|
|
|
|
Nicola Dioguardi
Scientific Superintendent
Education
Experience
Scientific Profile
Prof. Nicola Dioguardi entered the Medical Faculty of the University of Bologna
at the beginning of the II World War, a period in which new forms of analysis were being developed
in the field of medicine as a practical science. At that time, the use of statistics was spreading
as a means of evaluating quantified propositions describing the qualities of human organs and
apparatuses. The concept of quantity was beginning to be seen as the key element in the conception
of science, and its symbolism was also being introduced as a part of the knowledge of
medicine.
At a time in which medical research tended to be based on purely qualitative
means of classifying the observed, Dioguardi started his own research work by studying the
transmethylation of the amides of nicotinic acid, a molecular component of the oxidative cell
chain. After beginning his university career, he developed his clinical and speculative interests
in internal medicine particularly in the areas of hepatology, gastroenterology and hematologia,
concentrating on the clinical applications of biochemistry. He qualified as a teacher of Internal
Medicine and became a Director of Clinical Institutes at the Università di Cagliari and, three
later, the University of Milan. In both places, he set and coordinated groups to study the
characteristics of the enzyme systems of erythrocytes and white blood cells, and mitochondria
isolated from the liver of rodents; these studies were among the first to document the
anti-oxidative activity of vitamin E. Particular attention was given to the behaviour of the
molecular forms of the lactate-dehydrogenases of these cells, and in the serum of normal blood and
blood affected by some pathological states, as well as to studying liver tissue homogenates. He
also studied lipid metabolism with a group of cardiologists. This phase of his research, which was
founded on qualitative criteria, was aimed at classifying the natural and pathological states of
liver function in the light of general systems theory, and he continued by applying the concepts of
Rashevsky’s relational biology and then (RM)-systems according to Robert Rosen. These studies led
to the official report of the National Congress of the Society of Internal Medicine (Rome
1982), and Masson’s publication of his book
Il fegato un sistema aperto [The liver: an open system], the first outline of a machine
for quantitative studying the dynamics of the metabolism of cells cultivated
in vitro. This machine has now been patented and is called a “metaboliser” in his
laboratory. This phase also led to another book
Fegato a più dimensioni [The multi-dimensional liver], which was published by Etas
Libri.
The result of this series of research studies led Dioguardi to conclude that: 1)
the description of the liver as an open system suggested by the General Systems Theory provided an
exhaustive laguage for defining the organ a functional body; 2) the assembly of very different
structures which, for some functions, are dispersed in interacting sub-systems having the same
function, to classify the actions and functional behaviours of diseases in clear terms; and 3)
functional-structural descriptions apply an extraordinary language in order to discriminate
dispersed elements belonging to clearly identifiable sub-systems of the complex function of the
organ.
In more strictly clinical terms, Dioguardi reviewed the debate between
quantitative definition and the semi-quantitative descriptions with which hepatological disciplines
confront the problem of interpreting liver biopsies, and began to explore the metric measurement
and geometry of hepatic lesions caused by chronic viral inflammation on the basis of the
mathematical precepts underlying the most modern theory of measurement (fractal theory). This
brought to light the tension provoked by the differences between semiquantitative and
(geometrico-mathematical) quantitative findings (i.e. between empirical and mathematical reality,
at a time in which the latter was experiencing renewed uncertainties as to its infallibility
induced by Goedel’s principle of incalculability), and led him to reflect on the measurability of a
complex organ belonging to a living system, about which doubts were raised because of our
incomplete knowledge of it, and the elements capable of representing its essence. This involves
distinguishing the significance of the elements that can best be used as formalisms on which to
base biological (and not only mathematical) interpretations founded on reason, the demonstration of
theorems, and the identification of concepts from which new knowledge can be drawn.
This mental position led Dioguardi to interpret such formalisms automatically,
and to design a rapid and user-friendly automatic machine that can provide within a few minutes a
quantitative index of the metrical variations of the state changes caused by the hepatocellular
mass (necrosis), the topical immune system (inflammation) and the collagenous component (fibrosis)
of liver tissue, and the consequent changes in (i.e. loss of) the order of tissue tectonics. The
intent is to standardise:
1)
measuring large numbers of biopsies in a short time
2)
obtaining rigorous and repeatable results
3)
discovering the unknown but measurable physical characteristics of
the objects being examined
4)
respecting the ethical principle that, as the aggressiveness of
bioptic examinations involves a small risk for the patient, in addition to entrusting them to
expert hands the tissue specimen obtained must be interpreted as precisely as possible.
It can be seen that such studies not only respond to the theoretical challenge of
the transition from semi-quantitative to quantitative medicine, but above all from the conviction
that the results of the research can have a practical impact on patient well-being and offer
advantages in relation to health policies. In economic terms, diagnostic certainty will reduce
costs as a result of correct therapeutic indications and the possibility of making predictions, and
the utmost rigour in performing biopsies will certainly lead to improvements in the ethics related
to the manoeuvre.
This means that the type of research carried out by Dioguardi will have both a
social and economic impact. The lower costs associated with automatic biopsy readings and diagnoses
will reduce expenditure at a time in which welfare systems are going through an economic
crisis.
Honours and awards
Three times awarded the Gold Medal for Civic Merit by the
Civiche Benemerenze of Milan City Council
Awarded the Gold Medal for Services to Culture and Science by the Ministry of Education
Nominated
Cavaliere di Gran Croce della Repubblica Italiana, by the President of the Italian
Republic
Honorary Member of the Italian Society of Internal Medicine
Honorary Member of the Italian Society of Radiology
Member of the
Istituto Lombardo di Scienze e Lettere, Milan
Member of the
Istituto Veneto di Scienze e Lettere, Venice
Career Prize at the V
Giornate della Scuola Medica Salernitana
Rudolph L.K. Virchow Award
|
Nico
Istituto Clinico Humanitas