Varicose vein Saphenous veins Ablation techniquesAlthough varicose veins are known to have a very high prevalence, there are many different treatment methods available.The optimal extent of treatment for the incompetent great saphenous vein has not yet been clearly established.Recent guidelines recommend the proper extent and method of treatment based on expert opinion.Considering complications and subjective data, such as symptoms and quality of life, above-the-knee treatment could be suggested.However, in terms of recurrence and objective data, below-the-knee treatment might be preferred.It would be better to approach treatment on a customized basis for each patient by carefully analyzing the results based on both subjective and objective data.

Seung Chul Lee, M.D., Tae Sik Kim, M.D., Sangchul Yun, M.D., Wooshik Kim, M.D., Heangjin Ohe, M.D., Sang Seob Yun, M.D. and Sung Ho Lee, M.D.. Ann Phlebology 2023;21:70-3. https://doi.org/10.37923/phle.2023.21.2.70

Wooshik Kim, M.D., Tae Sik Kim, M.D., Sangchul Yun, M.D., Heangjin Ohe, M.D., Seung Chul Lee, M.D., Sung Ho Lee, M.D. and Sang Seob Yun, M.D.. Ann Phlebology 2023;21:60-2. https://doi.org/10.37923/phle.2023.21.2.60

Sangchul Yun, M.D., Tae Sik Kim, M.D., Wooshik Kim, M.D., Heangjin Ohe, M.D., Seung Chul Lee, M.D., Sung Ho Lee, M.D. and Sang Seob Yun, M.D.. Ann Phlebology 2023;21:66-9. https://doi.org/10.37923/phle.2023.21.2.66

This paper addresses the syntatic aspect of a bound noun pa in Korean. Woo (2006) extensively discusses the bound noun pa in terms of syntax, semantics, and grammaticalization. Woo (2006) argues that there are two different syntactic structures of pa: a relative-clause structure with an ellipsis operation and a noun-complement-clause structure. However, the two structures appear to have empirical problems. Unlike normal relative clauses, pa cannot be separated into two different clauses, and the elided parts cannot have full pronunciation. The problem of the noun complement clause is that pa cannot be modified by adjectives. Given that pa can be replaced by a bound noun kes in general (Woo 2006), we may assume Kim’s (2016) N-to-n movement of kes. However, we find a difference between pa and kes in terms of an adjectival modification pattern. In this paper, I argue that pa directly merges in small n, and it takes an NP complement which is headed by a null noun. This analysis has more explanatory power than Woo (2006) in that it accounts for the related phenomena seamlessly, and its grammaticalized nature is directly reflected in the structure.

HeangJin Ohe, M.D., Tae Sik Kim, M.D., Wooshik Kim, M.D., Sangchul Yun, M.D., Seung Chul Lee, M.D., Sung Ho Lee, M.D. and Sang Seob Yun, M.D.. Ann Phlebology 2023;21:63-5. https://doi.org/10.37923/phle.2023.21.2.63

Tae Sik Kim, M.D., Sangchul Yun, M.D., Wooshik Kim, M.D., Heangjin Ohe, M.D., Seung Cheol Lee, M.D., Sung Ho Lee, M.D. and Sang Seob Yun, M.D.. Ann Phlebology 2023;21:53-9. https://doi.org/10.37923/phle.2023.21.2.53

Treatment for acute pulmonary embolism includes anticoagulation, thrombolysis, catheter-directed therapy, and surgical pulmonary embolectomy.Surgical embolectomy is indicated in select patients based on a risk/benefit assessment and when other treatment options are contraindicated.A multidisciplinary approach along with a meticulous surgical technique might significantly lower the mortality associated with surgical embolectomy.(

BACKGROUND:Although the number of vascular surgeries performed is increasing, the incidence of complications associated with this surgery has not improved and re-operations are frequently required. Thrombosis in a vessel is the most hazardous postoperative complication.OBJECTIVE:The aim of this study was to evaluate the anti-thrombotic and anti-inflammatory effects of sulodexide compared to aspirin in a rat model.METHODS:We divided the animals into three groups (sham (saline), aspirin, and sulodexide). The abdominal aorta was surgically opened and closed, primarily with 8/0 Prolene sutures. Postoperatively, saline, aspirin, or sulodexide was administered by oral gavage for 14 days to the rats. The degree of neovascularization, thrombus, calcification, inflammatory infiltrates, and fibrosis were analyzed histopathologically by hematoxylin and eosin staining.RESULTS:There was no significant difference in the incidence of postoperative thrombogenesis, but less calcification and inflammatory infiltrates were observed in the sulodexide group compared to the aspirin group. Histopathologic score revealed less infiltration of inflammatory cells and mild calcification for the sulodexide group (0.17±0.41 and 1.33±0.52, respectively) compared to the aspirin group (0.67±0.52 and 1.67±0.52, respectively) at days 14.CONCLUSIONS:This study offers the possibility that sulodexide could be used as an aspirin substitute for the postoperative management of vascular patients, with low gastrointestinal discomfort. In addition, it may also offer reduced postoperative calcification and inflammation.

Although the number of vascular surgeries using vascular grafts is increasing, they are limited by vascular graft-related complications and size discrepancy. Current efforts to develop the ideal synthetic vascular graft for clinical application using tissue engineering or 3D printing are far from satisfactory. Therefore, we aimed to re-design the vascular graft with modified materials and 3D printing techniques and also demonstrated the improved applications of our new vascular graft clinically. We designed the 3D printed polyvinyl alcohol (PVA) templates according to the vessel size and shape, and these were dip-coated with salt-suspended thermoplastic polyurethane (TPU). Next, the core template was removed to obtain a customized porous TPU graft. The mechanical testing and cytotoxicity studies of the new synthetic 3D templated vascular grafts (3DT) were more appropriate compared with commercially available polytetrafluoroethylene (PTFE) grafts (ePTFE; standard graft, SG) for clinical use. Finally, we performed implantation of the 3DTs and SGs into the rat abdominal aorta as a patch technique. Four groups of the animal model (SG_7 days, SG_30 days, 3DT_7 days, and 3DT_30 days) were enrolled in this study. The abdominal aorta was surgically opened and sutured with SG or 3DT with 8/0 Prolene. The degree of endothelial cell activation, neovascularization, thrombus formation, calcification, inflammatory infiltrates, and fibrosis were analyzed histopathologically. There was significantly decreased thrombogenesis in the group treated with the 3DT for 30 days compared with the group treated with the SG for 7 and 30 days, and the 3DT for 7 days. In addition, the group treated with the 3DT for 30 days may also have shown increased postoperative endothelialization in the early stages. In conclusion, this study suggests the possibility of using the 3DT as an SG substitute in vascular surgery.

Background: Esophageal reconstruction after esophagectomy is a complex procedure with high morbidity and mortality.Anastomotic leakage is more severe and frequent in patients with preoperative comorbidities and may present with septic conditions.Considering the possibility of an easier management of such cases, we evaluated the safety and feasibility of subcutaneous esophageal reconstruction in patients with high operative risks.Methods: We performed a non-randomized retrospective observational study on the 75 (subcutaneous: 21, intrathoracic: 54) esophageal cancer patients who underwent esophageal reconstruction either through subcutaneous or intrathoracic route between January 2003 and February 2015.Preoperative data including the estimated reasons for the selection of the subcutaneous route were obtained from medical charts.Clinical outcomes were evaluated and compared between the two groups.Results: The mean postoperative hospital stay was longer in the subcutaneous group than the overall group.Anastomotic leakage occurred more frequently in the subcutaneous group [10 (47.6%) vs. 7 (13%), P=0.004].Three major leakages resulted in chronic cutaneous fistula, but were successfully treated by lower neck reconstruction using radial forearm fasciocutaneous free flap (RFFF).There was no in-hospital mortality in the subcutaneous group.Conclusions: Subcutaneous esophageal reconstruction in high-risk patients showed a higher rate of anastomotic leakage.However, easier correction without fatal septic conditions could be obtained by primary repair or flap reconstruction resulting in lower perioperative mortality.Therefore, esophageal reconstruction through the subcutaneous route is not recommended as a routine primary option.However, in highly selected patients with unfavorable preoperative comorbidities or intraoperative findings, especially those with poor blood supply to the graft, graft hematoma or edema, or gross tumor invasion to surrounding tissues, esophageal reconstruction through the subcutaneous route may carefully be considered as an alternative to the conventional surgical techniques.

This paper discusses a bound noun tongan in Korean in terms of grammaticalization. As a bound noun, it cannot stand alone in a sentence, but requires...

OBJECTIVES In the treatment of patients with atrial fibrillation (AF), the efficacy and safety of epicardial thoracoscopic ablation (TA) versus endocardial catheter ablation (CA) using radiofrequency energy remains unclear. This meta-analysis was performed to assess the efficacy and safety of each ablation technique using a pooled comparative analysis. METHODS Studies comparing the efficacy and safety of TA and CA were identified by searching electronic databases. Those that reported patients' freedom from atrial arrhythmia and significant side effects were included. RESULTS Three randomized controlled trials (RCTs) and two retrospective cohort studies with a total of 587 patients were included in the meta-analysis (273 patients underwent TA and 314 patients underwent CA). The proportion of patients who were free of atrial arrhythmia without antiarrhythmic drugs during 12 months of follow-up was significantly higher after TA than after CA in the RCTs [P < 0.001; relative risk (RR), 1.77; 95% confidence interval (CI), 1.34-2.32] and in the retrospective cohort studies (P = 0.010; RR, 1.68; 95% CI, 1.12-2.51). The incidence of significant side effects during the post-procedural period was significantly higher in the TA group than in the CA group in both the RCT (P = 0.007; RR, 7.23; 95% CI, 1.71-30.49) and the retrospective cohort studies (P = 0.020; RR, 4.39; 95% CI, 1.33-14.46). CONCLUSIONS Based on the available data, TA was found to be more effective than CA in achieving freedom from atrial arrhythmia; however, TA had a higher rate of immediate post-procedural complications than CA.

This paper argues that an alleged ellipsis phenomenon in Standard Japanese (Saito, Lin and Murasugi 2008, Maeda and Takahashi 2013, inter alia), in...

Background: We compared the clinical outcomes of cardiac valve surgery in adult Jehovah’s Witness patients refusing blood transfusion to those in non-Jehovah’s Witness patients without any transfusion limitations. Methods: From 2005 to 2014, 25 Jehovah’s Witnesses (JW group) underwent cardiac valve surgery using a blood conservation strategy. Twenty-five matched control patients (non-JW group) were selected according to sex, age, operation date, and surgeon. Both groups were managed according to general guidelines of anticoagulation for valve surgery. Results: The operative mortality rate was 4.0% in the JW group and 0% in the non-JW group (p = 1.000). There was no difference in postoperative major complications between the groups (p = 1.000). The overall survival rate at 5 and 10 years was 85.6% ± 7.9% and 85.6% ± 7.9% in the JW group, respectively, and 100.0% ± 0.0% and 66.7% ± 27.2% in the non-JW group (p = 0.313). The valve-related morbidity-free survival rates (p = 0.625) and late morbidity-free survival rates (p = 0.885) were not significantly different between the groups. Conclusions: Using a perioperative strategy for blood conservation, cardiac valve surgery without transfusion had comparable clinical outcomes in adult patients. This blood conservation strategy could be broadly applied to major surgeries with careful perioperative care.

This paper starts from the examination of categorial status of cis in Korean and argues that cis is not a free noun, but a bound noun. Cis shows typical behaviors as a bound noun: it cannot stand alone in a sentence, but requires the aid of other lexical items such as possessors, adjuncts, and complements. Further, adopting the movement analysis from a lexical N position to a functional small n position given in Kim (2011, 2016) for a bound noun kes in Korean, I show that the same analysis can be applied to the bound noun cis. The movement is motivated by the metaphorical/abstract meaning of cis, since the small n is more related to a functional meaning rather than a lexical meaning. In terms of grammaticalization, I argue that both kes and cis are closer to functional items and they are in the stage between a fully lexical item and a more functional item.