H-이진트리 구조를 갖는 타임스탬프 설계 및 분석

정경원,도경화,전문석,Jung, Kyung-Won,Do, Kyoung-Hwa,Jun, Moon-Seog 한국정보처리학회 2002 정보처리학회논문지 C : 정보통신,정보보안 Vol.9 No.6

전자문서의 안전한 전송과 법적인 시점확인을 위하여 안전하고. 효율적인 타임스탬프 방법이 요구된다. 된 논문은 H-이진트리에서 작성되는 타임스탬프 구조를 이용하여, 간단하고 효율적인 전자문서 패킷을 작성할 수 있는 프로토콜을 제안한다. 기존 전자서명에이용되고 있는 RSA 프로토콜은 비도면에서 취약하기 때문에, 강한 타임스탬프 구조가 요구된다. 이러한 문제점을 보완하기 위해서 이론적으로 트리구조를 갖는 형태이며 H-이진트리O(logn) 시간복잡도를 갖는, 전자문서에 대한 타임스탬프 프로토콜을 설계하고 기존의 프로토콜 방식과 비교 분석한다. We want to find a timestamping method which improves efficient performance and have high-level security to send secured messages in the digital signature and the law of e-commerces. Our paper shows a H-binary tree of time stamp to use a time stamp protocol with high suity and performance in the packets of sending messages. We implement and analyze the protocols, show to compare with previous RSA methods. Our proposed protocol has O(log n) time complexity and high-performance.

현재의 국내 응급의료체계에서 중증외상환자의 이송 지연

정경원 ( Kyoung Won Jung ),장정문 ( Jeong Moon Jang ),김지영 ( Ji Young Kim ),백숙자 ( Suk Ja Baek ),송서영 ( Seo Young Song ),강찬숙 ( Chan Suk Gang ),이국종 ( Kug Jong Lee ) 대한외상학회 2011 大韓外傷學會誌 Vol.24 No.1

Purpose: Major trauma patients should be transferred to a definitive care facility as early as possible because prompt management will prevent death. This study was designed to discover the obstacles leading to delayed transfers under the current emergency medical system in Korea and whether there are any negative outcomes associated with conducting procedures at primary care hospitals prior to transferring patients to higher levels of care. Methods: The medical records of major trauma patients with an Injury Severity Score above 15 within the past year were reviewed. Patients were divided three groups as follows: (A) came directly to our emergency center, (B) were transferred without CT or MRI scan at the primary care hospital and (C) transferred with CT or MRI scans. The transfer time of each group were compared and analyzed statistically. Additionally, the number and type of imaging performed at the primary care hospital were analyzed. Results: All qualified patients (n=276) were enrolled in this study: 121 patients in group A; 104 in group B; 51 in group C. There was a statistically significant difference in the transfer time between the three groups (pvalue< 0.001), and 79 (28.6%) were transferred to an emergency medical center within one hour. In group C, CT or MRI scans were performed an average of 1.86 times at the primary care hospital, and the median transfer time was 4 hours 5 minutes. Conclusion: Only 28.6% of the cases in the study arrived within the golden hour at a definitive care facility. Such delays are in part the result of prolonged times at the primary care hospital for radiologic examinations, such as CT or MRI scans. Major multiple trauma patients should be transferred to a definitive care facility directly or as soon as the primary survey and the resuscitation of Advanced Trauma Life Support guideline are completed at the primary care hospital. (J Korean Soc Traumatol 2011;24:25-30)

H1N1 Influenza 폐렴 환자에서 발생한 Mycobacterium abscessus 감염

정경원 ( Kyoung Won Jung ),유훈 ( Hoon Yu ),이태훈 ( Tae Hoon Lee ),권오성 ( O Sung Kwon ),최석원 ( Suk Won Choi ),강세훈 ( Se Hun Kang ),심태선 ( Tae Sun Shim ),김동순 ( Dong Soon Kim ),송진우 ( Jin Woo Song ) 대한결핵 및 호흡기학회 2010 Tuberculosis and Respiratory Diseases Vol.69 No.3

Novel influenza A (H1N1) virus is a common pathogen of febrile respiratory infection recently. Here, we report the case of a 63-year-old male patient who presented with 3 days` ongoing cough and fever. He was diagnosed with novel influenza A (H1N1) pneumonia by real-time reverse-transcriptase-polymerase-chain-reaction (rRT-PCR). During treatment for novel influenza A (H1N1), his symptoms and radiologic findings improved initially, but multiple lung nodules developed subsequently and found on chest x-ray (on the 5th hospital day). Mycobacterium abscessus was isolated repeatedly from sputum and bronchoalveolar lavage fluid. To our knowledge, this is the first reported case of Mycobacterium abscessus lung disease in a patient with H1N1 influenza pneumonia.

일개 권역응급의료센터에서의 중증 외상환자의 전원 현황과 문제점

이원철 ( Won Chul Lee ),조충현 ( Choong Hyun Jo ),정경원 ( Kyoung Won Jung ),민영기 ( Young Gi Min ),최상천 ( Sang Cheon Choi ),김기운 ( Gi Woon Kim ),안정환 ( Jung Hwan Ahn ),정용식 ( Yong Sik Jung ),황선애 ( Sun Ae Hwang ),김지 대한외상학회 2010 大韓外傷學會誌 Vol.23 No.1

Purpose: Trauma is one of the leading causes of death, especially among young people. Life-threatening conditions are very common in multiple-traumatized patients due to concurrent multi-organ injuries. Treating such severely injured patients is time critical. However, in Korea, the transfer of severely injured patients is not uncommon due to the lack of a mature trauma care system. In developed countries, the preventable trauma death rate is very low, but the rate is still very high in Korea. This study`s objective was to demonstrate the current serious state in which severely injured patients have to be transferred from a Regional Emergency Medical Center even though it actually serves as a trauma center. Methods: Ajou University Medical Center is a tertiary hospital that serves as a trauma center in Gyeonggido. The medical records at Ajou University Medical Center for a 1-year period from January 1, 2008, to December 31, 2008, were retrospectively reviewed. A severely injured patient was defined as a patient who showed more than 15 point on the ISS (injury severity score) scale. We investigated the clinical characteristics of such patients and the causes of transfer. Results: Out of 81,718 patients who visited the Regional Emergency Medical Center, 19,731 (24.1%) were injured patients. Among them, 108 severely-injured patients were transferred from one Regional Emergency Medical Center to other hospitals. The male-to-female ratio was about 3.5:1, and the mean ISS was 23.08. The most common mechanism of injury was traffic accidents (41.7%). A major cause of transfer was the shortage of intensive care units (44.4%); another was for emergent operation (27.8%). Most of the hospitals that received the severely-injured patients were secondary hospitals (86.1%). Conclusion: Although the Regional Emergency Medical Center played a role as a trauma center, actually, severely-injured patients had to be transferred to other hospitals for several reasons. Most reasons were related with the deficiencies in the trauma care system. If a mature trauma care system is well-organized, the numbers of transfer of severely injured patients will be reduced significantly. (J Korean Soc Traumatol 2010;23:6-15)

H-이진트리체제의 타임스탬프 프로토콜 분석

정경원(Kyung-won Jung),도경화(Kyoung-Hwa Do),전문석(Moon-Seog Jun) 한국전자거래학회 2002 한국전자거래학회지 Vol.7 No.2

위분문부 및 식도암 환자에서 경열공 식도절제술

최동휘,정경원,김동헌,Choi Dong-Hui,Jung Kyoung-Won,Kim Dong-Heon 대한위암학회 2005 대한위암학회지 Vol.5 No.1

목적: 현재 위분문부 및 식도암에 대한 근분 치로 원칙은 수술적 치료이며, 이에 대한 방법으로는 기존에는 주로 개흉을 요하는 McKeown술식(transthoracic esophagectomy, TTE)을 시행하였으나 최근에는 개흉술을 시행하지 않고 경열공을 통한 식도절제술(transshiatal esophagectomy, THE)도 많이 시행하고 있다. 이에 최근 본원에서 시행한 TTE와 THE의 임상 및 병리 결과를 분석하여 봄으로써 기존의 TTE에 대한 THE의 유용성에 대해 고찰해 보고자 한다. 상 및 방법: 최근 10년간 부산대학교병원에서 식도 및 위분문부암으로 진단 받고 수술적 치료를 받은 52예를 대상으로 후향적으로 자료를 수집, 분석하였다. 결과: 총 52예 중 20예에서 TTE를 32예에서 THE를 시행하였다. TTE는 중간부식도암 12예, 하부식도암 8예에서 시행되었고, THE는 중간부식도암 7예, 하부식도암 15예, 위분문부암 10예에서 시행되었다. TTE 후 식도대체장기로는 17예에서 위를, 3예에서 대장을 사용했으며, THE에서는 29예에서 위를, 3예에서 대장을 사용하였다. 술 후 합병증은 TTE를 시행한 13예(폐렴, 흉수 등 호흡기게 합병증 5예, 문합부유출 3예, 간병증 2예, 창상감염 1예, 패혈증 1예)에서, THE를 시행한 19예(문합부협착 13예, 흉수 3예, 문합부유출 1예, 창상감염 1예, 회귀후두신경마비 1예)에서 발생했다. 술 후 치료기간 동안 사망한 예는 TTE에서 1예 있었다. 수술 후 입원기간은 TTE에서 평균 25.6일, THE에서 20.6일 이었다. 결론: THE가 수술 이환율(morbidity)과 사망률(mortality)이 낮고 술식이 간편하여 시행하기가 용이하여 기존의 개흉을 통한 TTE 술식과 비교했을 때 식도절제를 요하는 대부분의 암환자들에게 유용한 술식이라 하겠다. Purpose: The debate is still on-going as to whether a transthoracic esophagectomy (TTE) or a transhiatal esophagectomy(THE) is the proper treatment for patients with cardia and esophageal cancers. This study tries to demonstrate and assess the efficacy and the validity of both surgeries. Materials and Methods: In a retrospective study, data from 52 cases of patients with esophageal and/or cardia cancer who received a surgical operation during the last decade were analyzed. Results: A TTE was done in 20 cases and a THE in 32 cases. The average times for the operations were 558.0 min for a TTE and 451.7 min for a THE (P>0.05). The estimated blood loss was 1,825.0 ml in a TTE and 1459.4 ml in a THE (P>0.05). The amounts of transfusion during the operations were 3.9 units in a TTE and 2.6 units in a THE (P<0.05). Post-operative complications occurred in 15 cases of TTE and 23 cases of THE. The average length of stay in the hospital was 25.6 days for a TTE and 20.6 days for a THE. The 5-year survival rate was $10\%$ for TTE patients and $28\%$ for THE patients (P>0.05). Conclusion: For most factors, including morbidity and mortality, there was no statistically significant difference between a TTE and a THE. However, a THE is expected to be more convenient, leading to a shorter operative duration, a shorter post-operative hospitalization and lesser amounts of hemorrhage and transfusion. Hence, the THE may be a more valid or efficient surgical method for those patients with cardia and esophagus cancer who require a resection of the esophagus. (J Korean Gastric Cancer Assoc 2005;5:1-9)

일개 외상외과에서의 중증외상환자 1년 치료 경험 분석

김태연 ( Tae Yoen Kim ),정경원 ( Kyoung Won Jung ),권준식 ( Jun Sik Kwon ),김지영 ( Ji Young Kim ),백숙자 ( Suk Ja Baek ),송서영 ( Seo Young Song ),강찬숙 ( Chan Suk Gang ),이국종 ( Kug Jong Lee ) 대한외상학회 2011 大韓外傷學會誌 Vol.24 No.1

Purpose: Recently, social interest in an organized trauma system for the treatment of patients has been increasing in government and academia and the establishment of trauma center is being considered across the country. However, establishing such a system has not been easy in Korea, because enormous experiences and resources are necessary. The objectives of this study were (1) to estimate a trauma patient`s demands during the course of treatment and (2) to provide appropriate direction for trauma centers to be established in Korea. Methods: The records of 207 patients who were admitted to the Department of Trauma Surgery in Ajou University Medical Center due to trauma were retrospectively reviewed for a 1 year period from March 2010 to February 2011. Patients were reviewed for general characteristics, number of hospital days, numbers and kinds of surgeries, numbers and kinds of consultations, ISS (Injury Severity Score) and number of patients with ISS more than 15. Results: All 207 patients were enrolled. The average number of hospital days was 36.7 days. The ICU stay was 15.9 days, and the general ward stay was 20.8 days. Admitted patients occupied 9.02 beds in ICU and 11.80 beds in the general ward per day. The average number of surgeries per patient was 1.4, and surgery at the Department of Trauma Surgery was most common. Number of consultations per patient was 14.23, and consultations with orthopedic surgeons were most common. The average ISS was 18.6. The number of patients with ISS more than 15 was 141 (61.8%) and the average number of patients treated per trauma surgeon as a major trauma patient was 94.3. The number of mortalities was 20, and the mortality rate was 9.7%. Conclusion: To reduce mortality and to provide proper treatment of patients with major trauma, hospitals need some number of beds, especially in the ICU, to treat patients and to prepare them for emergent surgery. An appropriate number of trauma surgeons and various specialists for consultation are also needed. (J Korean Soc Traumatol 2011;24:37-44)

담지·소성법을 이용하여 MgO 코팅된 고기능성 세라믹 마이크로 필터의 폐수 내 유해중금속 제거 특성 연구

이선용(Seon Yong Lee),정경원(Kyung-Won Jung),임영재(Yeong Jae Lim),서경수(Kyoung Su Seo),이영재(Young Jae Lee) 대한지질학회 2018 대한지질학회 학술대회 Vol.2018 No.10

대학병원 응급의료센터로 전원되는 중증 외상환자의 현황 및 문제점

한상수 ( Sang Soo Han ),정경원 ( Kyoung Won Jung ),권준식 ( Jun Sik Kwon ),김지영 ( Hu Young Kim ),최상천 ( Sang Cheon Choi ),이국종 ( Kug Jong Lee ) 대한외상학회 2011 大韓外傷學會誌 Vol.24 No.2

Purpose: The incidence of multiple trauma is increasing nowadays and is the leading cause of death among young adults, Initial treatment is well known to be crucial in multiple trauma victims. However, many indiscriminate transfers occur due to the lack of a well-organized trauma system in Korea. The objective of this study is to demonstrate the current serious state in which major trauma patients are transferred to the Emergency Medical Center of a university hospital from another medical center. Methods: From November 2009 to October 2010, we performed a retrospective study to analyze the characteristics of patients who visited the Ajou University Medical Center located in Gyeonggi-do. We evaluated the ISS (injury severity score), and a score over 15 point was identified as major trauma. The major trauma patients were separated into two groups according to the visit route, and the characteristics of each group were analyzed. Results: Among the 88,862 patients who visited to the Emergency Medical Center, trauma patients accounted for 19,950, and 343 of them were evaluated as major trauma patients. Among the 343 patients, 170 patients had been transferred from other medical centers. The proportion of males to females was 3.3:1, and the mean ISS was 22.7. The leading cause of trauma was motor vehicle accidents. Of the total 170 patients, 77.6% were admitted to the Intensive care unit and 36.3% underwent surgery. The 170 patients that had been transferred to our medical center, 78.8% were transferred from Gyeonggi-do, 15.3% were transferred from other regions, and 5.9% were miscellaneous, Conclusion: Almost half of the major trauma victims treat at our medical center had been transferred from other medical centers, Establishing a traumatic system, supported by well-organized trauma centers and emergency medical services, that can reduce inappropriate transfers among medical facilities is essential.

증례 : 감염 ; 결핵성복막염에 의한 간동맥류 1예

유훈 ( Hoon Yu ),이승범 ( Seung Bum Lee ),정경원 ( Kyoung Won Jung ),박현정 ( Hyun Jung Park ),조정제 ( Jung Je Cho ),박영훈 ( Young Hoon Park ),김성한 ( Sung Han Kim ) 대한내과학회 2011 대한내과학회지 Vol.80 No.6

감염성 동맥류는 대부분의 경우 무증상이거나 비 특이적인 증상을 보여 진단이 어려운 질환이다. 그러므로 진단이되지 못하거나 늦어짐으로써 생명을 잃는 수도 있다. 본 증례는 결핵성 복막염으로 치료받던 환자에게서 간동맥에 발생한 감염성 동맥류를 진단하였으며, 성공적 치료를 시행한경우이다. 감염성 동맥류는 드물지만 환자의 생명과 직결되는 상황을 초래할 수 있는 질환으로 감염성 질환의 진단과 치료를 하는 데 있어 이러한 합병증의 가능성을 항상 염두에 두어야겠다. A 28-year-old man was admitted due to abdominal pain and nausea. The patient had been diagnosed with peritoneal tuberculosis and was being treated with anti-tuberculous drugs. After 7 months of therapy, he developed abdominal pain, nausea, and melena. Gastrofiberscopy showed a duodenal ulcer and fistular opening. Abdominal CT revealed an aneurysm of the replaced hepatic artery due to abdominal tuberculous lymphadenopathy. After embolization of the aneurysm, his symptoms improved. Although mycotic aneurysm occurs rarely as a complication of tuberculous lymphadenopathy, it should be diagnosed as early as possible because of the high rate of rupture and associated high mortality. (Korean J Med 2011;80:734-738)