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      • Ergonomic-friendly total laparoscopic hysterectomy versus conventional abdominal hysterectomy: surgical outcomes

        ( Hwajung Lee ),( Kyung Jin Eoh ),( Jung-yun Lee ),( Eun Ji Nam ),( Sunghoon Kim ),( Sang Wun Kim ),( Young Tae Kim ) 대한산부인과학회 2019 대한산부인과학회 학술대회 Vol.105 No.-

        Objective: Ergonomic constraints of surgeons have been a pivotal issue in minimally invasive surgery. The repetitive motion injuries can occur when surgeons are improperly positioned or uncomfortable while performing surgery. We sought to compare surgical outcomes between ergonomic-friendly total laparoscopic hysterectomy (EF-TLH) that aims to ease the physical workload of laparoscopists and conventional abdominal hysterectomy (TAH). Methods: A retrospective review of 1970 patients who underwent ergonomic-friendly total laparoscopic hysterectomy (n=909) or conventional abdominal hysterectomy (n=1061) between July 2013 to February 2019 was done. The ergonomically friendly setting of laparoscopic surgery begins with adjustment of operator seating position with minimal musculoskeletal pressure and flexibility of port site locations that are suitable for each operation. Results: Both groups shared similar patients’ characteristics including age, BMI, parity, pre-operative hemoglobin and previous abdominal surgery. EF-TLH group showed shorter operating time (P<0.001), less estimated blood loss (P<0.001), less post-operative hemoglobin drop (P=0.009), and fewer cases of transfusion during the operation (P<0.001). In the TAH group, the weight of the uterus was heavier, which is assumed to inevitably have more open cases as the uterus is larger. Conclusion: EF-TLH can be practical substitution for TAH with less operating time and blood loss when a hysterectomy is considered to be done laparoscopically while supporting optimal position of laparoscopists during surgery.

      • KCI등재

        Assessment of Temporary Radioactivation for Tissue Expanders in Breast Radiation Therapy: Preliminary Study

        Lee Hwajung,Oh Do Hoon,Yoo Lee,전민수 대한방사선방어학회 2023 방사선방어학회지 Vol.48 No.2

        Background : As breast tissue expanders consist of metallic materials in the needle guard and ferromagnetic injection port , irradiation can produce radioactivation . Materials and Methods : A CPX4 (Mentor Worldwide LLD) breast tissue expander was ex- posed using the Versa HD (Elekta) linear accelerator. Two photon energies of 6 and 10 MV-flat- tening filter free (FFF) beams with 5 , 000 monitor units (MU) were irradiated to identify the types of radiation . Furthermore , 300 MU with 10 MV-FFF beam was exposed to the CPX4 breast tissue expander by varying the machine dose rates (MDRs) 600 , 1 , 200 , and 2 , 200 MU/ min . To assess the instantaneous dose rates (IDRs) solely from the CPX4 , a tissue expander was placed outside the treatment room after beam irradiation , and a portable radioisotope identifi- cation device was used to identify the types of radiation and measure IDR . JRPR Results and Discussion : After 5 , 000 MU delivery to the CPX4 breast tissue expander, the en- ergy spectrum whose peak energy of 511 keV was found with 10 MV-FFF, while there was no resultant one with 6 MV-FFF. The time of each measurement was 1 minute , and the mean IDRs from the 10 MV-FFF were 0 . 407 , 0 . 231 , and 0 . 180 μSv/hr for the three successive measure- ments . Following 10 MV-FFF beam irradiation with 300 MU indicated around the background level from the first measurement regardless of MDRs . Conclusion : As each institute room entry time protocol varies according to the working hours and occupational doses , we suggest an addition of 1 minute from the institutes’ own room entry time protocol in patients with CPX4 tissue expander and the case of radiotherapy vaults equipped with a maximum energy of 10 MV photon beams .

      • SCISCIESCOPUS
      • Da Vinci SP single-port robot-assisted radical trachelectomy and sentinel lymph node mapping

        ( Hwajung Lee ),( Sang Wun Kim ) 대한산부인과학회 2020 대한산부인과학회 학술대회 Vol.106 No.-

        Objective: Demonstrate a new instrument, technique or procedure Target: Adanced practicioners Methods: 31-year-old single woman who was diagnosed with poorly differentiated invasive squamous cell carcinoma on cervical biopsy was scheduled for robot-assisted trachelectomy for fertility-sparing. She showed no sign of gross mass or distant metastases on MRI and PET-CT imaging and clinical staging was IB1. In order to minimize complication and still retain radicality, the sentinel lymph node mapping with indocyanine green was planned. About 2.5cm long incision was made on umbilicus and we used GelPOINT Mini platform to insert a trocar for Da Vinci SP system as well as 12mm assistant trocar. During the operation, a fenestrated bipolar forcep, cautery spatula, ProGrasp forcep, and Mega Needle driver were used on Da Vinci SP system. In order to refer to sentinel node imaging, a monitor connected to PINPOINT endoscopic fluorescence imaging camera was placed next to robot console. After inserting uterine manipulator (RUMI), indocyanine green (ICG: 1.25mg/mL) was injected 1mL each in superficial and deep uterine cervix at 3 and 9 Oclock direction. A 5mm PINPOINT endoscopic scope was applied through assistant port and allowed real-time visualization of sentinel lymph node. Bilateral pelvic sentinel lymph nodes were identified on PINPOINT monitor and dissection was done with Da Vinci SP system. Uterine artery braches were dissected and only cervical and vaginal braches of uterine arteries were ligated. After skeletonizing both ureters, parametrium was excised and colpotomy was performed. The pathologic part of cervix was cut out and frozen biopsy on the resection margin was sent to pathology. With 1-0 Proline, cervical cerclage was done on the isthmic portion. Then the uterus and vaginal cuff was sutured with Quill 1-0 by single continuous manner. Results: Fertility-sparing trachelectomy with sentinel lymph node mapping was successfully executed using Da Vinci SP system and PINPOINT as assisting imaging device. The patient was discharged two days after the surgery without complication and showed no sign of recur after 6 months. Conclusion: Assisting imaging with near-infrared fluorescence camera with Da Vinci SP system can be efficient substitution for previous Da Vinci robot systems with multi-port arms while limiting the scar only to umbilicus and minimizing surgical complication by sentinel lymph node dissection.

      • Ergonomic-friendly total laparoscopic hysterectomy versus conventional laparoscopic hysterectomy for preinvasive cervical disease

        ( Hwajung Lee ),( Kyung Jin Eoh ),( Jung-yun Lee ),( Eun Ji Nam ),( Sunghoon Kim ),( Sang Wun Kim ),( Young Tae Kim ) 대한산부인과학회 2020 대한산부인과학회 학술대회 Vol.106 No.-

        Objective: To demonstrate ergonomic-friendly surgical approach that aims to ease the physical workload of laparoscopists for total laparoscopic hysterectomy and compare surgical outcomes between ergonomic-friendly total laparoscopic hysterectomy (EF-TLH) and conventional total laparoscopic hysterectomy for preinvasive uterine disease. Methods: As the field of minimally invasive surgery grows, laparoscopists are exposed to risk of developing musculoskeletal disease due to increase in physical workload. The repetitive motion injuries occur when surgeons remain static position or improperly positioned while performing surgery. We sought to minimize physical burden to laparoscopists while performing total laparoscopic hysterectomy which is one of the most common gynecological surgery. Also, a retrospective review of 277 patients with pre-invasive uterine disease who underwent ergonomic-friendly total laparoscopic hysterectomy (n=150) or conventional total laparoscopic hysterectomy (n=81) between July 2013 to May 2019 (Table 1) was done. Preinvasive uterine disease included all stages of cervical intraepithelial neoplasia as well as pathologically-proven carcinoma in situ and patients with underlying benign uterine condition such as uterine myoma or adenomyosis were excluded. Results: In terms of surgical outcome of two groups, operating time was significantly shorter in EF-TLH group and estimated blood loss was much less in EF-TLH group. Post-op hemoglobin drop and transfusion during operation showed no significant difference between two groups. Conclusion: EF-TLH is efficient substitution for conventional TLH under similar circumstances with less operating time and blood loss when a hysterectomy is considered to be done while supporting optimal position of laparoscopists during surgery.

      • Oseltamivir-Resistant Pandemic (H1N1) 2009 Virus, South Korea

        Yi, Hwajung,Lee, Joo-Yeon,Hong, Eun-Hye,Kim, Mi-Seon,Kwon, Donghyok,Choi, Jang-Hoon,Choi, Woo-Young,Kim, Ki-Soon,Lee, Jong-Koo,Oh, Hee-Bok,Kang, Chun Centers for Disease Control and Prevention 2010 Emerging infectious diseases Vol.16 No.12

        <P>To identify oseltamivir resistance, we analyzed neuraminidase H275Y mutations in samples from 10 patients infected with pandemic (H1N1) 2009 virus in South Korea who had influenza that was refractory to antiviral treatment with this drug. A neuraminidase I117M mutation that might influence oseltamivir susceptibility was detected in sequential specimens from 1 patient.</P>

      • KCI등재

        공항 종사원의 내부마케팅과 고용형태가 고객지향성에 미치는 영향

        이화정 ( Hwajung Lee ),이상학 ( Sanghak Lee ) 한국항공경영학회 2021 한국항공경영학회지 Vol.19 No.4

        전 세계적으로 항공 운송 시장은 지속적으로 성장추세에 있으며, 코로나19로 인해 다소 주춤한 현황이지만 2024년도 이후에는 회복되어 정상적인 항공 운항과 공항간의 치열한 경쟁이 예상되고 있다. 따라서, 공항간 경쟁에서 경쟁력을 갖추기 위하여 공항마케팅과 공항종사원의 서비스 품질 향상이 중요하다. 공항종사원의 서비스 향상을 위한 내부마케팅 및 최근 정규직으로 전환된 고용형태 변화로 인한 고용안정성이 직무만족과 심리적 주인의식 그리고 고객지향성에 미치는 영향에 대해 규명하고자 한다. 이를 위해 본 연구는 내부마케팅의 구성요인을 평가보상, 경영진 지원, 내부 커뮤니케이션, 교육훈련으로 구분하였고, 최근 정규직으로 고용형태의 변화가 있었던 점을 고려하여 고용안정성을 변수로 활용하였다. 본 연구는 전국공항의 종사원을 대상으로 378명의 설문자료를 수집하여 분석하였고, 구조방정식 모형(SEM)을 통해 각 변수간의 관계를 분석하였다. 분석결과, 내부마케팅 구성요인(평가보상, 경영진 지원, 내부 커뮤니케이션, 교육훈련) 중 평가보상과 경영진 지원이 직무만족에 유의한 정(+)의 영향을 미쳤고, 고용안정성은 직무만족과 심리적 주인의식에 모두 유의한 정(+)의 영향을 미치는 것으로 확인되었다. 무엇보다도 고용안정성이 심리적 주인의식에 매우 큰 영향을 미쳤으며, 심리적 주인의식은 고객지향성에 미치는 영향 또한 큰 것으로 확인되었다. 다만, 직무만족은 고객지향성과의 관계에 있어 유의하지 않은 것으로 나타났다. 즉, 공항 종사원을 대상으로 공정하고 다양한 가시적 보상과 함께 적극적인 경영진과의 커뮤니케이션을 통한 경영진의 지원은 종사원의 직무만족과 고객지향성에 긍정적인 영향을 미치며, 심리적 주인의식을 더욱 강화시키는 요인이 될 것이라는 시사점을 발견하였다. The air transportation market is seeing continuous growth around the world. Although it had been stalled due to the COVID-19, its full recovery is predicted by 2024, with normal air operations and intense competition among airports. Therefore, it is important to improve airport marketing and service quality provided by the airport employees in order to gain competitiveness among airports. The current study aims to identify the specific impact of internal marketing for service improvement among airport employees. In addition, the influence of the transformation of employment on employment stability, job satisfaction, psychological ownership, and customer orientation is also analyzed. Therefore, this study divided the components of internal marketing into evaluation compensation, management support, internal communication, and education and training. The study collected data from 378 survey respondents who are currently employed at the various airports in South Korea. The relationships among the research variables were analyzed using the Structural Equation Model (SEM). The results indicated that compensation evaluation and management support of internal marketing components were affected significantly (+) for job satisfaction. Employment stability has also been confirmed to have a positive effect on both job satisfaction and psychological ownership. Above all, it has been confirmed that employment stability has a very large effect on psychological ownership and psychological ownership also has a large effect on customer orientation. However, job satisfaction has been shown to be insignificant in relation to customer orientation. Therefore, through active communication between management and staff, where the latter is compensated fairly and accordingly, along with the support from the management we saw a positive impact on the overall job satisfaction and customer orientation. We found the latter implications would be a strong factor that'd further strengthen the psychological ownership factor.

      • SCIESCOPUSKCI등재

        Immunological characterization of monoclonal antibodies used in rapid influenza diagnostic test for detection of the 2009 pandemic influenza A(H1N1)pdm09 infection

        Yi, Hwajung,Lee, Mi-Seon,Lee, Joo-Yeon,Lee, Hae Kyung,Kang, Chun Springer-Verlag 2015 The journal of microbiology Vol.53 No.2

        <P>Since the 2009 pandemic, monoclonal antibodies (mAbs) for rapid influenza diagnostic tests (RIDT) have been developed for specific diagnostics of pandemic viral infection. Most of the mAbs were poorly characterized because of urgency during the pandemic. Further characterization of the mAbs for RIDTs would be beneficial for understanding the immunological properties of the pandemic virus and utilizing the mAbs for other research purposes. In this study, it was confirmed that two mAbs (138 and D383) in an RIDT for H1N1pdm09 diagnostics were able to detect H1N1pdm09 virus through enzyme-linked immunosorbent assay (ELISA) and immunofluorescence assay (IFA). Also, the two mAbs exhibited reactivity to hemagglutinins (HAs) of both the H1N1pdm09 and 1918 H1N1 viruses; therefore, the RIDT using the mAbs could detect HAs of H1N1pdm09 and also HAs of 1918 H1N1-like strains. In an extension to our previous study, the epitopes (Sa antigenic site and the interface area of F' and vestigial esterase subdomahis on the HA1 domain of HA of H1N1pdm09) recognized by the mAbs were corroborated in depth by IFA with escape-mutants from the mAbs and mapping of the epitopes on the crystal structure of human H1N1 viral HAs. Collectively, these results imply that the mAbs for the RIDT may be suitable for use in studying the immunological properties of H1N1pdm09 viruses and that the Sa antigenic site and the interface area between F' and vestigial esterase subdomains on influenza viral HA recognized by the mAbs are immunologically conserved regions between H1N1pdm09 and 1918 H1N1.</P>

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