High-rate settlement and unconsciousness with shime-waza in young judo athletes from a video analytic study in Judo World Championships.

OBJECTIVES: We aimed to investigate the incidence rate of unconsciousness related to shime-waza and the accompanying symptoms by age categories using video analysis of the Judo World Championships. DESIGN: Observational retrospective study. METHODS: We included 6918 elite judo athletes and 7426 bouts from the Judo World Championships between 2015 and 2021. Incidence rates of matches settled using shime-waza and unconsciousness were calculated by age categories: cadet, junior, and senior. Furthermore, in cases of unconsciousness resulting from shime-waza, the duration of choking initiation and release, unconsciousness, and awareness were recorded from video analysis and compared by the presence of post-awareness symptoms. A relationship between the duration of shime-waza and the post-awareness symptoms was investigated using receiver operating characteristic analysis. RESULTS: Shime-waza was used to settle 307 (4.1 %) bouts comprising 6.0 %, 4.4 %, and 3.0 % of the cadet, junior, and senior bouts, respectively (p < 0.001). The unconsciousness rates were 18.9 %, 14.6 %, and 4.3 % in the cadet, junior (p = 0.008), and senior bouts (p < 0.001), respectively. Among the 39 unconsciousness cases, 24 (61.5 %) showed convulsions or staggers after awareness. The duration from unconsciousness to choking release in cases with and without symptoms was 5.0 ±â€¯3.5 s and 2.4 ±â€¯2.0 s, respectively (p = 0.009); moreover, this duration was significantly correlated with the duration from unconsciousness to awareness (ρ = 0.480, p = 0.002). The cut-off point for symptom occurrence was a duration from unconsciousness to choking release of ≥4 s (area under the curve = 0.746, p = 0.003, odds ratio = 6.7). CONCLUSIONS: Considering the risk of unconsciousness and accompanying symptoms resulting from shime-waza, appropriate education and responses are required.

Current topics in sports-related head injuries: a review.

We review the current topic in sports-related head injuries including acute subdural hematoma (ASDH), concussion, and chronic traumatic encephalopathy (CTE). Sports-related ASDH is a leading cause of death and severe morbidity in popular contact sports like American football in the USA and judo in Japan. It is thought that rotational acceleration is most likely to produce not only cerebral concussion but also ASDH due to the rupture of a parasagittal bridging vein, depending on the severity of the rotational acceleration injury. Repeated sports head injuries increase the risk for future concussion, cerebral swelling, ASDH or CTE. To avoid fatal consequences or CTE resulting from repeated concussions, an understanding of the criteria for a safe post-concussion return to play (RTP) is essential. Once diagnosed with a concussion, the athlete must not be allowed to RTP the same day and should not resume play before the concussion symptoms have completely resolved. If brain damage has been confirmed or a subdural hematoma is present, the athlete should not be allowed to participate in any contact sports. As much remains unknown regarding the pathogenesis and pathophysiology of sports-related concussion, ASDH, and CTE, basic and clinical studies are necessary to elucidate the crucial issues in sports-related head injuries.

Boron neutron capture therapy (BNCT) for newly-diagnosed glioblastoma: comparison of clinical results obtained with BNCT and conventional treatment.

The purpose of this study was to evaluate the clinical outcome of boron neutron capture therapy (BNCT) and conventional treatment in patients with newly diagnosed glioblastoma. Since 1998 we treated 23 newly-diagosed GBM patients with BNCT without any additional chemotherapy. Their median survival time was 19.5 months; the 2-, 3-, and 5-year survival rates were 31.8%, 22.7%, and 9.1%, respectively. The clinical results of BNCT in patients with GBM are similar to those of recent conventional treatments based on radiotherapy with concomitant and adjuvant temozolomide.

Catastrophic head and neck injuries in judo players in Japan from 2003 to 2010.

BACKGROUND: Few studies have documented catastrophic head and neck injuries in judo, but these injuries deserve greater attention. PURPOSE: To determine the features of catastrophic head and neck injuries in judo. STUDY DESIGN: Descriptive epidemiological study. METHODS: This study was based on the accident reports submitted to the All Japan Judo Federation's System for Compensation for Loss or Damage. A total of 72 judo injuries (30 head, 19 neck, and 23 other injuries) were reported between 2003 and 2010. The investigated parameters were mechanism of injury, age at time of injury, length of judo experience, diagnosis, and outcome. RESULTS: Among head injuries, 27 of 30 (90%) occurred in players younger than 20 years of age. The relationship between age, mechanism, and location of injury was more relevant when players younger than 20 years incurred head injury while being thrown (P = .0026). Among neck injuries, 13 of 19 (68%) occurred in players with more than 36 months of experience. The relationship between experience, mechanism, and location of injury was more relevant when experienced players incurred neck injury while executing an offensive maneuver (P = .0294). Acute subdural hematoma was diagnosed in 94% of head injuries. The outcomes of head injury were as follows: 15 players died; 5 were in a persistent vegetative state; 6 required assistance because of higher brain dysfunction, hemiplegia, or aphasia; and 4 had full recovery. Among neck injuries, 18 players were diagnosed with cervical spine injury, 11 of whom had fracture-dislocation of the cervical vertebra; there was also 1 case of atlantoaxial subluxation. The outcomes of neck injury were as follows: 7 players had complete paralysis, 7 had incomplete paralysis, and 5 had full recovery. CONCLUSION: Neck injuries were associated with having more experience and executing offensive maneuvers, whereas head injuries were associated with age younger than 20 years and with being thrown.

[Severe head injuries during Judo practice].

The goal of this study is to elucidate the characteristic features of Judo head injuries and to propose safety measures and a reaction manual on how to prevent and to deal with such accidents in Japan. Thirty cases of severe head injuries suffered during Judo practice were enrolled in this study. They have made insurance claims for damage compensation and inquiries about Judo accidents attributed to the All Japan Judo Federation, from 2003 to 2010. The average age of the patients was 16.5 year old. The incidence of injury showed 2 peaks in different academic grade levels; one is in the first year of junior high-school (30.0%, n=9) and the other is in senior high school (26.7%, n=8). Around half of them were beginners. Four cases (13.3%) had past history of head trauma or headache and dizziness before a catastrophic accident, suggesting the presence of a second impact. Lucid interval was observed in 25 cases (83.3%). Most patients (93.3%) suffered acute subdural hematoma associated with avulsion of a cerebral bridging vein. Of patients who underwent emergency removal of the hematoma, 15 patients (50%) died and 7 patients (23.3%) entered a persistent vegetative state. Based on these findings, we propose an emergency manual with safety measures for effectively preventing and treating Judo head injuries in an appropriate manner. To reduce the disastrous head injuries in Judo, the safety measures and an optimal action manual should be reconsidered and widely spread and accepted by society.

Retinal artery embolization during carotid angioplasty and carotid artery stenting: case report.

A 69-year-old man presented with a rare case of retinal artery embolization, which occurred as a complication of carotid angioplasty and carotid artery stenting performed for recurrent cerebral infarction. Magnetic resonance imaging and angiography showed right internal carotid artery stenosis with ulceration. Carotid angioplasty and carotid artery stenting were performed using the distal protection system with the PercuSurge GuardWire. However, just after dilation, the patient complained of ocular pain and blurred vision on the right, which was subsequently diagnosed as retinal artery embolization. Heparin was given for 15 hours after stenting, and aspirin and ticlopidine medication were continued. The patient received hyperbaric oxygen therapy for 1 week. The patient's blurred vision gradually improved, but visual field defect remained. Debris was probably flushed into the external carotid artery, and passed through an anastomosis into the ophthalmic artery, resulting in retinal artery embolization.

Serum response factor is modulated by the SUMO-1 conjugation system.

Serum stimulation leads to activation of the serum response factor (SRF)-mediated transcription of immediate-early genes such as c-fos via various signal transduction pathways. We have previously reported that promyelocytic leukemia protein (PML) is involved in the transcriptional regulation by SRF. PML is one of the well-known substrates for modification by small ubiquitin-related modifier-1 (SUMO-1) and several SUMO-1-modified proteins associate with PML. Here, we report that SRF is modified by SUMO-1 chiefly at lysine(147) within the DNA-binding domain. Substitution of this target lysine for alanine did not affect the translocation of SRF to PML-nuclear bodies. The SRF mutant augmented the transcriptional activity under Rho A-stimulated condition but not under serum-starved condition, suggesting that activated SRF is suppressed by its sumoylation. These data support the transcriptional role of SUMO-1 conjugating system in cellular serum response.

Brain abscess and glioblastoma identified by combined proton magnetic resonance spectroscopy and diffusion-weighted magnetic resonance imaging--two case reports.

The differential diagnosis between brain abscesses and necrotic tumors such as glioblastomas is sometimes difficult to establish by conventional computed tomography and magnetic resonance imaging. Combined proton magnetic resonance spectroscopy (1H-MRS) and diffusion-weighted magnetic resonance imaging (DWI) were used to establish the preoperative diagnosis of brain abscess and glioblastoma. DWI visualized the brain abscess as a homogeneous hyperintense lesion and 1H-MRS revealed the presence of acetate, lactate, and amino acids and the absence of the normal brain components. DWI sometimes shows glioblastoma as a hyperintense lesion, but 1H-MRS reveals markedly increased lactate and decreased N-acetyl-aspartate. Combined DWI and 1H-MRS findings can distinguish brain abscess and glioblastoma.