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PubMed2001

The antiquity of rheumatoid arthritis: a reappraisal.

OBJECTIVE: To demonstrate the existence of rheumatoid arthritis (RA) before the 19th century. METHODS: Survey of primary and secondary references on the history of rheumatic diseases. RESULTS: Paleopathological evidence suggests the existence of RA in America since 8000 BC and in Europe since the 7th century. Descriptions and representations of a symmetric chronic polyarthritis producing characteristic deformities can be found in Rome since 100 BC and India since 500 BC. The first clinical distinction between RA and gout was published in Mexico in 1578. Different historical conditions contributed to lack of recognition of RA by official medicine before 1800. The recognition of RA as a distinct entity in the 19th century was influenced by socioeconomic circumstances. CONCLUSION: RA is not a recent disease. Historical investigation can provide useful clues on its pathogeny.

Arthritis, Rheumatoid↗
PubMed1995

[Archaelogical documentation of the atmospheric pollution in antiquity].

Authors examines the paleopathologic evidences of the atmosferic pollution in ancient time, point out the attention on two principal findings: pulmonar anthracosis and lead exposure. Pulmonar anthracosis is present in many mummified bodies and was due to the deposition on the pulmonar alveoli of carbon particles coming from the combustion of oils or vegetables for illumination, cooking or heating. Lead atmosferic pollution was very high between V century B.C. and III century A.D. in the North emisphere, in consequence to the impressive quantity of lead produced by Greek and Roman metallurgic technology (perhaps 80,000 metric tons per year around the start of I century AD). Cumulative lead fallout to the Greenland Ice Sheet during these eight centuries was as high as 15 percent of that caused by the massive use of lead alkyl additives in gasoline since the 1930s. Finally, the high atmosferic lead concentration caused a high exposure of humans to the lead: in fact paleopathologists, have clarely demonstrated a high quantity of lead concentration in the human bone dated to the period between III century B.C. and VI century AD circa.

Anthracosilicosis↗
PubMed1999

Renaissance mummies in Italy.

The paleopathological study of 40 Italian Renaissance mummies has allowed us to perform about 20 diagnoses, of which 5 concern infectious (smallpox, hepatitis, condyloma, syphilis and pneumonia), 4 metabolic (obesity, atherosclerosis, gallstones and uric acid nephrolithiasis), 2 articular (DISH and rheumatoid arthritis) and 2 neoplastic (skin apithelioma and colon adenocarcinoma) diseases. The mummy of an anonymous child, dated back to the 16th century (C14=1569 +/- 60), presented a diffuse vesiculo-pustular exanthema. Macroscopic aspects and regional distribution suggested smallpox, while EM reavealed many egg-shaped, virus-like particles (250 x 50 nm), with a central dense core. Following incubation with anti-smallpox virus antiserum and protein A-gold complex immunostaining, the particles resulted completely covered with protein A-gold. These results clearly show that this Neapolitan child died of a severe form of smallpox some four centuries ago. The mummy of Maria of Aragon, Marquise of Vasto (1503-1568), reavealed on the left arm an oval, cutaneous ulcer (15x10 nm) with linen dressing. Indirect immunofluorescence with anti-treponema pallidum antibody identified a large number of filaments with the morphological characteristics of fluorescent treponemes. EM evidenced typical spirochetes, with axial fibril. These findings clearly demonstrate a treponemal, probably venereal, infection. The mummy of Ferrante I of Aragon, King of Naples (1431-1494), revealed an adenocarcinoma extensively infiltrating the muscles of the small pelvis. A molecular study of the neoplastic tissue evidenced a typical mutation of the K-ras gene codon 12:the normal sequence GGT (glycine) was altered into GAT (aspartic acid). At present this genetic change is the most frequent mutation of the K-ras gene in sporadic colorectal cancer. The alimentary "environment" of the Neapolitan court of the XV century, with its abundance of natural alimentary alkylating agents, well explains this acquired mutation. These and other diseases as, for example, a fatal puerperal complication, a thyroid goiter, a case of Wilson's cirrhosis, some cases of anthracosis and other peculiar traumatic conditions, such as a mortal stab-wound, can elucidate the pathocenosis of the wealthy classes of the Italian Renaissance.

History, 16th Century↗
PubMed1992

[Ten physicians who were precursors to physical anthropology in Venezuela].

The purpose of this paper is to report on the pioneering research of ten Venezuelan physicians who played an important role in the development of physical anthropology, paleopathology and, to a certain extent, of forensic anthropology in the country. A brief historical overview of the progress of this science in Venezuela, in the context of its evolution in other parts of the world, is also presented.

Anthropology, Physical↗
PubMed1994

History of medicine and prehistoric orthopedics.

Increasing efforts have been recently made to apply medical technologies to history of medicine of ancient time. Despite the use of molecular biology techniques, the most reliable results have been obtained by the paleopathological study on disease which may be recognized by the observation of stigmata of bones: the datation of skeletal lesions and the findings of cranial and orthopedic lesions indicate that the attempts of cure of bones are typical of early medical activity, dating from the prehistoric antiquity.

History, Ancient↗
PubMedDate not supplied

[When the Egyptian mummies are speaking about the infections that have made them ill].

The microbiological study of mummies has started in 1910 when Sir M.A. Ruffer first applied the histologic methods to the study of mummified tissues and found Schistosoma haematobium ovas dated from the XXth dynasty. Up to the 1990 years, morphological methods including radiology, computed tomography, endoscopy, history, electron microscopy, and serology have been the main tools used in Paleopathology. They led to identify schistosomiasis, dracunculiasis, trichinosis, ascariasis and bone tuberculosis as the most prevalent diseases of the ancient residents of Egypt. The recent introduction of molecular methods (PCR) allowed t confirm the high prevalence of helminth diseases and tuberculosis among these populations, but also added new data exemplified by the widespread distribution of Plasmodium falciparum malaria. In addition, cases of bacterial septicemias and diphteria possibily occurred. Thousands of human and animal mummies remain to be studied with the hope to discover another pathogens responsible for viral or zoonotic infections prevalent during the pharaons' times.

Egypt↗
PubMed1992

New approaches to the study of disease in archeological New World populations.

One of the objectives of paleopathology is to clarify the role of disease in the evolution of human groups. The recovery of DNA and immunoglobulins from archeological human skeletal tissue offers a method for enhancing and expanding our knowledge about the presence and significance of disease in past human populations. DNA also might reveal the presence of genetic disease. Immunoglobulins recovered from archeological bone indicate some of the diseases to which an individual was exposed during life. This information also provides supporting evidence for anatomical observations of skeletal disease. This is illustrated by the identification of treponemal antibody in an archeological skeleton that has gross lesions suggestive of treponematosis. Similar biochemical methods could be applied to other research problems to clarify the presence of various syndromes of the inflammatory erosive arthropathies, such as rheumatoid arthritis, in New World archeological populations. Some of these syndromes are associated with DNA sequences and specific proteins that are recoverable from archeological skeletal tissue.

Archaeology↗
PubMed2005

[Healed war injuries of the cranium in the osteologic collection from the Broumov Ossuary (13th-18th century)].

Traumatic bone lesions form an important part of the study of human paleopathology. Injuries of the skull are frequent in the history of the human race. 647 adult dry skulls of both sexes from the "Broumov Ossuary" (13th-18th century) were examined for the incidence of cranium injuries. In this paper, an extensive collection (n=122) of healed dry skull injuries is presented. In the neuro- and splanchnocranium of skulls (n=78), linear and depressed fractures, slash and stab wounds have been seen but no gunshot wound. In part of the skulls (n=29), multiple injuries have been observed. Many detected traumatic lesions seem to have been caused by traditional weapons of the last centuries: war swords, axes, or pole-arms with metal spikes. All the skull injuries show clear signs of well-healing with bone remodelling that indicates the survival of victims for a long period after the cranial trauma.

Adult↗
PubMed2006

Malignant tumors in two ancient populations: An approach to historical tumor epidemiology.

The actual increase in the rate of malignant tumors has been ascribed to a higher life expectancy and the influence of various environmental factors. Herein, we present data on the frequency of malignant tumors in paleopathologically well-defined historic populations. Thereby, we looked for malignant growth affecting the skeleton in three study populations of 905 individuals that have been excavated from the necropoles of Thebes-West and Abydos, Upper Egypt covering the time period between 3200 and 500 BC and 2547 individuals that have been buried in a Southern German ossuary dating from between AD 1400 and 1800. The tissue preservation of both the Egyptian and Southern German material was excellent. All available specimens were subjected to a very careful macroscopic examination; isolated findings were also radiologically investigated. In parallel, anthropological data, such as gender and age at death, were recorded. We identified 5 cases of malignant tumors affecting the skeleton in the Egyptian material and 13 cases affecting the skeletal material from Southern Germany. In most instances, multiple osteolytic lesions with slight osteoblastic reaction are strongly suggestive for metastatic carcinoma. Few cases with poorly reactive osteolyses were most compatible with plasmacytoma. Relative tumor frequencies on an age- and sex-adjusted population basis (using a mathematic model of skeletal involvement of malignant tumors in a well-defined English study population from AD 1901 to 1905) indicated that the tumor rates were not statistically different between ancient Egyptian, the historical Southern German and the recent English reference population. These observations indicate that malignant tumors were present in spatially and temporarily different populations over the last 4000 years with an age- and gender-adjusted frequency not different from Western industrial populations of c. 100 years ago. Therefore, we conclude that the current rise in tumor frequencies in present populations is much more related to the higher life expectancy than primary environmental or genetic factors.

Adolescent↗
PubMed2006

[Cripples at the medieval hospital of Bátmonostor, Hungary--archeological findings].

Cripples from the medieval hospital of Bátmonostor, Hungary. People with disabilities were generally burdened with a painful fate in ancient times, however in the hospitals was no effective therapy. The hospital of Batmonostor was founded at late 13th century, The authors examine by morphological, radiological and histological methods 426 complete skeletons excavated from medieval (14th-15th century) cemetery of Bátmonostor (Hungary). Among them 30 cases (7.1%) of bony ankylosis, (24 cases on lower limb and 6 cases on upper limb) was found. Sacroiliac ankylosis 3 cases, Bechterew's spondylitis ankylopoetica 1 case was seen. Spondylitis tuberculosa and malum Potti 4 cases, and hunchback with other aetiology 2 cases was detected. Beside the cases with ankylosis severe posttraumatic osteomyelitis (7 cases), primary malignant bone tumors (2 cases) and an osteoplastic metastatic tumors (probably prostata carcinoma) was diagnosed. Paleopathologic study of the physically disabled may yield information and insight on the prevalence of crippling disorders. The authors hypothetize, that crippled persons lived in the hospital until their deaths.

Ankylosis↗
PubMed1991

[Correct and incorrect paths in the history of ankylosing spondylitis].

This article retraces the history of ankylosing spondylitis. While the first part takes into consideration the paleopathological aspects of illness, the second part retains the main stages of the research on the subject from the 16th to the 19th century. This part refers to B.O. Connor, who in 1694 was the first to give a complete description of a characteristic skeleton. This part also mentions Benjamin Brodie who in 1850 wrote the first complete clinical description and Charles Fagge who in his work was the first to combine clinical and anatomical elements. The scientific discussion at the end of the 19th century between Adolf Strümpell. Wladimir von Bechterew and Pierre Marie is also part of this paragraph. The last part shows the important discoveries of the 20th century, specially useful for a better understanding of the pathogenesis of the disease.

Europe↗
PubMedDate not supplied

Tuberculosis among American Indians of the contiguous United States.

Paleopathologic findings provide strong evidence for the existence of tuberculosis in Andean populations of pre-Columbian America. Indirect evidence is available also to suggest its possible endemicity among some American Indian tribes who lived within the present-day contiguous United States before the arrival of Europeans. The available data suggest that tuberculosis became a major health problem in some tribes with increased population density and cultural changes after increased contact with European civilization, paralleling the deterioration in living conditions after relocation of the tribes to reservations. By 1900, tuberculosis had become one of the most serious health problems among North American Indians. Tuberculosis control was hampered by the lack of a specific treatment, and only the advent of specific chemotherapy in an ambulatory setting brought a breakthrough. Mortality, morbidity, and risk of infection have all sharply decreased over the past three decades. However, tuberculosis incidence rates among American Indians remain well above rates in the white population. An intensified effort to identify those with tuberculosis and those at risk of tuberculosis as well as to develop compliance-enhancing strategies with treatment regimens will be necessary to eliminate tuberculosis from Indian reservations.

Antitubercular Agents↗
PubMed1979

Computed tomography of ancient Egyptian mummies.

This first report of the application of computed tomography (CT) to the study of ancient mummies, the desiccated brain of a boy and the body of a young woman within her cartonnage, shows that CT is uniquely suitable for the study of such antiquities, a study that does not necessitate destruction of the mummy or its cartonnage. Exquisite images result that are of great paleoanatomical, paleopathological, and archeological significance.

Adolescent↗
PubMed1981

Craniofacial anomalies in the Upper Missouri River over a millennium: archeological and clinical evidence.

Congenital facial clefting occurs more often in Native Americans from the Upper Missouri River Basin (UMRB) than it does in the general population. However, no facial clefts were seen in 3,750 ancient UMRB skeletons. Very few reports concerning defective palate crania are in the literature of paleopathology. Findings regarding craniofacial anomalies in today's native Americans in the UMRB are presented briefly and compared to those in skeletons from this region. There is a marked difference between the frequency of anomalies which occurred in the past and those which are present today. Although the people sampled here were from many cultures and lived during different time periods, encompassing over a millenium, the fundamental denominator was a common geographic location. Reasons for the differences between the past and the present are advanced. It may be possible to estimate the frequency of anomalies which have not been found in archeological specimens but which are present today. By comparing data concerning "occult" congenital anomalies of the past with those of the present, the actual prevalence of past cranio-facial anomalies may be estimated through careful extrapolation.

Bone and Bones↗
PubMedDate not supplied

Immunohistochemistry: a new outlook in histopaleopathology.

To date, rehydration techniques on mummified tissues as well as the methods for histological specimen preparation with standard basic stains and with histochemical techniques are commonly known and well established. The application of immunohistochemical techniques is a further development in the study of mummified tissues. Similarly to what is done on fresh and fixed tissues, reaction sensitivity and specificity must be guaranteed. While reaction sensitivity depends on serum quality and the detection method employed, specificity is guaranteed by serum quality but also by method standardisation. Method standardisation is the most serious problem in the study of mummified tissues. Mummified tissues have different antigen preservation characteristics, varying from subject to subject, and even within the same subject, depending on the topographic region and the site. These changes are due to different mummification methods and to subsequent environmental conditions in which the mummy was preserved. The Streptavidin-Biotin-Peroxidase Complex (SABC) technique guarantees excellent detection sensitivity. However, the method accuracy and reliability can be ensured only through a rigorous case by case examination with internal controls on structures in which the antigens we are looking for are surely expressed. Today, with these artifices (technique optimisation), cell differentiation phenotype markers can be detected which are useful in paleopathological studies and in the diagnosis of morphologically doubtful lesions.

Antigens, Differentiation↗
PubMed1994

[Preservation of cutaneous structures of egyptian mummies. An ultrastructural study].

INTRODUCTION: The recent development of studies applied to ancient materials may be explained by the application of molecular biology techniques on the extracted ancient DNA mainly the polymerase chain reaction (PCR), the ultrasensitive DNA-amplification technique that hit the headlines in the late 1980s. PCR was used to amplify human immunodeficiency virus (HIV), genetic material in stored tissue specimens and to document people who died in 1976. In addition, recent discoveries of mummified bodies in ice of the Tyrolean Alps or Greenland allowed a new approach in archeological studies. Mummies are a good material for investigations of ancient tissues. The studies concern the techniques of embalming, tissue preservation and palepathological aspects. In cutaneous paleopathology, mummies from Egypt, South or North America and Europe were considered. Various skin lesions were characterized: histiocytoma, Chagas' disease, smallpox, syphilis. Recently drugs (cocaine, hashish and nicotine) were extracted from skin and head hair of Egyptian mummies. Only a few studies were concerned with the ultrastructure of the skin of such mummies. MATERIAL AND METHODS: We had the opportunity to obtain skin samples of two Egyptian mummies. One of them was embalmed between 150 BC-90 AC. The skin was studied by transmission electron microscopy. As the mummified materials had dried out and shrunk, it was necessary to rehydrate them for ultrastructural observation. Skin samples were fragmented into small pieces before fixation with 2 p. 100 glutaraldehyde in sodium cacodylate buffer for 10 days (allowing for removal of the materials used for embalming). The samples were then washed in the same buffer for 10 days. After washing the pieces were post-fixed with 1 p. 100 osmium tetroxyde, dehydrated and embedded in Epoxy medium. RESULTS: With this process, it was possible to observe the excellent preservation of the cutaneous structures. The epidermis was well preserved. It was possible to observe the different cell layers and mainly the upper layers. The nuclei and the desmosomes of keratinocytes were recognized. Intercellular spaces were narrow. Desmosomes showed dense thickenings of the cell membrane on both sides and an intercellular band with narrow lucent spaces adjacent to the dense cell membrane. The nuclei showed dense spots of chromatin and in the cytoplasm recognizable tonofilament bundles were identified. Langerhans cells and melanocytes were not observed. In the dermis, the collagen fibrils formed thick bundles and showed the characteristic axial periodicity. Elastic fibers were also recognized showing two main components: the amorphous substance and the fibrils. Throughout the dermis, a number of round or oval structures were found. They had the typical appearance of spores of bacteria. In the centre, they had an electron dense and granular core surrounded by an inner membrane and a spore coat. DISCUSSION: Only a few investigations were performed on the ultrastructure of the skin of the Egyptian mummies. In the majority of cases, the epidermis was not preserved. The present work demonstrates the good preservation of epidermal structures and specially desmosomes and intercellular connections. The presence of spores of bacteria was previously reported. These spores enter a highly resistant resting phase in order to survive in a dormant state for a long period of starvation or other adverse environmental conditions. Similar investigations were performed on skin obtained from Eskimo mummies preserved by the extremely cold and dry polar weather. In these conditions, the authors reported the observation of melanocytes, vessels and nerves. Additionally, biochemical investigations demonstrated the very good preservation of collagen and glycosaminoglycans of the dermal extracellular matrix.

Collagen↗
PubMedDate not supplied

International perspectives of lead exposure and lead toxicity.

Three approaches have been used to examine how human body burdens of lead depend on different environments: (1) In paleopathologic studies, lead concentrations have been determined in well-preserved human bones or teeth, and pre-pollution samples generally show lead concentrations of about 1% of current levels in industrialized countries. (2) Geographic comparisons of blood-lead concentrations show low levels in, Nepal, Faroe Islands, and Sweden, while high levels occur in Mexico and Malta; average blood-lead levels may vary by a factor of 10 or more. (3) In analytical epidemiology, major exposure sources have been related to lead levels in blood, by either prospective or cross-sectional design. Increased blood-lead concentrations are related to smoking, drinking alcoholic beverages, eating vegetables for dinner, urban residence, and exposure from lead-using industries; average blood-lead values of subgroups within well-defined populations may vary by a factor of 3 or more. The dose-relationships for lead-induced neurotoxicity will depend on the sensitivity of the parameters chosen as indicators of lead exposure and of neurotoxicity. The temporal relationship between lead exposures and the development of deficits must be ascertained. Individual susceptibility and interacting factors must also be taken into account. Differences in addressing these issues impede the comparison between studies. Recently neonatal jaundice has been found to be a risk factor for subsequent neurobehavioral dysfunction in children with a birth weight above 2500 g, but only in children with increased lead exposure. Lead exposure may act in combination with several other factors and result in additive, or synergistic effects.(ABSTRACT TRUNCATED AT 250 WORDS)

Environmental Exposure↗
PubMed1994

[Philippe-Charles Schmerling (1790-1836) reveals the antiquity of man thanks to antediluvian deposits of the Liège caves].

Philippe-Charles Schmerling, often considered as the founder of paleontology, was undoubtedly a prominent personality in the province of Liège. The author evoques the beginning of paleontologic and prehistoric research in Wallonia through the biography and the analysis of Schmerling's works. Some of his contributions were completely disregarded, especially in the field of paleopathology where he can really be considered as a founder. Posterity will mainly retain his assertion about the contemporaneity of mankind with extinct animal species.

Belgium↗