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Biomedical subjects

M Falcioni

Publications and source records attributed to M Falcioni.

At least 19 recordsLinked to original sources

Brownian motion and diffusion: from stochastic processes to chaos and beyond.

One century after Einstein's work, Brownian motion still remains both a fundamental open issue and a continuous source of inspiration for many areas of natural sciences. We first present a discussion about stochastic and deterministic approaches proposed in the literature to model the Brownian motion and more general diffusive behaviors. Then, we focus on the problems concerning the determination of the microscopic nature of diffusion by means of data analysis. Finally, we discuss the general conditions required for the onset of large scale diffusive motion.

Biophysics↗

Pulsatile tinnitus as a rare presenting symptom of residual cholesteatoma.

Pulsatile tinnitus is an uncommon otological symptom, which often presents a diagnostic and management dilemma to the otolaryngologist. This symptom always deserves a thorough evaluation to avoid disastrous consequences from potentially life-threatening associated pathology. In most of the patients a treatable underlying aetiology can be identified. Frequent causes mentioned in the literature responsible for pulsatile tinnitus are benign intracranial hypertension syndrome, temporal bone paragangliomas and arteriovenous fistulae. Pulsatile tinnitus as a consequence of sigmoid sinus compression by a cholesteatoma has not been reported previously in the literature. Here a case of residual cholesteatoma with pulsatile tinnitus is presented, nine years after the first surgery.

Adult↗

Internal auditory canal metastasis.

This report deals with 3 cases of internal auditory canal metastasis, an extremely rare lesion, few cases having been reported in the international literature. Since pre-operative diagnosis is fundamental in the planning of a correct therapeutic strategy, it is important that the neurotologist be aware of the possibility of their occurrence in this particular area. Metastasis can occur unilaterally as well as bilaterally; the latter being the case in 1 of the patients described herein. Correct pre-operative diagnosis is particularly difficult in patients in whom the primary tumour has not been detected at the time of identification of the lesion in the internal auditory canal. The only characteristic, specific of metastasis, is the presence of multifocal cerebral lesions. However, these were detected in only 1 of the present cases. On the contrary, in cases of a single metastasis, both magnetic resonance imaging and computed tomography usually fail to show any distinctive feature when compared to the most common tumours of the internal auditory canal (vestibular schwannomas and meningiomas). Bilateral metastases can also be misdiagnosed as neurofibromatosis type 2. Clinical data that should alert the clinician are: rapidly progressive sensorineural hearing loss, followed by onset of progressive facial nerve weakness. Radiotherapy and/or chemotherapy are the two main treatment modalities, while surgical removal is reserved for selected cases of a single metastasis. Albeit, due to the paucity of specific radiological and clinical characteristics, surgical removal is often necessary to reach the correct diagnosis, as occurred in 2 of the present patients.

Aged↗

[Preoperative imaging in chronic otitis surgery].

High resolution computed tomography (CT) is presently the most accurate technique to study the temporal bone. Nevertheless, there is no general agreement about its usefulness in pre-operative evaluation of chronic otitis media. Indeed, if we rule out some exceptions, CT is not fundamental for diagnosis which can often be obtained through an accurate otomicroscopy. The Otology Group in Piacenza applies the following absolute indications for pre-operative CT in chronic otitis media: 1) difficult otomicroscopy evaluation; 2) suspected petrous bone cholesteatoma; 3) dubious diagnosis; 4) suspect of malformations; 5) review of cases that had previously undergone mastoidectomy; 6) suspected intracranial complications and/or meningoencephalic herniation (in this case also a magnetic resonance imaging must be performed). With the exception of these specific conditions, pre-operative CT is useless in cases of simple chronic otitis. However, when a cholesteatoma is suspected, CT can provide the surgeon, particularly when inexperienced, useful, but not indispensable, informations. Pre-operative knowledge of these informations can allow a more accurate evaluation of the case, with a better planning of the surgical procedure, in order to ensure a more specific informed consent. Finally, the Authors point out the fact that surgeon must be able to interpret by his own the CT data to have a real advantage by this examination.

Ear↗

Meningiomas intrinsic to the geniculate ganglion.

Geniculate ganglion meningiomas are extremely rare lesions-only 14 cases have been reported in the literature. Two new cases of these tumors are described. On computed tomography and magnetic resonance imaging, both lesions appeared centered on the area of the geniculate ganglion, extending to the tympanic cleft and eroding the middle cranial fossa floor. The first case was treated through a middle cranial fossa approach. Because the tumor was so large in the second case, a subtotal petrosectomy was used. The authors review the literature to clarify the clinical and radiological characteristics of these tumors and their surgical treatment.

Case Reports↗

Electromyographic evaluation of facial nerve damage in acoustic neuroma surgery.

OBJECTIVE: This study aimed to determine whether postoperative facial nerve paralysis or surgical manipulation causing paralysis could be predicted on train responses during intraoperative facial nerve monitoring in acoustic neuroma surgery. STUDY DESIGN AND SETTING: This was a prospective study performed at a tertiary referral center. PATIENTS AND METHODS: Train responses were recorded on a floppy disk and compared with postoperative facial nerve function in 51 patients who underwent enlarged translabyrinthine acoustic neuroma surgery. MAIN OUTCOME MEASURES: The number, duration, frequency, and peak-to-peak amplitude of train responses were analyzed and compared with postoperative facial nerve function. RESULTS: Trains were observed in 42 of 51 patients. Six of seven patients with high-amplitude trains more than 250 microV, and three of five patients with bomber-type high-frequency trains elicited during tumor dissection from the facial nerve or stretching the nerve, showed severe facial nerve dysfunction. On the other hand, seven of the nine patients with no trains also showed severe facial nerve dysfunction. CONCLUSIONS: The presence of high-amplitude or high-frequency trains elicited by surgical manipulation to the facial nerve seems to indicate a critical situation for the facial nerve. However, certain types of mechanical trauma resulting in severe facial nerve paralysis cannot be identified by train responses.

Adult↗

[Enlarged translabyrinthine approach in large acoustic neurinomas].

The translabyrinthine approach has long been, and in some centers is still, considered inadequate for the removal of large acoustic neuromas (AN). Over the years, with experience, the original technique has been modified, extending the approach to what is now called the enlarged translabyrinthine (ET) approach. Applying these modifications, between April 1987 and February 2000, the Gruppo Otologico in Piacenza, Italy removed 132 ANs, 3 cm or larger, from the cerebello-pontine angle. These tumors accounted for 25.9% of the 510 cases of AN to undergo surgery during that period. Of the 132 cases only one patient died and the percentage of complications was very low, generally lower than analogous series published in the literature. Such complications were progressively reduced in time, leading to a significant reduction in the length of post-operative hospitalization: on the average the 8.8 days were reduced to 5.7 in the last 43 cases. Ipsilateral preoperative hearing, inevitably sacrificed using the ET approach, was already significantly compromised in more than 65% of the cases. On the basis of the present data, it can be asserted that tumor diameter does not in any way preclude the use of the ET approach in AN surgery, rather the reduced morbility and shorter post-operative hospitalization make it the approach of choice for large ANs.

Adult↗

Exit-time approach to epsilon-entropy.

An efficient approach to the calculation of the epsilon-entropy is proposed. The method is based on the idea of looking at the information content of a string of data, by analyzing the signal only at the instants when the fluctuations are larger than a certain threshold epsilon, i.e., by looking at the exit-time statistics. The practical and theoretical advantages of our method with respect to the usual one are shown by the examples of a deterministic map and a self-affine stochastic process.

Journal Article↗

Fast-growing vestibular schwannoma.

A case of a Jehovah's witness affected by an intracanalicular vestibular schwannoma with an extremely fast growth rate is presented. Nine months after presentation, the tumor reached 23 mm in the cerebellopontine angle. A partial removal through a retrosigmoid approach was planned. Because of the presence of a dominant high jugular bulb masquering the internal auditory canal, the intracanalicular portion of the tumor was left in place. The residual tumor grew 12 mm in 2 months. Even after a gross total removal through a middle cranial fossa approach, the tumor recurred, reaching the size of 30 mm in 17 months. A modified transcochlear approach was then performed, and the patient was free of disease at the last radiologic follow-up, 8 months after the surgery. We illustrate our strategy in treating this aggressive benign lesion with unusual behavior.

Case Reports↗

Library design in combinatorial chemistry by Monte Carlo methods.

Strategies for searching the space of variables in combinatorial chemistry experiments are presented, and a random energy model of combinatorial chemistry experiments is introduced. The search strategies, derived by analogy with the computer modeling technique of Monte Carlo, effectively search the variable space even in combinatorial chemistry experiments of only modest size. Efficient implementations of the library design and redesign strategies are feasible with current experimental capabilities.

Combinatorial Chemistry Techniques↗

Chaos or noise: difficulties of a distinction

In experiments, the dynamical behavior of systems is reflected in time series. Due to the finiteness of the observational data set, it is not possible to reconstruct the invariant measure up to an arbitrarily fine resolution and an arbitrarily high embedding dimension. These restrictions limit our ability to distinguish between signals generated by different systems, such as regular, chaotic, or stochastic ones, when analyzed from a time series point of view. We propose to classify the signal behavior, without referring to any specific model, as stochastic or deterministic on a certain scale of the resolution epsilon, according to the dependence of the (epsilon,tau) entropy, h(epsilon, tau), and the finite size Lyapunov exponent lambda(epsilon) on epsilon.

Journal Article↗