Background: and Purpose Previous research on patients with acute ischemic stroke (AIS) has shown a 0.5% incidence of major gastrointestinal bleeding (GIB) requiring blood transfusion during hospitalization. The existing literature has insufficiently explored the long-term incidence in this population despite the decremental impact of GIB on stroke outcomes. Methods: We analyzed the data from a cohort of patients with AIS admitted to 14 hospitals as part of a nationwide multicenter prospective stroke registry between 2011 and 2013. These patients were followed up for up to 6 years. The occurrence of major GIB events, defined as GIB necessitating at least two units of blood transfusion, was tracked using the National Health Insurance Service claims data. Results: Among 10,818 patients with AIS (male, 59%; mean age, 68±13 years), 947 (8.8%) experienced 1,224 episodes of major GIB over a median follow-up duration of 3.1 years. Remarkably, 20% of 947 patients experienced multiple episodes of major GIB. The incidence peaked in the first month after AIS, reaching 19.2 per 100 person-years, and gradually decreased to approximately one-sixth of this rate by the 2nd year with subsequent stabilization. Multivariable analysis identified the following predictors of major GIB: anemia, estimated glomerular filtration rate <60 mL/min/1.73 m2 , and a 3-month modified Rankin Scale score of ≥4. Conclusion Patients with AIS are susceptible to major GIB, particularly in the first month after the onset of AIS, with the risk decreasing thereafter. Implementing preventive strategies may be important, especially for patients with anemia and impaired renal function at stroke onset and those with a disabling stroke.

Background: and Purpose Previous research on patients with acute ischemic stroke (AIS) has shown a 0.5% incidence of major gastrointestinal bleeding (GIB) requiring blood transfusion during hospitalization. The existing literature has insufficiently explored the long-term incidence in this population despite the decremental impact of GIB on stroke outcomes. Methods: We analyzed the data from a cohort of patients with AIS admitted to 14 hospitals as part of a nationwide multicenter prospective stroke registry between 2011 and 2013. These patients were followed up for up to 6 years. The occurrence of major GIB events, defined as GIB necessitating at least two units of blood transfusion, was tracked using the National Health Insurance Service claims data. Results: Among 10,818 patients with AIS (male, 59%; mean age, 68±13 years), 947 (8.8%) experienced 1,224 episodes of major GIB over a median follow-up duration of 3.1 years. Remarkably, 20% of 947 patients experienced multiple episodes of major GIB. The incidence peaked in the first month after AIS, reaching 19.2 per 100 person-years, and gradually decreased to approximately one-sixth of this rate by the 2nd year with subsequent stabilization. Multivariable analysis identified the following predictors of major GIB: anemia, estimated glomerular filtration rate <60 mL/min/1.73 m2 , and a 3-month modified Rankin Scale score of ≥4. Conclusion Patients with AIS are susceptible to major GIB, particularly in the first month after the onset of AIS, with the risk decreasing thereafter. Implementing preventive strategies may be important, especially for patients with anemia and impaired renal function at stroke onset and those with a disabling stroke.

Background: and Purpose Previous research on patients with acute ischemic stroke (AIS) has shown a 0.5% incidence of major gastrointestinal bleeding (GIB) requiring blood transfusion during hospitalization. The existing literature has insufficiently explored the long-term incidence in this population despite the decremental impact of GIB on stroke outcomes. Methods: We analyzed the data from a cohort of patients with AIS admitted to 14 hospitals as part of a nationwide multicenter prospective stroke registry between 2011 and 2013. These patients were followed up for up to 6 years. The occurrence of major GIB events, defined as GIB necessitating at least two units of blood transfusion, was tracked using the National Health Insurance Service claims data. Results: Among 10,818 patients with AIS (male, 59%; mean age, 68±13 years), 947 (8.8%) experienced 1,224 episodes of major GIB over a median follow-up duration of 3.1 years. Remarkably, 20% of 947 patients experienced multiple episodes of major GIB. The incidence peaked in the first month after AIS, reaching 19.2 per 100 person-years, and gradually decreased to approximately one-sixth of this rate by the 2nd year with subsequent stabilization. Multivariable analysis identified the following predictors of major GIB: anemia, estimated glomerular filtration rate <60 mL/min/1.73 m2 , and a 3-month modified Rankin Scale score of ≥4. Conclusion Patients with AIS are susceptible to major GIB, particularly in the first month after the onset of AIS, with the risk decreasing thereafter. Implementing preventive strategies may be important, especially for patients with anemia and impaired renal function at stroke onset and those with a disabling stroke.

Background: Islet transplantation holds promise for treating selected type 1 diabetes mellitus patients, yet the scarcity of human donor organs impedes widespread adoption. Porcine islets, deemed a viable alternative, recently demonstrated successful longterm survival without zoonotic risks in a clinically relevant pig-to-non-human primate islet transplantation model. This success prompted the development of a clinical trial protocol for porcine islet xenotransplantation in humans. Methods: A single-center, open-label clinical trial initiated by the sponsor will assess the safety and efficacy of porcine islet transplantation for diabetes patients at Gachon Hospital. The protocol received approval from the Gachon Hospital Institutional Review Board (IRB) and the Korean Ministry of Food and Drug Safety (MFDS) under the Investigational New Drug (IND) process. Two diabetic patients, experiencing inadequate glycemic control despite intensive insulin treatment and frequent hypoglycemic unawareness, will be enrolled. Participants and their family members will engage in deliberation before xenotransplantation during the screening period. Each patient will receive islets isolated from designated pathogen-free pigs. Immunosuppressants and systemic infection prophylaxis will follow the program schedule. The primary endpoint is to confirm the safety of porcine islets in patients, and the secondary endpoint is to assess whether porcine islets can reduce insulin dose and the frequency of hypoglycemic unawareness. Conclusion A clinical trial protocol adhering to global consensus guidelines for porcine islet xenotransplantation is presented, facilitating streamlined implementation of comparable human trials worldwide.

Background and Objectives: Flexible laryngoscopes are indispensable tools in otolaryngology, but their frequent use makes them vulnerable to contamination, thus posing a risk of cross-infection. Unlike gastrointestinal endoscopes, flexible laryngoscopes currently lack standardized disinfection protocols. This study evaluates the efficacy of Cidex OPA (0.55% ortho-phthalaldehyde) to establish an effective, practical disinfection protocol for flexible laryngoscopes.Materials and Method This multicenter study involved the use of flexible laryngoscopes in otolaryngology outpatient clinics across five university hospitals. Laryngoscopes were immersed in Cidex OPA for 1, 5, or 12 minutes, with an additional group treated using Tristel wipes and foam after a 12-minute immersion. Swab samples were collected from the distal 15 cm of each laryngoscope following disinfection and cultured on blood agar plates under aerobic conditions at 35°C–37°C with 5% CO2 for 72 hours. Positive controls included laryngoscopes directly contaminated with saliva or laryngeal secretions. Results: Six out of ten positive control samples demonstrated bacterial growth. However, no bacterial growth was observed in any sample from the Cidex OPA immersion groups (1, 5, or 12 minutes), including the group treated with Tristel. These findings indicate that even a 1-minute immersion in Cidex OPA effectively eliminates bacterial contamination. Conclusion This study provides evidence supporting an efficient disinfection method that can enhance infection control and streamline clinical workflow. Further research with a larger sample size and varied disinfection techniques is needed to establish comprehensive disinfection guidelines for flexible laryngoscopes.

Background: Islet transplantation holds promise for treating selected type 1 diabetes mellitus patients, yet the scarcity of human donor organs impedes widespread adoption. Porcine islets, deemed a viable alternative, recently demonstrated successful longterm survival without zoonotic risks in a clinically relevant pig-to-non-human primate islet transplantation model. This success prompted the development of a clinical trial protocol for porcine islet xenotransplantation in humans. Methods: A single-center, open-label clinical trial initiated by the sponsor will assess the safety and efficacy of porcine islet transplantation for diabetes patients at Gachon Hospital. The protocol received approval from the Gachon Hospital Institutional Review Board (IRB) and the Korean Ministry of Food and Drug Safety (MFDS) under the Investigational New Drug (IND) process. Two diabetic patients, experiencing inadequate glycemic control despite intensive insulin treatment and frequent hypoglycemic unawareness, will be enrolled. Participants and their family members will engage in deliberation before xenotransplantation during the screening period. Each patient will receive islets isolated from designated pathogen-free pigs. Immunosuppressants and systemic infection prophylaxis will follow the program schedule. The primary endpoint is to confirm the safety of porcine islets in patients, and the secondary endpoint is to assess whether porcine islets can reduce insulin dose and the frequency of hypoglycemic unawareness. Conclusion A clinical trial protocol adhering to global consensus guidelines for porcine islet xenotransplantation is presented, facilitating streamlined implementation of comparable human trials worldwide.

Background: Islet transplantation holds promise for treating selected type 1 diabetes mellitus patients, yet the scarcity of human donor organs impedes widespread adoption. Porcine islets, deemed a viable alternative, recently demonstrated successful longterm survival without zoonotic risks in a clinically relevant pig-to-non-human primate islet transplantation model. This success prompted the development of a clinical trial protocol for porcine islet xenotransplantation in humans. Methods: A single-center, open-label clinical trial initiated by the sponsor will assess the safety and efficacy of porcine islet transplantation for diabetes patients at Gachon Hospital. The protocol received approval from the Gachon Hospital Institutional Review Board (IRB) and the Korean Ministry of Food and Drug Safety (MFDS) under the Investigational New Drug (IND) process. Two diabetic patients, experiencing inadequate glycemic control despite intensive insulin treatment and frequent hypoglycemic unawareness, will be enrolled. Participants and their family members will engage in deliberation before xenotransplantation during the screening period. Each patient will receive islets isolated from designated pathogen-free pigs. Immunosuppressants and systemic infection prophylaxis will follow the program schedule. The primary endpoint is to confirm the safety of porcine islets in patients, and the secondary endpoint is to assess whether porcine islets can reduce insulin dose and the frequency of hypoglycemic unawareness. Conclusion A clinical trial protocol adhering to global consensus guidelines for porcine islet xenotransplantation is presented, facilitating streamlined implementation of comparable human trials worldwide.

Background and Objectives: Flexible laryngoscopes are indispensable tools in otolaryngology, but their frequent use makes them vulnerable to contamination, thus posing a risk of cross-infection. Unlike gastrointestinal endoscopes, flexible laryngoscopes currently lack standardized disinfection protocols. This study evaluates the efficacy of Cidex OPA (0.55% ortho-phthalaldehyde) to establish an effective, practical disinfection protocol for flexible laryngoscopes.Materials and Method This multicenter study involved the use of flexible laryngoscopes in otolaryngology outpatient clinics across five university hospitals. Laryngoscopes were immersed in Cidex OPA for 1, 5, or 12 minutes, with an additional group treated using Tristel wipes and foam after a 12-minute immersion. Swab samples were collected from the distal 15 cm of each laryngoscope following disinfection and cultured on blood agar plates under aerobic conditions at 35°C–37°C with 5% CO2 for 72 hours. Positive controls included laryngoscopes directly contaminated with saliva or laryngeal secretions. Results: Six out of ten positive control samples demonstrated bacterial growth. However, no bacterial growth was observed in any sample from the Cidex OPA immersion groups (1, 5, or 12 minutes), including the group treated with Tristel. These findings indicate that even a 1-minute immersion in Cidex OPA effectively eliminates bacterial contamination. Conclusion This study provides evidence supporting an efficient disinfection method that can enhance infection control and streamline clinical workflow. Further research with a larger sample size and varied disinfection techniques is needed to establish comprehensive disinfection guidelines for flexible laryngoscopes.

Background: Islet transplantation holds promise for treating selected type 1 diabetes mellitus patients, yet the scarcity of human donor organs impedes widespread adoption. Porcine islets, deemed a viable alternative, recently demonstrated successful longterm survival without zoonotic risks in a clinically relevant pig-to-non-human primate islet transplantation model. This success prompted the development of a clinical trial protocol for porcine islet xenotransplantation in humans. Methods: A single-center, open-label clinical trial initiated by the sponsor will assess the safety and efficacy of porcine islet transplantation for diabetes patients at Gachon Hospital. The protocol received approval from the Gachon Hospital Institutional Review Board (IRB) and the Korean Ministry of Food and Drug Safety (MFDS) under the Investigational New Drug (IND) process. Two diabetic patients, experiencing inadequate glycemic control despite intensive insulin treatment and frequent hypoglycemic unawareness, will be enrolled. Participants and their family members will engage in deliberation before xenotransplantation during the screening period. Each patient will receive islets isolated from designated pathogen-free pigs. Immunosuppressants and systemic infection prophylaxis will follow the program schedule. The primary endpoint is to confirm the safety of porcine islets in patients, and the secondary endpoint is to assess whether porcine islets can reduce insulin dose and the frequency of hypoglycemic unawareness. Conclusion A clinical trial protocol adhering to global consensus guidelines for porcine islet xenotransplantation is presented, facilitating streamlined implementation of comparable human trials worldwide.

Background and Objectives: Flexible laryngoscopes are indispensable tools in otolaryngology, but their frequent use makes them vulnerable to contamination, thus posing a risk of cross-infection. Unlike gastrointestinal endoscopes, flexible laryngoscopes currently lack standardized disinfection protocols. This study evaluates the efficacy of Cidex OPA (0.55% ortho-phthalaldehyde) to establish an effective, practical disinfection protocol for flexible laryngoscopes.Materials and Method This multicenter study involved the use of flexible laryngoscopes in otolaryngology outpatient clinics across five university hospitals. Laryngoscopes were immersed in Cidex OPA for 1, 5, or 12 minutes, with an additional group treated using Tristel wipes and foam after a 12-minute immersion. Swab samples were collected from the distal 15 cm of each laryngoscope following disinfection and cultured on blood agar plates under aerobic conditions at 35°C–37°C with 5% CO2 for 72 hours. Positive controls included laryngoscopes directly contaminated with saliva or laryngeal secretions. Results: Six out of ten positive control samples demonstrated bacterial growth. However, no bacterial growth was observed in any sample from the Cidex OPA immersion groups (1, 5, or 12 minutes), including the group treated with Tristel. These findings indicate that even a 1-minute immersion in Cidex OPA effectively eliminates bacterial contamination. Conclusion This study provides evidence supporting an efficient disinfection method that can enhance infection control and streamline clinical workflow. Further research with a larger sample size and varied disinfection techniques is needed to establish comprehensive disinfection guidelines for flexible laryngoscopes.