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Securing an airway in a severely school-age patient with maxillofacial trauma is quite challenging and is an important part of treatment. A particularly useful technique for airway management in pediatrics, planned submental tracheal intubation (STI), has often been reported. We employed this technique in an eight-year-old girl who required open reduction and internal fixation of the mandible fracture along with suffered midface and skull base fractures, leading to the prevention of serious complications, such as intracranial penetration, when manipulating a nasotracheal tube. We described the novel aspects of this technique, known as the 1–1–1 rule, in a school-age patient with severe maxillofacial injuries and demonstrated its utility along with a review of the literature. [ABSTRACT FROM AUTHOR]

CCN2/CTGF (cellular communication network factor 2/connective tissue growth factor) plays critical roles in cartilage development, maintenance, and regeneration. Hypoxia‐induced expression of CCN2 mRNA is regulated post‐transcriptionally in the human chondrosarcoma‐derived cell line, HCS‐2/8. In the present study, the hypoxia‐induced increase in CCN2 mRNA expression was assessed with quantitative real‐time PCR in HCS‐2/8 cells in the presence of inhibitors of mitogen‐activated protein kinases (MAPKs). Subsequently, the stability of CCN2 mRNA in hypoxia was evaluated with mRNA degradation assays in the presence or absence of the selective p38 MAPK inhibitor, SB203580. We detected phosphorylation of p38 MAPK by immunoblot analysis within 30 minutes in hypoxia, and we observed ~twofold higher CCN2 mRNA levels in hypoxia compared to normoxia. Blockade of p38 MAPK activation with 10 µmol/L SB203580 abolished this CCN2 induction. Furthermore, we found that inhibition of p38 MAPK suppressed the elongation of CCN2 mRNA half‐life in hypoxia. Taken together, these findings suggest that the molecular mechanism, by which CCN2 mRNA expression is increased in hypoxia, induces the activation of p38 MAPK leading to the post‐transcriptional regulation of the stability of CCN2 mRNA. [ABSTRACT FROM AUTHOR]

The novel conceptual disease model, the oral–gut axis, which represents the immunomodulatory mutual relationship between oral and gut microbial compartments, has been attracting attention in relation to systemic health issues. We investigated whether this unique crosstalk influences the systemic condition of patients with COVID-19 infections who received extracorporeal membrane oxygenation (ECMO) in the intensive care unit (ICU) during April and December 2020. In this case-control study, patients were divided into two groups according to their survival (total entry size, n = 21; survivors, n = 13; non-survivors, n = 8). Patients were evaluated using the oral assessment guide from Fukuoka University (OAG-F) and the Bristol Stool Form Scale (BSFS) to examine the oral and fecal conditions. A blood-based inflammatory factor, the neutrophil-to-lymphocyte ratio (NLR), was used as an indicator of systemic immunity. The high total OAG-F scores were associated with both elevated BSFS and NLR values, and a mutually positive correlation between BSFS and NLR was observed. This indicated an interplay between oral deterioration, gut dysbiosis, and the impairment of immunity. Furthermore, oral deterioration was more frequently observed in non-survivors on day 14 of ICU admission. In addition, on days 7 and 21 of ICU admission, impaired immunity, reflected by an elevated NLR, was observed in non-survivors. However, the distribution of the gut microbiome—reflected by increased BSFS values—with the time it was examined was not directly observed in non-survivors. Taken together, these findings suggested that oral–gut health may be specifically associated with mortality in COVID-19 patients receiving ECMO in the ICU. [ABSTRACT FROM AUTHOR]