Objective : The goal of this study was to recognize the clinical feature and associated risk factors in spinal epidural abscess(SEA), and to improve the outcome accordingly. Methods : A retrospective study was performed in 14 patients with SEA who underwent surgical intervention at our hospital between 1990 and 1999. Results : After a mean follow-up period of 10.2 months(range, 1-57 months), 8 patients had no or minimal deficits, 4 patients had severe paresis or plegia and/or bowel/bladder dysfunction, and 2 patients died due to medical complications. Staphylococcus aureus was the predominant pathogen, isolated in 9 patients(64.3%). Cervical and thoracic spinal epidural abscesses showed a tendency to develop rapidly and were associated with severe neurological deficits. Conclusion : Thoracic spinal epidural abscesses were associated with a poorer prognosis than those in other regions. Therefore, it should be treated more aggressively. Good neurological recovery can be obtained despite severe neurologic deficit when treated by early diagnosis and prompt surgical intervention.

유성압연기를 사용한 스테인리스 강관 압연공정의 유한요소해석

이정길(Jung-Kil Lee),김관우(Kwan-Woo Kim),조해용(Hae-Yong Cho) 한국마린엔지니어링학회 2011 한국마린엔지니어링학회지 Vol.35 No.2

전위된 관절 내 종골 골절에서 확장된 족근동 접근법을 통한 Kirschner Wire 강선 지지대 고정술의 임상 및 영상학적 결과

이정길(Jeong-Kil Lee),강찬(Chan Kang),김상범(Sang-Bum Kim),이기수(Gi-Soo Lee),황정모(Jung-Mo Hwang),안병국(Byung-Kuk An) 대한정형외과학회 2021 대한정형외과학회지 Vol.56 No.3

목적: 종골 골절 후 발생하는 부정유합으로 인해 체부의 폭이 증가하면 후족부 외측의 통증이 발생한다. 외측벽 돌출을 줄이기 위해 저자들이 고안한 K-강선(Kirschner wire) 지지대의 정복 유지 효과를 임상 및 영상학적 결과로 후향적으로 평가해 보고자 하였다. 대상 및 방법: 2015년 1월부터 2017년 12월까지 전위된 관절 내 종골 골절 환자 중 정복 유지를 위해 K-강선 지지대를 사용한 환자 22명(A군)과 K-강선 지지대를 사용하지 않은 환자 중 A군 환자와 1:2로 짝지은 44명의 환자들(B군)을 대상으로 하였다. 모든 수술은 확장된 족근동 접근법으로 시행되었으며 유관나사와 Steinmann 핀, K-강선을 이용한 내고정술을 시행하였다. 술 후 임상적 평가로는 미국족부족관절학회의 족관절-후족부 수치와 수술 후 운동능력의 회복 정도를 비교하였다. 영상학적 결과는 Böhler 각, Gissane 각, 종골의 높이와 폭, 관절 내 함몰 정도와 종골 외측벽의 돌출 정도를 비교하였다. 또한 두 군의 환자에서 수술 후 발생한 합병증도 분석해 보았다. 결과: 임상적 결과는 두 군 간에 유의미한 차이가 없었다(p=0.924, p=0.961). 영상학적으로 Böhler 각, Gissane 각, 종골의 높이와 폭, 관절 내 함몰 정도에는 유의한 차이가 없었지만(p=0.170, p=0.441, p=0.230, p=0.266, p=0.400), 종골 외측벽의 돌출 정도는 A군이 평균 1.78 mm, B군이 4.95 mm로 유의한 차이가 있었다(p=0.017). B군에서 비복 신경 포착과 통증을 동반한 외골종의 빈도는 더 많았지만 통계적으로 유의한 차이가 없었다(p=0.293, p=0.655). 결론: 임상적 평가 및 영상학적 평가의 대부분과 두 군의 합병증 비교에서 유의한 차이는 없었으나 종골 외측벽의 돌출 정도에 있어서는 A군에서 우수한 결과를 보였다. 저자들이 고안한 K-강선 지지대 수술법은 전위된 관절 내 종골 골절에서 외측벽 돌출의 정복 유지에 효과적인 수술 방법이 될 수 있을 것이다. Purpose: The purpose of this study was to retrospectively evaluate the effect of ‘Blocking Kirschner Wire (K-Wire) Technique’, which has been developed to reduce protrusion of the lateral wall, in maintaining the level of reduction through clinical and radiological outcomes. Materials and Methods: Twenty-two patients with displaced intra-articular calcaneal fractures who used the blocking K-wire to maintain reduction (group A) and 44 patients that did not use blocking K-wire and were paired in 1:2 ratio with those Group A patients (group B), between January 2015 and December 2017 were enrolled in the study. All surgical procedures were performed via the extended sinus tarsi approach, and internal fixation using cannulated screws, Steinmann pins and K-wires was performed. American Orthopaedic Foot and Ankle Society (AOFAS) Ankle-Hindfoot scale and postoperative recovery of exercise ability were compared for postoperative clinical outcomes. The radiological results were compared the Böhler angle, Gissane angle, calcaneal height and width, step off of posterior calcaneal joint, and the degree of protrusion of the lateral wall. Moreover, postoperative complications in both groups were compared. Results: There were no significant differences in the clinical outcomes of the two groups (p=0.924, p=0.961). The amount of Böhler angle, Gissane angle, calcaneal height and width, and step off of posterior calcaneal joint from the radiological results was not significantly different between the two groups (p=0.170, p=0.441, p=0.230, p=0.266, and p=0.400). However, the degree of protrusion of the lateral wall was 1.78 mm and 4.95 mm in group A and group B, respectively, and the difference between the two groups was significant (p=0.017). Although sural nerve entrapment and painful exostosis were more frequent in group B, they were occurred in a non-significant manner (p=0.293, p=0.655). Conclusion: Most of the clinical and radiological results as well as the complications were not significantly different between the two groups. However, the degree of protrusion of the calcaneus lateral wall in group A was promising. The ‘Blocking K-Wires Technique’ established by the authors may be an effective surgical option for maintaining the reduction of the lateral wall protrusion in displaced intra-articular calcaneal fractures.

강관의 전단에 관한 연구

이정길(Jung-Kil Lee),이상민(Sang-Min Lee),오병기(Byung-Ki Oh),조해용(Hae-Yong Cho) 대한기계학회 2003 대한기계학회 춘추학술대회 Vol.2003 No.11

A guillotine type shearing of a steel pipe has been investigated by means of energy method. The term guillotine means shearing of material with shear blade's up and down motion that gives a high speed and easy cut. In this study, shear forces of a pipe with different semi-angles (30°, 45° and 60°) of shear blade are calculated using energy method. According to the analysis, 45° semi-angle shear blade give the lowest shear force. The experimentally measured shear force of shearing a φ35 steel pipe using 45° semi-angle shear blade show a good agreement with calculated shear force. As a result, it might be possible to design a guillotine type shearing system of steel pipe on the basis of shear force calculated by energy method.

유성압연기를 사용한 동관 압연공정의 유한요소해석

이정길(Jung-Kil Lee),한기범(Ki-Beom Han),김관우(Kwan-Woo Kim),최종웅(Jong-Woong Choe),김재훈(Jae-Hun Kim),조해용(Hae-Yong Cho) 한국마린엔지니어링학회 2010 한국마린엔지니어링학회지 Vol.34 No.2

STS304의 태핑과 탭 형상에 관한 연구

이정길(Jung Kil Lee),최만성(Man Sung Choi) Korean Society for Precision Engineering 2000 한국정밀공학회지 Vol.17 No.11

남북 분단이 한국의 체제 변동기에 미친 영향

이정길(Jung Kil Lee) 한국정치학회 2013 한국정치학회보 Vol.47 No.5

한국의 정치 발전 과정은 해방 후부터 시작된‘분단’과 밀접한 관련이 있다. 첫째, 한국의 자유민주주의 체제는 자유, 평등, 인권, 평화 및 복지 등을 쟁취하기 위한 과정에서 비롯된 것이 아닌, 소련과의 체제경쟁을 염두에 둔 미국의 일방적 의지로 도입되었다. 둘째, 해방후 38선 이남의 주도권을 쥐게 된 미국은 질서유지를 목적으로 식민지시대의 기득권을 온존시키고, 기득권 청산을 주장했던 임정 및 좌익세력들을 배제하여 보수의 독점적 우위라는 기형적 구조를 정착시켰다. 더욱이 이와같은 조건 위에 발발된 한국전쟁은 한반도에‘분단’을 고착화시켰는데, 이후 한국정치는 자유민주주의를 반공주의라는 왜곡된 논리로 민중들의 가치를 철저히 억압하였다. 하지만 권력층에 대한 민중의 저항도 끊이지가 않았는데, 이 과정들을 명확히 볼 수 있는 시기가 1961년, 1980년, 그리고 1987년이다. 본고는 이 시기에 대한 분석을 통해 첫째로는 체제변동에 대한 기존의 이론적 시각을 (근대화이론, 액터중심론, 역사적구조주의) 비판적으로 수용하면서도 액터의 인식영역에 보다 주목하여 기존이론들이 봉착해있는 한계를 풀어나갈 해독제를 제공하고자 한다. 둘째로는 4.19 혁명에 의한 제2공화국 등장과 군부 정권 성립, 1980년 서울의 봄 및 민주화 이행실패, 그리고 1987년 6.29 선언이라는 세시기에 주목하면서, 세번에 걸친 체제 이행기 사이의 비교를 통하여 87년 민주화가 성공하였던 이유를 명확히 하고, 오늘날의 정치현상을 재조명할 수 있는 분석시각을 제시하고자 한다. South Korea’s politics are closely related to the division of Korean peninsula, which began after the liberation of Japanese colonization. First, South Korea’s liberal democracy was derived from the unilateral commitment of the US, including consciousness of competition with the Soviet Union; not by the process to get freedom, equality, human right, peace, and welfare. Second, the US had an initiative under the 38th parallel of Korean peninsula after liberation caused the conservative monopoly system, excluding left-wing forces who claimed to liquidate a vested interest during the colonial period. In these conditions, the outbreak of the Korean War made the division adhered on the Korean peninsula. Since then, the value of people had been oppressed under the logic of anti-communism, which was changed from liberal democracy. But people’s struggles against it had also persisted at that time. In this article, First, I will offer an antidote to overcome a theoretical limitation of the existing theories concerned the regime transition. Second, I will clear the reason why Democratization of 1987 was successful, comparing 1961, 1980, and 1987. After fulfilling the two purposes above, I expect to be offered an analysis framework to refocus political phenomenon which is today.

악성 뇌경색증에 대한 감압 두개골절제술의 임상분석

김석철,이정길,김재성,김태선,정신,김재휴,김수한,강삼석,이제혁,Kim, Seok-Chul,Lee, Jung-Kil,Kim, Jae-Sung,Kim, Tae-Sun,Jung, Shin,Kim, Jae-Hyoo,Kim, Soo-Han,Kang, Sam-Suk,Lee, Je-Hyuk 대한신경외과학회 2001 Journal of Korean neurosurgical society Vol.30 No.3

Objective : Massive cerebral infarction could be accompanied by severe brain swelling and death secondary to transtentorial herniation. Approximately 10% to 15% of middle cerebral artery infarctions are associated with this phenomenon. However, the effectiveness and timing of decompressive surgery are still controversial. In this study, we present our results on the effect of decompressive craniectomy in life threatening cerebral infarction. Method : We retrospectively analyzed 15 patients who underwent decompressive craniectomy for massive cerebral infarction from January 1997 to April 1999. Surgical indication was based on the clinical signs such as neurological deterioration, pupillary reflex, and radiological findings. Clinical outcome was assessed by Glasgow Outcome Scale (GOS). Results : All 15 patients(five men, ten women ; mean age, 52.3 years ; right 11, left 4) were treated with wide craniectomy and duroplasty. The average time interval between onset of symptom and surgical decompression was 2.9 days. Clinical signs of uncal herniation(anisocoria, or fixed and dilated pupils) were presented in 13 of 15 patients. Mean Glasgow coma scale(GCS) was 12.4 points on admission, 8.1 points on preoperative state and 11.8 points postoperatively. Overall outcomes were favorable in 5 cases(Glasgow outcome scale : GOS I, II), unfavorable in 6 cases(Glasgow outcome scale : GOS III, IV) and dead in 4 cases. Conclusion : Early decompressive craniectomy before brain stem compression is considered as an effective lifesaving procedure for massive cerebral infarction unresponsive to aggressive medical therapy.

본태성 다한증의 후흉추 접근법 및 내시경수술의 임상고찰

전효철,김재휴,이정길,김태선,정신,김수한,강삼석,이제혁,Cheon, Hyo Cheol,Kim, Jae Hyoo,Lee, Jung Kil,Kim, Tae Sun,Jung, Shin,Kim, Soo Han,Kang, Sam Suk,Lee, Je Hyuk 대한신경외과학회 2001 Journal of Korean neurosurgical society Vol.30 No.8

Objectives : Essential hyperhidrosis is a common condition characterized by excessive body sweating. Excessive sweating beyond what is necessary to maintain normal body temperature need not be considered pathological unless it interferes with one's occupation and/or life-style. The existing non-operative therapeutic options seldom give sufficient relief or show a transient effect. In this regard, the thoracic sympathectomy may provide a definitive cure. In the past, surgical procedures were highly invasive and caused significant morbidity, but the minimally invasive thoracoscopic procedure provided detailed visualization of sympathetic ganglia and is associated with minimally postoperative morbidity. Nowadays, thoracoscopic transthoracic sympathectomy is accepted as the treatment of choice for essential hyperhidrosis. In palmar hyperhidrosis, however, the level of sympathetic chain to be blocked has been somewhat obscure. It is assumed that the incidence of compensatory hyperhidrosis may closely related to the extent of thoracic sympathectomy. Material & Methods : To compare the results of posterior midline approach with endoscopic sympathectomy, and the results of T2 with T2, 3 sympathectomy or sympathicotomy, we retrospectively studied 62 patients treated for palmar hyperhidrosis between September 1993 and May 2000. We reviewed medical records and recently interviewed the patients by telephone calls. Results : The treatment effect of T2 sympathectomy is no different from T2, 3 sympathectomy. But, the incidence of compensatory hyperhidrosis is less in the T2 sympathectomy group than the T2, 3 sympathectomy group. Conclusion : Thoracoscopic sympathectomy is considered a simple, safe, and effective method for treating palmar hyperhidrosis, with a shorter operation time, fewer hospital days, and a better cosmetic result, as compared with the open approaches. However, sympathicotomy seems to provide the advantages of a limited extent of denervation and the resultant decrease of compensatory hyperhidrosis compared to sympathectomy.

편측안면경련에서 미세혈관감압술의 성적

곽형준,김재휴,이정길,김태선,정신,김수한,강삼석,이제혁,Kwak, Hyoung Jun,Kim, Jae Hyoo,Lee, Jung Kil,Kim, Tae Sun,Jung, Shin,Kim, Soo Han,Kang, Sam Suk,Lee, Je Hyuk 대한신경외과학회 2001 Journal of Korean neurosurgical society Vol.30 No.4

Objectives : Hemifacial spasm is painless uncommon disorder characterized by involuntary paroxysmal movement on one side of face. It is known that hemifacial spasm is mainly due to pulsatile compression by vessels at the root exit zone(REZ) of the facial nerve. Microvascular decompression at REZ of the facial nerve has become the standard treatment modality for hemifacial spasm. The authors have analized patients with hemifacial spasm treated with microvascular decompression to evaluate operation result and clinical course after operation. Patients and Methods : From 1992 to 1999, 41 patients with hemifacial spasm underwent this operation. Retrospective analysis of operation results and clinical recovery patterns was done. The length of observation had been more than 6 months in all cases. Results : The ratio of male to female was 1:1.4, and age at operation ranged from 24 to 66 years. Their mean age was 47.6 years and the mean preoperative duration of symptoms was 7.2 years. Most common offending vessels were AICA in 18 cases(48%) and second most common were PICA in 13 cases(31.7%). The rest of them were 3 case in vertebral artery, and 7 cases(13%) in multiple offending vessels. Patterns of improvement after surgery could be divided into 4 clinical types. There was complete recovery in 3 days after operation in 24 cases(58.6%, Immediate complete recovery). There was complete recovery in 3 days after operation, and symptom was recurred partially, which was gradually subsided in 2 weeks after operation in 4 cases(9.8%, Delayed complete recovery type I). There was partial recovery after operation and symptom was compretely disappeared gradually in 6 months after operation in 7 cases(17.1%, Delayed complete recovery type II). Finally, there was partial recovery after operation, and symptom was somewhat remained after 6 months later(14.5%, Delayed partial recovery). Conclusion : In conclusion, microvascular decompression for hemifacial spasm is a safe and reliable treatment modality with good results of improvement and there are 4 recovery patterns in clinical course after operation in our series. Therefore, follow-up observation after microvascular decompression is necessary to evaluate the operative results and complication, especially in the delayed resolved cases.