Intraoperative descending saphenography was performed in 20 legs (17 patients) with primary varicose veins to determine the sites of venous reflux (the sites of valve incompetence) in the great saphenous vein. By this phlebography, the sites of valve incompetence in the great saphenous trunk could be visualized when a pressure gradient was produced between deep and superficial venous systems by our manual compression technique. There were variations in the sites of truncal reflux; the retrograde flow of the contrast media was observed in the entire length of the great saphenous vein (type 1), normal portions were present in the trunk at the lower leg (type 2), or the trunk was normal at the thigh (type 3). In some cases, retrograde venous flow from the saphenous trunk entered once into variceal branches and further drained into the trunk passing some distance (3 legs). Type 2 and 3 accounted for 15 legs (75%), and selective stripping operation with preservation of the normal portion of the trunk was considered to be possible in these types. Since the length of the portion that could be preserved was 20.5±4.0cm (mean±SD) in type 2, and less than 15cm in 2 legs, use of the vein for arterial reconstruction seems to be limited.

Background
The Pacific Islands is an area with one of the world's highest prevalence of obesity and diabetes. The Republic of the Marshall Islands (RMI) is an independent country of the Micronesian that extends along latitude 4 to 18 degrees north. In the past, several studies reported regarding the prevalence of diabetes among the people of the Pacific Islands. However, there is no report yet with respect to diabetes in Majuro, the capital of RMI. In RMI, diabetes and obesity are also recognized to be a serious problem, but the present state of affairs prevents an understanding of the situation.
Objectives
The purpose of the present study was to investigate the present situation and the prevalence of diabetes and obesity in Majuro.
Methods
The participants were Marshallese visited our thyroid cancer-screening program. Among those participants who undertook thyroid cancer screening, the Body Mass Index (BMI) and hemoglobinA1c (HbA1c) levels were taken of 850 participants. Participants with an HbA1c level of 6.5% or more were put into the diabetes group and participants with a BMI of 30 and over were the obese group. Prevalence was adjusted using the Majuro population based on 1999 national census and using world standard population of Segi.
Results
The age-adjusted prevalence of diabetes in aged 20 years and over in Majuro was 22.1%. After standardization, the prevalence was 31.0%.
Conclusion
The results suggest there is a high rate of diabetes in RMI similar to other pacific islands. It could be concluded, based on this research, that there is a crisis situation with regards to diabetes in the RMI. There is also a need for epidemiological research to be on a random sample of the population.