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Methane (CH4) is an important climate forcer, contributing about 17% of the total radiative forcing by long living greenhouse gases. The Po basin is one of the most polluted and densely populated areas in Europe representing an important source region for CH4. The aim of this work was to test an inter-species correlation approach to derive estimates of anthropogenic CH4 emissions for the period 2015-2019 from the Po basin by combining CO bottom-up inventory data and continuous CH4 and CO observations from a mountain site in the northern Italy. The tested methodology suggested lower emissions in respect to EDGAR (-17%) and the Italian National Inventory (-40%) for the Po basin. However, despite the two bottom-up inventories, the emissions derived from the atmospheric observations reported an increasing tendency from 2015 to 2019 for the CH4 emissions. A sensitivity study revealed that using different subsets of the atmospheric observations implied a difference of 26% in the CH4 emission estimates. The highest agreement with two bottom-up CH4 inventories (EDGAR and the Italian national inventory) were obtained when atmospheric data were strictly selected for periods representative of air mass transport from the Po basin. Our study identified various challenges when using this methodology as a benchmark to verify bottom-up CH4 inventories. Issues could be attributed to the annual aggregation of the proxies used to derive the emission amounts, to the CO bottom-up inventory used as input information and to the relatively high sensitivity of the results to the different subsets of the atmospheric observations. However, the use of different bottom-up inventories as input data for CO emissions can potentially provide information that should be carefully considered for the purpose of integrating CH4 bottom-up inventories.

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Pediatric liver transplantation is the treatment of choice for end-stage liver disease of various causes. With most patients surviving long term after surgery, questions and concerns nowadays focus on morbidity and quality of life. Characterizing health-related quality of life (HRQOL) after liver transplantation provides a more complete estimate of the overall health of liver transplant candidates and recipients. HRQOL remains, however, a wide concept, with various interpretations in the literature, varying from medical assessment of physical status to considering various nonmedical aspects. Among the former aspects, concerns are commonly addressed about physical health and the psychological and/or social functioning of both transplanted children and their families. This detailed review of the most relevant papers analyzing of HRQOL after pediatric liver transplantation published between January 2006 and September 2008 includes the psychosocial aspects in children/adolescents, parents, and/or family members after liver transplantation, emphasizing limitations inherent to "measuring" and analyzing HRQOL aspects.

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BACKGROUND/PURPOSE: The authors' 15-year experience with children shows a high percentage of recurrence of functional constipation (FC) with conventional treatment. These data, confirmed in the international literature, led them to develop a new therapeutic approach. The aim of this study was to achieve intestinal control and avoid recurrence of FC in children through use of medical-psychological treatment. METHODS: The authors studied 25 children (18 boys; mean age, 4.7 years; range, 2.10 to 7), 20% of whom had anal fissure, 30% retentive soiling, 52% pain on defecation, and 88% fecal retention owing to FC. Children and parents were questioned about eating and sleeping habits, school, toilet training, and daily routine. Treatment included increasing water and fiber intake, laxatives, and family therapy including making rules and working on autonomy and paternal role. RESULTS: Mean onset of FC was 3.5 years, after "stressful events" in 88%. The questionnaire shows that 68% lacked parental autonomy and authority; 84% of children decided on their own about eating habits and sleeping; 68% had a "peripheral" father with a mother-child symbiotic relationship. After one month of therapy, 92% of children showed a modification of at least 2 behavioral patterns; after 3 months, 88% had regular bowel movements. During follow-up (range, 6 to 28 months), 48% had 2 or 3 recurrent episodes. After one year, 68% had reinforced the new behavioral patterns with resolution of the pathologic aspects. CONCLUSIONS: A multidisciplinary approach in the treatment of childhood functional constipation showed consistent therapeutic results by making rules and by equalizing family roles.

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AIM: Neurologically impaired (NI) children present with neuromuscular incoordination and severe gastroesophageal reflux (GER). In these cases, Bianchi has proposed total oesophagogastric dissociation (OGD) as a primary procedure and not only after failed fundoplication. METHODS: Anthropometric and laboratory data, incidence of respiratory symptoms, days of hospitalisation, time of feeding, stool frequency and quality of life were tested preoperatively and after OGD over a 12-month period in 13 severe NI patients. RESULTS: Results are shown in Table 1. We also recorded improvement in quality of life, based on communication by the person responsible for the care of the subject, and determined by psychological interviews. CONCLUSIONS: OGD is a successful and feasible procedure and can be included as a primary definitive surgical treatment in individualised nutritional rehabilitation planning for each severe NI child.

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Non-destructive, in-situ detection of 10(-3) to 10(-4) M borohydride ions in aqueous alkaline solutions containing borates can be easily and rapidly accomplished by simply measuring open circuit potentials of selected metals (relative to a suitable reference) immersed in these solutions.

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It is a well-known fact that the clinical growth of laryngeal cancer varies according to the site of its origin. A number of macro and microscopy studies have attempted to explain the various routes it follows in spreading. The anatomical features of the anterior commissure, the conus elasticus and posterior commissure condition the direction and extent of tumour spreading as do the blood supply in the glottis and the distribution of mucous glands in the glottis and subglottis. Of the various regions of the larynx, the anterior commissure has provided perhaps the greatest challenge to investigators in that its boundaries as well as its morphology are still not clear. The possible spreading of glottic cancers exceeding these anatomic structures is very difficult to evaluate using two dimensional picture given by laryngoscopy as well as the images provided by TC and NMR which justifies a different behavior of same stage. Therefore these elements, in addition to the absence of a universally accepted clinical definition of the boundaries of AC, justify the diagnostic, pathologic, and therapeutic problems linked to AC carcinoma. Eight normal adult larynges were studied by microdissection and serial section after fixation in 10 percent formalin followed by decalcification. These specimens were dissected according to the stages of "evisceratio laryngis" performed in our Department for the treatment of T1a, T1b tumors. Our observations confirm that the island located at the anterior insertion of the thyroarytenoid muscle, easy reached during subperichondral dissection, cannot be identified with the so-called tendon described by Broyles. The specimens shown circumstantiate the fact that this fibrous-cartilagineous island act as a barrier and that when the neoplasia does start to spread into this segment, this fibrous area forces it to spread mainly along the surface. Our observations were confirmed by histologic examination of 6 surgical specimens after "evisceratio laryngis" performed on T1a, T1b tumors. Clinical positive results in subjects treated employing "evisceratio laryngis" appear to further confirm of our interpretation to these morphological observations.

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Oncocytic tumors rarely occur in major salivary glands and generally account for less than 1% of all salivary tumors. Oncocytomas are infrequent tumors that most commonly arise in the salivary, thyroid, parathyroid and pituitary glands, kidneys and pancreas. They are rarely malignant. Oncocytic differentiation may also occur focally in a benign or a malignant epithelial tumor, such as a thyroid adenoma, papillary cystadenoma lymphomatosum and mixed tumors of salivary glands, malignant carcinoids of the bronchus, adrenal cortical carcinoma, and renal cell carcinoma. The term oncocytoma refers to a single neoplasm contrast to nodular oncocytic hyperplasia, which refers to two or more distinct tumor nodules, and to oncocytic mucoepidermoid carcinomas, where there is evidence of infiltrative growth and malignant of clinical behavior. We here report surgical treatment and light and electron microscopical findings obtained in the case of an oncocytoma of the parapharyngeal prestyloid space in a 62-year-old man who was admitted to our Department because of a slowly enlarging, painless mass in the pharyngeal extension of the right parotid gland. The mass has distorted the isthmus of the fauces, compressing the contra lateral pharyngeal-palatal plica. A total right parotidectomy which spared the branches of the facial nerve was performed. During the operative procedure, tissue was removed for frozen-section examination. The patient had an uneventful post-operative course. For all that has previously been written about oncocytic tumors, relatively very little is known of their etiology. In the past a correlation was made between the etiology and the history of direct or indirect radiation exposure. As oncocytic metaplasia and oncocytomas are often seen most in older individuals, the oncocyte was previously regarded as a "functional exhaustion" of a normal cell. As far as we concerned, the preferred method of surgically exposing the parapharyngeal-prestyloid space is that of removing the parotid gland through a cervical approach. Because of the proximity of certain anatomical structures, the transoral approach is not the most suitable.

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