• Journal of Chest Surgery
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• v.56 no.6
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• pp.435-444
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• 2023

Background: Edwards Intuity is recognized as a relatively contraindicated bioprosthesis for bicuspid aortic valve disease. This study compared the early echocardiographic and clinical outcomes of rapid-deployment aortic valve replacement for bicuspid versus tricuspid aortic valves. Methods: Of 278 patients who underwent rapid-deployment aortic valve replacement using Intuity at Seoul National University Hospital, 252 patients were enrolled after excluding those with pure aortic regurgitation, prosthetic valve failure, endocarditis, and quadricuspid valves. The bicuspid and tricuspid groups included 147 and 105 patients, respectively. Early outcomes and the incidence of paravalvular leak were compared between the groups. A subgroup analysis compared the outcomes for type 0 versus type 1 or 2 bicuspid valves. Results: The bicuspid group had more male and younger patients. Comorbidities, including diabetes mellitus, hypertension, chronic kidney disease, and coronary artery disease, were less prevalent in the bicuspid group. Early echocardiographic evaluations demonstrated that the incidence of ≥mild paravalvular leak did not differ significantly between the groups (5.5% vs. 1.0% in the bicuspid vs. tricuspid groups, p=0.09), and the early clinical outcomes were also comparable between the groups. In the subgroup analysis between type 0 and type 1 or 2 bicuspid valves, the incidence of mild or greater paravalvular leak (2.4% vs. 6.7% in type 0 vs. type 1 or 2, p=0.34) and clinical outcomes were comparable. Conclusion: Rapid-deployment aortic valve replacement for bicuspid aortic valves demonstrated comparable early echocardiographic and clinical outcomes to those for tricuspid aortic valves, and the outcomes were also satisfactory for type 0 bicuspid aortic valves.

• Journal of Chest Surgery
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• v.32 no.11
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• pp.1042-1045
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• 1999

Background: Recently, open heart surgerys using homograft are progressively increasing in complex cardiac anomalies, and even though the use of homograft tissues harvested from hearts of transplant recipients and brain-death patients are allowed and their use is increasing, the supply of homograft tissue is very limited. Material and Method: The large diameter homografts are difficult to apply directly for RVOT reconstruction of small neonatal and infant hearts due to the size mismatching. Therefore, were surgically down-sized the large diameter tricuspid homograft into bicuspid conduits by means of a longitudinal incision of the oversized homograft, excision of one cusp, and oversewing of the“Bicuspid homograft”wrapped around a Hega dilator of the appropriate size. Result: 3 patients(Male 1, Female 2: tetralogy of Fallot with pulmonary atresia), ranging in age from 5 months to 4 years and ranging in weight from 5.5Kg to 12.95Kg underwent reconstruction of the RVOT with bicuspid conduits obtained by appropriate tailoring from large-diameter homografts. The mean follow-up period was 4.3 months(range, 2 to 6 months). There were no complications related to the homograft tissues. Conclusion: In the short term follow-up, the bicuspid homografts provided good competence and excellent hemodynamics although a long term follow-up is needed to assess the functions of the bicuspid homografts in RVOT. We believe this technique may be a more effective alternative than the use of synthetic conduits when the use of an appropriate-sized homograft is not possible.

• Korean Journal of Radiology
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• v.22 no.6
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• pp.890-900
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• 2021

Objective: To identify the association between morphological and functional characteristics of the bicuspid aortic valve (BAV) and bicuspid aortopathy and to identify the determinants of aortic dilatation using transthoracic echocardiography (TTE) and cardiac computed tomography (CCT). Materials and Methods: This study included 312 subjects (mean [SD] age, 52.7 [14.3] years; 227 males [72.8%]) who underwent TTE and CCT. The BAVs were classified by anterior-posterior (BAV-AP) or right-left (BAV-RL) orientation of the cusps and divided according to the presence (raphe+) or absence of a raphe (raphe-) based on the CCT and intraoperative findings. The dimensions of the sinus of Valsalva and the proximal ascending aorta were measured by CCT. We assessed the determinants of aortic root and proximal ascending aortic dilatation (size index > 2.1 cm/m²) by Univariable and multivariable logistic regression analyses. Results: Of the 312 patients, BAV-AP was present in 188 patients (60.3%), and 185 patients (59.3%) were raphe+. Moderate-to-severe aortic stenosis (AS) was the most common hemodynamic abnormality (54.8%). The most common type of aortopathy was the combined dilated root and mid-ascending aortic phenotype (62.5%). On multivariable analysis, age and AS severity were significantly associated with aortic root dilatation (p < 0.05), and age, sex, and AS severity were significantly associated with ascending aortic dilatation (p < 0.05). However, the orientation of the cusps, presence of a raphe, and severity of aortic regurgitation were not associated with aortic root and ascending aortic dilatation. Conclusion: BAV morphological characteristics were not determinants of aortic dilatation. Age, sex, and AS severity were predictors of bicuspid aortopathy. Therefore, age, sex, and AS severity, rather than valve morphology, need to be considered when planning treatment for BAV patients.

• The Journal of Korean Academy of Prosthodontics
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• v.29 no.2
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• pp.147-160
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• 1991

The purpose of this study was to examine, by the method of finite element analysis, how implant geometry with or without connection between natural tooth and osseointegrated abutments affected the stress distribution in surrounding bone and osseointegrated prosthesis. The mandibular first and second molars were removed and the two osseointegrated implants were placed in the first and second molar sites. Stress analysis induced by prostheses with connection(Model A)or without connection(Model B) between natural tooth(second bicuspid) and two osseointegrated abutments(first molar and second molar) was performed under vertical point load(Load P1) or distributed point load(Load P2). The results were as follows; 1. Under vertical point load, mesial tilting was shown in both Model A and Model B and inferior displacement of Model A was greater than that of Model B in the second bicuspid. 2. Under vortical point load, the first and second molars showed mesial tilting in both Model A and Model B, and inferior displacement of them was similar in Model A and Model B and was less than that of the second bicuspid. 3. Under distributed point load, mesial displacement was shown in Model A and Model B and inferior displacement of Model A was less than that of Model B in the second bicuspid. 4. Under distributed point load, mesial tilting was shown and inferior displacement of Model A was similar to that of Model B in the first and second molars. 5. In Model A under vertical point load, high stress was concentrated in the corneal portion of first molar and distributed throughout the second molar and the second bicuspid, and the stress distribution of the second molar was greater than that of the second bicuspid. 6. In Model B under vertical point load, high stress was concentrated in the coronal and mesio-cervical portion of the first molar. 7. In Model A under distributed point load, high stress was concentrated in the mesio-cervical portion of the first molar and evenly distributed throughout the second molar and the second bicuspid. 8. In Model B under distributed point load, high stress was concentrated in the disto-cervical portion of the second bicuspid and evenly distributed throughout the first and second molars.

• The korean journal of orthodontics
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• v.16 no.2
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• pp.123-133
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• 1986

The purpose of this study was to collect the information of the straight-wire appliance and to determine the amount of second-order bends in clinical orthodontics. The author analysed the study model of 50 individuals with normal occlusion and results were obtained as follows. 1. The crown angulation was 4 degree in upper central incisor, 7 degree in upper lateral incisor, and 0 degree in lower central incisor and lateral incisor. 2. The crown angulation was 8 degree in upper cuspid and 2 degree in lower cuspid. 3. The crown angulations were 4 degree in upper first bicuspid, upper second bicuspid and lower second bicuspid and 1 degree in lower first bicuspid. 4. The crown angulation was 3 degree in upper first molar, 0 degree in upper second molar, 5 degree in lower first molar and 8 degree in lower second molar. 5. The crown angulations in lower arch were progressively increased from first premolar to second molar. 6. In upper arch, as the crown angulation of one tooth was increased, those of adjacent teeth were increased, too. 7. In the case of lower arch, the crown angulation of cuspid was increased as that of lateral incisor was increased, the crown angulation of second premolar was increased as that of first premolar was increased, and similarity the crown angulation of second molar was increased as that of first molar was increased.

• Journal of the korean academy of Pediatric Dentistry
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• v.3 no.1
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• pp.48-51
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• 1976

Surveying the developmental degree of the crowns of mandibular first bicuspid in 566 korean children (264 males and 302 females) from 3 to 7 years of age by oblique cephalogram, the author got to the following results. 1. The developmental degree of the tooth crown of mandibular first bicuspid was earlier in female than in male. 2. The period of complete development of the crown of mandibular first bicuspid was 7 year 1 month in male and 6 year 3 month in female. 3. There was no significant difference in the period of complete development of the tooth crown compared with that of Japanese and American children.

• Korean Journal of Radiology
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• v.24 no.10
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• pp.960-973
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• 2023

The bicuspid aortic valve (BAV) is the most common congenital cardiovascular malformation. Patients with BAV are at higher risk of other congenital cardiovascular malformations and valvular dysfunction, including aortic stenosis/regurgitation and infective endocarditis. BAV may also be related to aortic wall abnormalities such as aortic dilatation, aneurysm, and dissection. The morphology of the BAV varies with the presence and position of the raphe and is associated with the type of valvular dysfunction and aortopathy. Therefore, accurate diagnosis and effective treatment at an early stage are essential to prevent complications in patients with BAV. This pictorial essay highlights the characteristics of BAV and its related congenital cardiovascular malformations, valvular dysfunction, aortopathy, and other rare cardiac complications using multimodal imaging.

• The Journal of Korean Academy of Prosthodontics
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• v.33 no.1
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• pp.130-143
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• 1995

The purpose of this study was to analyze the magnitude and distribution of stress using photoelastic model with the rigid connection using T-block attachment and non-rigid connection using key & keyway attachment. The vertical load of 16 Kg was applied on the central fossa of the tooth, the pontic and the implant, and the pattern and distribution under each condition was analyzed. The following results were obtained : 1. In case of vertical load on the central fossa of the implant, the stress was concentrated at the apex of the implant involving the mesial alveolar bone in both fixed partial denture with the rigid connection and that with the nonrigid connection and the stress concentration at the mesial cervical area of the implant was a little more in the nonrigid connection than in the rigid connection. 2. In case of vertical load on the central fossa of the pontic, the stress was concentrated at the apex of 2nd bicuspid in both 3 unit fixed partial denture with nonrigid connection and that with the rigid connection. The stress was more concentrated at the mesial alveolar bone of the implant, but the stress distribution at the natural teeth more favorable at the rigid connection than at the non-rigid connection in case of 4 unit fixed partial denture. 3. In case of vertical load of the central fossa of the 2nd bicuspid, much stress with 3 fringe order was observed at the apex of the 2nd bicuspid in the 3 unit fixed partial denture, but relatively even stress distribution was observed at the apex of the implant, the 1st and 2nd bicuspid, and the adjacent cuspid in the 4 unit fixed partial denture.

• The Journal of Korean Academy of Prosthodontics
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• v.18 no.1
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• pp.99-109
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• 1980

An investigation was made Into 1,357 fixed bridges which had been performed at the Department of Prosthetic Dentistry, Seoul National University Hospital from 1973 to 1979. The purpose of this investigation was to establish a basic reference of the treatment with fixed bridges by obtaining statistical conclusions from the data concerning the patients who had been treated with fixed bridges. The following conclusions were obtained; 1. The ratio of the fixed bridges made on the maxillae to those made on the mandible was 1:1. 2. The cases of fixed bridges with one pontic were the most frequent, i.e., 946 cases out of total 1,357 cases, which were 69.7% of the total. 3. As the number of missing teeth increased, the number of the relevant cases of fixed bridges decreased. 4. The most frequent age group of the patients who had been treated with fixed bridges was the twenties, which was 40.8% of the total. As the age of the patients increased, the number of corresponding cases of fixed bridges decreased. 5. Most of the fixed bridges with more than three pontics were made at the anterior portion samely on the maxilla and on the mandible. 6. As for the retainers, the porcelain fused to metal crown and the partial veneer crown were frequently used at the anterior portion, while the full veneer crown was frequently used and the inlay and the attachment were used in some cases at the posterior portion. The locations of fixed bridges in the order of their frequency were: canine, lateral incisor, second bicuspid, central incisor, second molar, first bicuspid, first molar, and third molar on the maxilla; second bicuspid, second molar, first bicuspid, first molar, canine, third molar, lateral incisor, and central incisor on the mandible.

• Journal of Chest Surgery
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• v.55 no.5
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• pp.413-416
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• 2022

A 32-year-old woman diagnosed with Turner syndrome presented to the hospital for an evaluation of cardiovascular complications. Preoperative computed tomography (CT) and echocardiography showed progression of aortic root and ascending aorta dilatation, as well as a bicuspid aortic valve. There was no evidence of aortic regurgitation. We planned valve-sparing aortic root replacement and ascending aorta replacement with a high risk of aortic rupture. Intraoperatively, we incidentally found a juxtacommissural origin of the right coronary artery (RCA). We performed aortic valve reimplantation using a graft designed with a key-shaped hole to wrap the juxtacommissural-origin RCA by modifying the Florida sleeve technique. Coronary blood flow was patent on postoperative CT angiography, and there was no evidence of aortic regurgitation on postoperative echocardiography. The patient was discharged from the hospital on postoperative day 7 without any complications.