Development and Quality Characteristics of Jangjorim Prepared Using Long-Arm Octopus (Octopus minor) as an Elderly-Friendly Food.

We prepared a long-arm octopus Jangjorim prototype (LOJP) by optimizing the ratio of ingredients for seasoning and establishing heat sterilization parameters. The optimal amounts of purified water (2.9-56.6%, A), starch syrup (0.3-37.8%, B), and soy sauce (25.5-71.5%, C) for the production of seasoning soy sauce were obtained using response surface analysis. The LOJP was prepared by combining A, B, and C under the optimal conditions and evaluated for consumer preferences and physicochemical, nutritional, and microbiological properties and compared with Korea's legal management standards for geriatric nutrition. The hardness of the LOJP produced using the optimal mixing ratio of purified water (51.2%, 154.0 g), starch syrup (29.3%, 308.0 g), and soy sauce (19.5%, 256.9 g) was 36.7 × 1000 N/m2. This value was lower than the hardness of raw octopus (2153.6 × 1000 N/m2) by 2116.9 × 1000 N/m2. It received the highest score (8.7) in the preference evaluation of older consumers. The LOJP was classified as level 2, allowing consumption through the gums of elderly consumers per Korea's food standards for the elderly. The LOJP was the product highly preferred by elderly consumers with chewing disorders due to its ease of intake and nutritional content.

Using CT Perfusion in the Interictal State.

SUMMARY: Periodic discharges seen in patients undergoing continuous EEG pose a challenge to physicians in falling into the interictal-ictal continuum and need for appropriate diagnostic and management approach. The authors herein present an 83-year-old male patient with an acute subdural hematoma who developed intermittent right upper and lower extremity weakness with change in mental status post craniotomy and hematoma evacuation. The patient was intubated and sedated with midazolam and propofol and placed on anti-seizure medications to control seizures. He was placed on continuous EEG monitoring and later developed lateralized periodic discharges. To guide treatment, a computed tomography perfusion study of the brain was performed. The results were consistent with an ictal phenomenon because of the presence of left hemispheric hyperemia. This increased cerebral blood volume and blood flow was used as a diagnostic tool to warrant more aggressive antiepileptic regimen. The patient was then started on an additional anti-seizure medication and dosages were further optimized. This led to an improvement in the patient's EEG and clinical state. There are numerous studies that show lateralized periodic discharges are seen as examples of subclinical status epilepticus and demonstrate hypermetabolism and hyperemia on positron emission tomography and single-photon emission computed tomography scans. When such imaging modalities are unavailable, cortical hyperperfusion on a computed tomography perfusion study might be a valid predictor of ongoing, subclinical, ictal activity and may be used as a complementary diagnostic tool to EEG to guide treatment.

Association between humidifier disinfectant exposure during infancy and subsequent neuropsychiatric outcomes during childhood: a nation-wide cross-sectional study.

BACKGROUND: The purpose was to determine the association between infant exposure to humidifier disinfectant (HD) with neuropsychiatric problems in pre-school children. METHODS: A total of 2,150 children (age 4-11 months) were enrolled in the Panel Study of Korean Children (PSKC) study. The Korean version of the Child Behavior Checklist (CBCL) was used for assessments of neuropsychiatric problems. 1,113 children who participated in all the first to third PSKC studies and answered a question about HD exposure were finally enrolled. RESULTS: There were 717 (64.5%) children in non-HD group who were not exposed to HD and 396 (35.5%) in HD group with former exposure to HD. Exposure to HD was associated with total neuropsychiatric problems (adjusted odds ratio, aOR = 1.54, 95% CI = 1.15-2.06), being emotionally reactive (aOR = 1.55, 95% CI = 1.00-2.39), having attention problems (aOR = 1.96, 95% CI = 1.10-3.47), having oppositional defiant problems (aOR = 1.70, 95% CI = 1.07-2.71), and having attention deficit/hyperactivity problems (aOR = 11.57, 95% CI = 1.03-2.38). The risks for neuropsychiatric problems were clearly increased in boy, firstborn, and secondary smoker. CONCLUSIONS: Exposure to HD during early childhood had a potential association with subsequent behavioral abnormalities.

A presumed case of new-onset focal seizures as a delayed complication of COVID-19 infection.

Previously seizures have been reported as presenting neurological manifestation with COVID-19 infection. There is a growing literature on the delayed neurologic effects of COVID-19 infection. Here, we report a case with insidious onset of focal impaired awareness seizures associated with left temporal epileptiform interictal and ictal discharges consistent with focal epilepsy; occurring within a short time frame of the diagnosis of COVID-19 infection. This may be possibly a post COVID-19 inflammatory syndrome manifesting as new onset focal epilepsy with focal non-motor seizures with impaired awareness. As implicated by presentation with seizure as in our case, longterm follow-up studies are warranted to further investigate if the patients who acquire COVID-19 infection are at increased risk of developing epilepsy as a delayed manifestation.

IgLON 5 Antibody Syndrome: Isolated Case of a Patient With Indolent Disease Progression and Unusual MRI Findings.

IgLON-5 antibody syndrome has a myriad of clinical presentations, including gait instability, movement disorders, abnormal eye movements, bulbar symptoms, sleep disorders, neuropsychiatric symptoms, dysautonomia, and peripheral neuropathy. Abnormal magnetic resonance imaging (MRI) findings have also been reported such as leukoariotic changes and cerebral and cerebellar atrophy. We present a case of IgLON-5 antibody syndrome with a unique MRI finding of persistent leptomeningeal enhancement. A close follow-up would be warranted as the progression of the disease may be indolent.

Neurological Predictors of Clinical Outcomes in Hospitalized Patients With COVID-19.

Introduction: Multiple risk factors of mortality have been identified in patients with COVID-19. Here, we sought to determine the effect of a history of neurological disorder and development of neurological manifestations on mortality in hospitalized patients with COVID-19. Methods: From March 20 to May 20, 2020, hospitalized patients with laboratory confirmed or highly suspected COVID-19 were identified at four hospitals in Ohio. Previous history of neurological disease was classified by severity (major or minor). Neurological manifestations during disease course were also grouped into major and minor manifestations. Encephalopathy, ischemic or hemorrhagic stroke, and seizures were defined as major manifestations, whereas minor neurological manifestations included headache, anosmia, dysgeusia, dizziness or vertigo, and myalgias. Multivariate logistic regression models were used to determine significant predictors of mortality in patients with COVID-19 infection. Results: 574/626 hospitalized patients were eligible for inclusion. Mean age of the 574 patients included in the analysis was 62.8 (SD 17.6), with 298 (51.9%) women. Of the cohort, 240(41.8%) patients had a prior history of neurological disease (HND), of which 204 (35.5%) had a major history of neurological disease (HND). Mortality rates were higher in patients with a major HND (30.9 vs. 15.4%; p = 0.00002), although this was not a significant predictor of death. Major neurological manifestations were recorded in 203/574 (35.4%) patients during disease course. The mortality rate in patients who had major neurological manifestations was 37.4% compared to 11.9% (p = 2 × 10-12) in those who did not. In multivariate analysis, major neurological manifestation (OR 2.1, CI 1.3-3.4; p = 0.002) was a predictor of death. Conclusions: In this retrospective study, history of pre-existing neurological disease in hospitalized COVID-19 patients did not impact mortality; however, development of major neurological manifestations during disease course was found to be an independent predictor of death. Larger studies are needed to validate our findings.