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The study analyses the sociological problem of recognising the Other going beyond the mix of holism and individualism and instead proposing a relational vision that recognises the Other through the reflexivity of familiarity. This recognition is the result of a relational reason that, in order to be so, must necessarily be reflexive. The challenge of the widespread argument about the individualisation of the individual is turned into the argument of the personalisation of the person. According to the author, a human person is someone who, standing in between the bio-physical world and culture, develops through social interaction and reflexivity. We need a new scientific paradigm to understand how the human person can be both dependent on society and autonomous. In the differing ways of employing reflexivity (instrumental reflexivity, autonomous reflexivity, communicative reflexivity, value reflexivity), its capacity to achieve or not recognition as a relational good is revealed. In this process, the recognition through familiarity is no longer of pre-modern, modern or post-modern societies but of after-modern societies. [ABSTRACT FROM AUTHOR]

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In the recent years lung sonography has overcome his pioneer phase with the contribution of significant data from authors of different disciplines. Today there is therefore a strong evidence that this diagnostic method could have an important impact for the diagnosis of cardiothoracic symptoms, mainly dyspnea, in emergency or in ambulatory medicine. Since the cardiologist already uses ultrasound for the study of the heart, he or she could consider the integrated cardiopulmonary sonography extremely attractive in this specific context. In this review the authors describe the anatomical, biophysical and clinical basis of lung ultrasonography in a cardiological setting.

Background: The present study deals with the main methods for assessment of hot environments: i.e., WBGT, SWreq and PHS. It is stressed how the WBGT index, which is strictly empirical, although a very practical tool for the assessment of the hot environments, can only be used for a rough evaluation of heat stress, and especially for a not very high metabolic rate (M<175 W/m2). On the contrary, the SWreq method, which is based on both subject-environment heat exchange and the effect of clothing, allows a better assessment of the work situation with a general reduction of the exposure limits with respect to WBGT, especially in non-uniform environments (ta not equal to tr). However, it should be noted that application of SWreq is required by the ISO standard 7243 when the WBGT limit values are exceeded., Methods: In this study interest was extensively focused on the "Predicted Heat Strain" method, highlighting via a special software the differences in heat stress assessment related to this new approach, which will be adopted by the ISO in the next revision of standard 7933., Results: The PHS method, unlike SWreq, allows the prediction of the time-response of the main physiological variables of interest (i.e., skin temperature, core temperature and sweat rate). Moreover thanks to better modelling of heat exchanges, the PHS method allows account to be taken of both movement and clothing effects, resulting in even more reduced exposure.

In studying the vestibular-oculomotor reflex (VOR) in patients with equilibrium disorders, both active and passive methods are used and at different stimulation frequencies, particularly to evaluate vestibular compensation. The present study compares the sensitivity and specificity of the low-frequency pendular test and the HST in normal subjects and in subjects suffering from various vestibular pathologies but showing no signs of spontaneous nystagmus, even under optimal evaluation conditions (infrared videonystagmoscopy). These spontaneous nystagmus-free subjects underwent a routine study including: case history, infrared videonystagmoscopy (HST with 2 Hz stimulation) and ENG recording (saccadic movement, smooth pursuit, OKN, VOR, VOR-fix during pendular stimulation at 0.05 Hz and VOR after Fitzgerald-Hallpike heat stimulation). On the basis of the results the subjects were classified as follows: normal (N): case history free of any equilibrium disorders and all tests negative (122 cases; 8.1%); peripheral vestibular pathology (P): case history of equilibrium disorders and labyrinthine predominance (LP) in excess of 20% upon caloric testing (716 cases; 47.6%); central pathology (C): case history of equilibrium disorders and at least 3 pathological results from among the following tests: saccadic movement, smooth pursuit, OKN, VOR-fix (226 cases; 15.0%); mixed pathology (M): with both signs of P and C (440 cases; 29.3%). The pendular test showed signs of directional dominance (DP) higher than 10% (normal limit) in 7 cases of N (5.7%), 308 P (43.0%), 33 C (14.6%) and 162 M (36.8%). DP was higher than 10% in 55.2% of the P and M cases with onset less than 1 month before, in 42.8% of those with onset within the year and in 37.2% of those with onset more than a year before. A pathological response to the HST was observed (characterized by a series of at least 3 nystagmus shakes after a maximum latency of 15 seconds) in 0 N (0.0%), 378 P (52.8%), 4 C (1.8%) and 247 M (56.1%). The nystagmus seen was nearly always monophasic (92.5%), biphasic nystagmus was only seen in only a few cases (7.5%); moreover it was predominantly horizontal in nature (94.9%) while it was vertical in only a few of the C cases (5.1%). The HST proved pathological in 46.5% of those pathologies with onset less than 1 month before, in 55.8% of those with onset within the year and in 54.4% of those with onset more than a year before. In 213 of the cases presenting pathological response to the HST there was agreement between VOR DP at the pendular test and the direction of the nystagmus evoked by the HST: 138 P (74.6%), 0 C (0.0%), 75 M (68.2%): moreover there was no agreement in 83 cases. When the DP was lower than 10% at the pendular test, the HST proved pathological in 213 P (52.2%), 3 C (1.6%), 150 M (53.9%). Both tests gave negative results in 112 N (91.8%), 163 P (22.8%), 186 C (82.3%), 123 M (27.9%). In cases of peripheral vestibular deficit (P and M) the sensitivity of the rotoacceleration test was 40.7%, specificity 88.5%. The sensitivity of the HST was 54.1%, specificity 98.8%. The sensitivity of the association using both tests was 75.2%, specificity 85.7%.

Objective: To study the use of a modification of the classical biophysical profile by the combination of computerized analysis of fetal heart rate (cCTG) and the amniotic fluid index (AFI) in the prediction of neonatal acidemia at birth., Methods: We considered 89 singleton third trimester high risk pregnancies delivered by cesarean section, with an AFI evaluated within 24 hrs from birth, and an antepartum cCTG performed within 6 hrs from delivery. We assigned values for AFI (oligo/anhydramnios = 1, normal = 0) and cCTG (Dawes-Redman criteria, not satisfied = 1, satisfied = 0). The endpoint was to predict an abnormal neonatal outcome as defined by an umbilical artery (UA) pH < or = 7.2., Results: Fifteen neonates presented an UA pH < or = 7.2. By performing a logistic regression, we found that cCTG + AFI score (abnormal value 1-2) was able to significantly predict a pH value (< or = 7.20) with an Odds Ratio = 2.83 (p < 0.02). The diagnostic accuracy of the combination of cCTG + AFI was as follows: sensitivity: 80%, specificity: 58%., Comment: We suggest that the combination of cCTG + AFI included in the simple score we propose, may be of value in the prediction of neonatal acidemia and help in the management of third trimester high risk pregnancies.

Occupational exposure of subjects working on break-rock engins for production of porfido cube, in hand-harm system, has been here evaluated. The breaking mechanism of the rock and its biophysic effects has been studied. The results show a significant exposure of hands, mainly due to the break-rock engine called "by control falling".

Tissue Doppler imaging or myocardial velocity imaging is a variation of conventional Doppler. This modality allows the quantification of the Doppler shift within the range of myocardial tissue motion. The velocity of motion at a variety of myocardial sites can be determined and distinguished very rapidly using Doppler techniques. The velocity of moving tissue can be studied with pulsed wave tissue Doppler sampling, which displays the velocity of a selected myocardial region against time, with high temporal resolution. In addition, the velocities can be calculated with time velocity maps and displayed as color coded velocity maps in either M-mode or two-dimensional format. This review will focus on the technical aspects and the different methods of tissue Doppler for regional systolic and diastolic left ventricular function analysis. While pulsed wave tissue Doppler allows us to measure the velocities of a selected myocardial region, color tissue Doppler gives the best overall view of cardiac dynamics because the whole scanned color data are displayed simultaneously. However, there is an increasing need for objective evaluation of tissue Doppler information. Digital images and data post-processing allow for quantitative off-line analysis, and the different approaches and parameters proposed from different centers are discussed. In recent years, tissue Doppler imaging has been applied for accurate evaluation of diastolic function, quantifying regional function particularly during stress, pre-excitation syndrome, and left ventricular hypertrophy. The results of these experiences indicate that tissue Doppler imaging is a promising technique for quantifying the response of the myocardium and endocardium during both normal and abnormal function. Again, there is a significant learning curve concerning its application, but with experience it will be a useful and reproducible technique.

A significant portion of the traditional concepts of homeopathy (similia principle, experimentation on healthy humans, the cure of whole person, the use of minimum doses or high dilution/potency of medicines) are amenable to investigations conducted according to criteria accepted by biomedical science. Even though many randomized and controlled clinical studies seem to demonstrate the efficacy of some homeopathic medicines and their superiority to placebo, other trials have given negative results. A definite clear answer is not yet possible due to the scarce quality of some published reports, to lack of reproduction by independent investigators and to the uncertainty regarding the methodologies to be used for testing the claims of homeopathy. As regards the possible physiopathological, biophysical and pharmacological explanations for the action of homeopathic remedies, there are models which tend to set the similia principle as a general expression of the action-reaction principle, within the context of dynamic systems theory. The clarification of the more controversial aspects regarding dilution/potency of medicines remains tied to several promising developments in physics of condensed matter, in chaos theory and in biophysics.

The exposure to radiofrequency (RF) electromagnetic fields is one of the main aspects to be controlled in order to ensure the safety of patients in an NMR environment. Starting from the description of the main physical characteristics of RF fields active in imaging instrumentation, a simple model is obtained which accounts for the experimental interdependence between the parameters of the stimulus and SAR values deposited on the patients. This model can yield a preliminary/approximate prediction of exposure levels for a given test. Some NMR equipment admit the estimation of the actual SAR values during the test on the basis of electrical measurements. The paper illustrates the basic principles of these measurements. The biological effects associated with the absorption of RF energy are discussed with particular attention to the physical and biological factors which may result in local heating on the body, a danger which may not be prevented by simply observing the prescribed thresholds of mean exposure.

This review summarizes experimental bases, limitations and rationale of guide-lines and recommendations adopted by national health authorities for the safety of patients exposed to the magnetic fields utilized during magnetic resonance (MR) examinations: static magnetic field (B0); time-varying magnetic field gradients (dB/dt) and radiofrequency magnetic fields. Although the mechanisms of interaction of these fields with the living matter are today sufficiently understood to identify the main categories of potentially associated health hazards, epidemiological studies and dosimetric concepts are still far from the levels of definition of protection standards adopted in the field of ionizing radiations. The definition of safety thresholds and levels of exposure to magnetic fields during MR examinations has evolved in the last decade and the matter is still under study today. This article summarizes the main steps in this continuous updating process and discusses limitations and criteria, which recently suggested the adoption in some Countries (including Italy) of a two-tier system for the levels of exposure of patients to the magnetic fields generated by clinical MR equipment.

Magnetic resonance imaging has become an established diagnostic modality. The clinical usefulness of in vivo magnetic resonance spectroscopy was demonstrated in several instances and is being explored further. These techniques involve exposure of the patient to static and time-varying magnetic fields and radiofrequency electromagnetic fields. In particular exposure situations, these fields may pose a health hazard. The purpose of this paper is to provide information on the guidelines issued by the International Non-Ionizing Radiation Committee of the International Radiation Protection Association on levels of exposure and health effects from magnetic and radiofrequency electromagnetic fields associated with magnetic resonance diagnostic devices, and on precautions to be taken to minimize health hazards to patients undergoing magnetic resonance examinations.

The neologism "hadrontherapy" means radiotherapy with hadrons, which are the particles constituted by quarks, such as protons, neutrons and ions. The theoretical considerations about the clinical advantages this treatment modality can yield and the results obtained at the centers where it has already been used justify the proposal to project a center of this kind also in our Country. To this purpose, two of the authors of this paper (U. Amaldi, G. Tosi) founded the TERA Group formed by physicists, engineers and radiotherapists who work in close collaboration on a feasibility study for a hadrontherapy facility. The first aim of the Hadrontherapy Project is to design a center equipped with a synchrotron which, at the beginning, will accelerate negative hydrogen ions (H-) which will first produce 70-250 MeV proton beams and, then accelerate light ions (up to 16O) to 430 MeV/amu. This accelerator will serve four or five treatment rooms where patients can be irradiated simultaneously. Two rooms will be equipped with a fixed horizontal beam for the treatment of eye, head and neck tumors; the others will be equipped with rotating gantries to administer, in any clinical situation, really adequate treatment. Such a unit, when enough experience is fained, will allow at least 1000 patients to be treated yearly. The synchrotron injector will be designed so as to allow, parallel to the radiotherapy activities, other applications of medical and biological interest such as: the production of radioisotopes for diagnostic use (especially positron emitters), the analysis of trace elements through the PIXE technique and the production of thermal and epithermal neutrons for boron neutron capture therapy.

Ultrafiltration improves the clinical condition of patients with moderate congestive heart failure. Ultrafiltration (1895 +/- 120 ml of plasma water, rate 600 ml/h, veno-venous bypass) was performed in 30 patients with moderate congestive heart failure in stable clinical conditions. The effects of ultrafiltration were assessed through pulmonary function and cardiopulmonary exercise tests performed before and 30 days after the procedure. Vital capacity, forced expiratory volume (1 s) and maximal voluntary ventilation improved as improved exercise performance (increase in oxygen consumption at peak exercise and at anaerobic threshold). Tidal volume at anaerobic threshold and at peak exercise increased by 10% with no changes in respiratory rate. This suggests that ultrafiltration induces changes at the physical characteristics of the lungs probably related to changes in lung water content.

The network of both intra- and intercellular, either physical (bioconductive connectional system) and/or chemical signals, plays a significant role in the maintenance of tissue architecture and integrity of epithelial cell layers. The basement membrane is not only a static barrier but a dynamic regulator of the urothelium. Any change in the basement membrane can lead, by the extracellular matrix-cytoskeleton-nuclear matrix interaction, to altered gene regulation of the urothelial cells. Abnormal production and deposition or proteolytic degradation of the extracellular matrix components correlate with tumour stage and progression. In some experimental models, tissue inhibitors of metalloproteinases or anti-proteinase antibodies can abrogate the proteolytic activity of those matrix metalloproteinase enzymes (collagenase IV, cathepsin, stromelysin, etc.) which promote tumour invasion. Finally, the current researches investigating the use of biologic protein (e.g., TIMP-1 e-2; agents that affect angiogenesis and spread of neoplasias) are aimed at offer new therapeutic opportunities in oncology.

In the cardiovascular system, morphology and functionality are closely related. The observation that atherosclerotic lesions appear with different incidence in the various sites and prefer bifurcations, suggested that vascular architecture might be an important pathogenic factor. Vascular geometry deals with the evaluation of the "form" element from a theoretical point of a view, pointing out the angles and diameters which can make the arterial system physiologically more efficient. The key element of the system is the bifurcation: depending on whether bifurcations are considered as a single entity or as a whole, either "local" or "global" geometry is employed. The morphology of the bifurcation directly affects blood flow patterns, influencing both blood flow velocity and wall shear stress. Experimental studies evidenced that high blood flow velocities and low wall shear stress have, respectively, a preventive or favorable role in atheroma development. By observing these altered flow sites, the areas which are most likely to develop atherosclerotic damage have been detected in the various bifurcations; the areas correspond to angiographic and autoptic findings. Based on their experience, the authors discuss the contribution that the different imaging techniques can give to the study of vascular geometry.

Metabolic bone disorders are extremely interesting from an epidemiological, clinical and social point of view. In particular, some of them are important for they are typical of elderly people--i.e., the portion of population which is on the increase due to the lengthening of the average life. On the other hand, thanks to the current intervention techniques, the number of chronic nephropathics (in whom metabolic bone conditions may develop) has markedly increased. Therefore, sufficiently reliable methods are needed to allow the thorough evaluation of bone mineral components. Unfortunately, these methods are only of quantitative value because they are unable to discriminate the statuses of the two essential bone components--i.e., cortex and spongiosa--; we all know that bone mineral loss can currently be quantified only when amounting to < 20% of the total value, due to the addition of the mineral contents of the two components. In this paper the authors briefly report on the noninvasive techniques currently in use for the measurement of bone mineral components, especially relative to their physical bases, the knowledge of which is essential for a correct evaluation. The authors accurately reviewed the literature data relative to the various techniques and compared the results obtained by the different authors. Thus, no personal experience is reported, since this paper is aimed at being considered as a reference mark for the reader to be helped in the choice of the equipment suiting him most. However, as to preventing metabolic osteopathies, quantitative methods cannot yield absolute data, which addresses the current research to densitometry by means of the Compton method. The latter may finally lead to the development of operative equipment allowing not only the separate measurement of cortical and spongiose values, but also the qualitative evaluation of bone status--i.e., not limited to mineral loss but including also the determination of the protein, fat and water components.

Among the numerous techniques used to measure body composition, this study utilised anthropometric methods (weight, height, circumference and skin folds) and impedance measurement (measurement of bioelectric impedance). Results from the two methods were compared in order to assess whether BMI parameters and the waist/hips ratio (WHR) influenced this correlation. One hundred and eighty patients (133 F, 47 M) were included in the study. Patients were divided into groups according to the degree of obesity expressed as BMI and WHR. Body composition was evaluated using anthropometric methods (according to Garrow Webster, Durnin-Womersley, modified Durnin-Womersley and Jackson-Pollock) and impedance measurement in which resistive bioelectric impedance is measured using a tetrapolar technique. A good correlation was generally observed in the female population between impedance assessment and anthropometric methods, and this correlation was not influenced by either BMI or WHR. In the male group, on the other hand, the correlation between the two methods was limited by BMI greater than 30 and WHR greater than 1. In conclusion, impedance measurement and plicometric methods are generally compatible, but areas of uncertainty arise in the male population with BMI greater than 30 and WHR greater than 1.

The use of impedance analysis is becoming increasingly widespread as a safe, non-invasive and quick method to assess body composition. Numerous equations, based on variables derived from anthropometric variables as well as from impedance measurements analysis, have been developed to predict the alipidic mass from the resulting analysis. The most frequently used statistical method is the least squares technique. The inadequate reliability of this statistical technique is examined in this study and the use of the technique known as "ridge regression" is suggested.

An account is given of the employment of an O2 concentrator (De VO2 955) in chronic bronchopneumopaths with respiratory insufficiency and pulmonary hypertension. An assessment was made of the gas supply modalities, particularly with Venturi masks. In patients with normal or low ventilation, 24% and 28% FiO2 masks gave suitable results, whereas those with a higher concentration were unusable, since the present FiO2 value was not reached. This was probably due to the fact that there is a fall in O2 concentration at high low flow rates, and as a result of an insufficient Venturi effect.

The various biochemical and biophysical methods to assess fetal lung maturity are reviewed. So far the most widely used biochemical method is the L/S ratio, but in complicated pregnancies mainly in diabetes mellitus, the determination of the lung profile (including PG) must be carried out to reduce false immature ratios. Biophysical methods, like foam stability tests and optical density, are easy and quick, but less precise.

Introduction - Dose and dose-rate in radiotherapy and in electromagnetic hyperthermia - Isodose curves and isotherm curves - Isotherm curves as a function of the target temperature - Dose and target-volume - Why computerized tomography in oncologic hyperthermia CAT and the geometry of normal and pathologic tissues. CAT and the body walls; interfaces between adjacent tissue layers - CAT, water content and dielectric properties of tissues - CAT and thermic properties of tissues - Conclusions.