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PubMed2002

Paget's disease in an archeological population.

The aim of this investigation was to study the prevalence and distribution of Paget's disease in an archeological population. Paget's disease, first described over 100 years ago, is a well-recognized chronic disorder involving abnormal bone turnover with established radiological features. Prevalence within modern populations varies both within individual countries and between them. Paleopathological examples are uncommon and sporadically reported both from Europe and the Americas and from many periods of history. A large skeletal assemblage (2,770 individuals) from Barton on Humber, UK, provided an opportunity to examine the prevalence of Paget's disease in one area of the northern England over the period 900-1,850 AD. All bones were examined visually for evidence of Paget's disease of the bone (PDB) and all abnormal bones were examined further by plain radiography. Fifteen cases of probable Paget's disease were found. The overall prevalence was 2.1% in those aged >40 years. The prevalence before 1500 AD was 1.7% and post-1500 AD was 3.1%. The distribution of disease mirrored modern disease, with the lumbar spine, pelvis, and proximal femur being the commonest sites. The prevalence of Paget's disease in the United Kingdom over the last 1,000 years has been assessed. Although there is a trend of increasing prevalence, this did not reach statistical significance. This is likely caused by the small sample size, but this is by far the greatest number of cases of PDB described in a single skeletal assemblage to date. The distribution of lesions within the skeleton is unchanged.

Adult↗
PubMed2002

Head and skull base features of nine Egyptian mummies: evaluation with high-resolution CT and reformation techniques.

OBJECTIVE: CT is an indispensable imaging tool in the evaluation of Egyptian mummies because it can noninvasively generate large amounts of data. We applied current CT imaging and postprocessing techniques to methodically survey the head and skull base features of nine Egyptian mummies in the hope of providing paleopathologic and radiologic information. MATERIALS AND METHODS: Nine Egyptian mummies were evaluated on helical CT using 1-mm axial scans obtained from the skull vertex to the mid cervical spine. Systematic evaluation of the skull and intracranial contents, paranasal sinuses, craniocervical junction, orbits, temporal bones including the middle and inner ears, teeth, and superficial soft tissues was undertaken. Reformatted and volume-rendered images were generated. RESULTS: CT findings indicated that the intracranial contents of the nine mummies varied tremendously. Destruction of the anterior skull base structures in mummies without intracranial contents suggested a transnasal, transethmoidal approach to excerebration. A large amount of expensive embalming material within the skull of one mummy suggests that he may have been a royal pharoah. A cleft palate deformity was identified in a child mummy. Temporal bone analysis revealed one case of asymmetric mastoid air cell erosion and dehiscence, which is strongly suggestive of prior mastoiditis. Craniocervical junction abnormalities and ossicular chain disruption in several mummies were attributed to postmortem damage. The orbital structures had intentionally been removed in several mummies. Dental disease was ubiquitous among the adult specimens. CONCLUSION. The systematic evaluation of the head and skull base of mummies with CT can provide insight into the life, disease, death, and postmortem treatment of these ancient Egyptians.

Adolescent↗
PubMed1988

Aspects of the history of rheumatoid arthritis in the light of recent osteo-archaeological finds.

Rheumatoid arthritis (RA) is one of our most common disabling diseases today. Whether or not RA also existed in ancient times has been questioned and debated in recent years. Supporters of the view of recent onset claim that evidence of the existence of RA in antiquity can be found neither in old literature nor in paintings--and most important--convincing paleopathological finds are lacking. The following presentation reviews the results of an examination of skeletons found during an excavation of a neolithic burial place in the island of Gotland, Sweden. In two skeletons there were marked peripheral changes in both large and small joints. These changes are compatible with in vivo presence of a chronic aseptic polyarthritis. Different diagnostic possibilities for such polyarticular joint disease are discussed. It is suggested that RA might be the most probable alternative although other possibilities cannot be excluded.

Adult↗
PubMed1994

Did Bechterew describe the disease which is named after him? A question raised due to the centennial of his primary report.

From paleopathological studies of egyptian mummies it is known that pelvospondylitis existed in ancient times. In spite of that a disease entity has not been clearly defined until recent years. The discovery of the rheumatoid factor, 1940 by Waaler and 1948 by Rose, allowed differentiation from RA. The first criteria for pelvospondylitis were proposed at a symposium in Rome 1961. Another important step in the history of pelvospondylitis occurred in 1973 when the connection to the HLA-B27 was discovered. Initial clinical descriptions appeared in the last decade of the 18th century. One of the contributors was the Russian Wladimir Bechterew (Fig. 1) whose name thereafter has been linked to the disease. Since it is the centennial of Bechterew's original report it seems appropriate to review that publication.

Europe↗
PubMedDate not supplied

Use of the amplification refractory mutation system (ARMS) in the study of HbS in predynastic Egyptian remains.

We conducted a molecular investigation of the presence of sicklemia in six predynastic Egyptian mummies (about 3200 BC) from the Anthropological and Ethnographic Museum of Turin. Previous studies of these remains showed the presence of severe anemia, while histological preparations of mummified tissues revealed hemolytic disorders. DNA was extracted from dental samples with a silica-gel method specific for ancient DNA. A modification of the polymerase chain reaction (PCR), called amplification refractory mutation system (ARMS) was then applied. ARMS is based on specific priming of the PCR and it permits diagnosis of single nucleotide mutations. In this method, amplification can occur only in the presence of the specific mutation being studied. The amplified DNA was analyzed by electrophoresis. In samples of three individuals, there was a band at the level of the HbS mutated fragment, indicating that they were affected by sicklemia. On the basis of our results, we discuss the possible uses of new molecular investigation systems in paleopathological diagnoses of genetic diseases and viral, bacterial and fungal infections.

Anemia, Sickle Cell↗
PubMed2001

A career takes form: Ellis Kerley's tenure at the Armed Forces Institute of Pathology (1957-1966).

From 1957 to 1966, Ellis Kerley was employed at the Armed Forces Institute of Pathology (AFIP) in Washington, DC. Kerley worked in the Orthopedic Pathology section under the supervision of Lent C. Johnson, MD. As the only staff anthropologist at the AFIP, he lectured, conducted research, and consulted on forensic cases. His best-known research completed during these years was the osteon aging technique. He also conducted research and lectured on paleopathology and skeletal identification. Kerley's AFIP experience aided him in pursuing a distinguished career as a forensic scientist, within both academia and the federal government.

District of Columbia↗
PubMed2001

Benign familial hypermobility syndrome and Trendelenburg sign in a painting "The Three Graces" by Peter Paul Rubens (1577-1640).

Clinical features suggestive of hypermobility syndrome and a positive Trendelenburg sign are described in a painting "The Three Graces" (1638-1640) by Peter Paul Rubens, Prado, Madrid. The most obvious findings are scoliosis, positive Trendelenburg sign, and hyperextension of the metacarpal joints, hyperlordosis, and flat feet. The sitters, presumably Hélène Fourment (second wife of Rubens) and her sisters, support the hereditary familial aspect of hypermobility. Manifest hypermobility of the hand has also been found in two other ancient paintings: "Saint Cyriaque" in the Heller Retable by Mathias Grünewald (1450-1528), Frankfurt, and "The wounded man" by Gaspare Traversi, Venice (1732-1769). The finding of signs of hypermobility in ancient paintings shows that artists who are keen observers of nature could describe, or at least record, this condition long before doctors did. The art of the past can be a useful tool in the field of paleopathology.

Female↗
PubMed1995

[The history of rheumatoid arthritis].

The paper is a brief survey of the manner by which rheumatoid arthritis appears in modern clinical practice. The symmetric joint involvement, the location of synvial inflammatory changes in the joints of the hands, and the erosive bone lesions are stressed. The past and present nomenclature of chronic arthritis as well as the differential diagnostic possibilities, especially gout, are discussed. Rheumatoid arthritis may be of recent origin in Europe. The first reliable description of the disease was published in the year 1800. The medical and nonmedical literature, the visual arts, and the paleopathological examinations of skeletal findings from ancient and mediaeval times have failed to disclose certain evidence of the existance of the disease in The Old World before 1800, but bone changes found in skeletal material excavated in a district in America may indicate the existance of the disease here two or three thousand years ago. Since rheumatoid arthritis seems to have a hereditary as well as an environmental etiology the disease may have been brought from The New World to the Old World after the time of Columbus.

Arthritis, Rheumatoid↗
PubMed2001

[Some aspects of the history of tuberculosis with special reference to Finland].

A popular theory has been that Mycobacterium (M) tuberculosis evolved from M. bovis after cattle domestication. The evidence of M. tuberculosis complex in the Western Hemisphere before Columbus and the paleopathological evidence from the Near East indicate that this relationship between cattle domestication and evolution of tuberculosis might not have been so straightforward. Tuberculosis was already familiar in Scandinavia during the Middle Ages. In Finland consumption was firmly established in both towns and countryside at the end of the 1700s and the epidemic peaked during the following century. Tuberculosis infection must have been an almost universal feature of childhood in many areas of Finland, even in the early decades of the 20th century. After the Second World War, specific and effective chemotherapy and preventive measures rapidly diminished the number of new cases of tuberculosis.

Finland↗
PubMedDate not supplied

The "Braids Lady" of Arezzo: a case of rheumatoid arthritis in a 16th century mummy.

OBJECTIVE: To diagnose a probable case of rheumatoid arthritis in a mummified female body from the 16th century and to backdate the first clinical diagnosis, entering the diatribe regarding the ancientness of the disease. METHODS: Image techniques such as normal X-ray, X-ray by mammography, total body CT and high resolution CT were used. Microscopic examination by stereomicroscopy was performed. Samples of tissue were submitted to histology. These data and the review of past literary references, of artistic representations and of paleopathological cases provided an interesting contribution to reconstruct the history of the disease. RESULTS: The body of the "Braids Lady" showed all the "stigmata" of the disease. The left hand revealed large erosions of the metacarpophalangeal joints of both the third and the fourth fingers, volar metacarpophalangeal subluxation of both the third and the fourth fingers and lateral deviation of all the fingers. The carpus showed some minute and marginal erosions of the bones. The bases of the first phalanges were slightly flared. The toes showed partially overlapped fibular deflection. CT evidenced subluxations of the joints. The body showed no involvement of sacroiliac articulation. CONCLUSIONS: The "Braids Lady" was affected by rheumatoid arthritis. A large number of features typical of the disease were recorded. Differential diagnosis supported the findings. The death of the lady was established at the end of 16th century, namely 200 years before the first clinical diagnosis worked out by Landré Beauvais in the early 1800s.

Arthritis, Rheumatoid↗
PubMed1992

[Genetic evidence corroborates Negme's hypothesis about the greater mildness of American trypanosomiasis in Chile].

Chagas disease is present in northern and central Chile. Not more than 25% of infected individuals have had a pathologic condition presumably due to Trypanosoma cruzi. The majority of individuals with chronic infectious Chagas disease in Chile are asymptomatic in contrast to what has been observed in other South American countries. Historic and paleopathologic evidences suggest that this particular behavior could be explained by a genetic adaptation of Chilean aborigines to T cruzi. Associations between ethnic admixture, presence of Chagas disease, associated cardiac pathology and 4 blood groups (ABO, MNSs, Rh and Duffy) were investigated among inhabitants of San Pedro de Atacama in northern Chile. Cardiac pathology was determined by positive serologic reactions in individuals with abnormal electrocardiographic findings. Individuals with negative serologic results had a significantly greater aboriginal admixture (88%) compared to those with positive serology (66%). This findings supports the hypothesis of genetic adaptation explaining mildness of Chagas disease in Chile.

Adaptation, Physiological↗
PubMed2004

Factors affecting postmortem tooth loss.

Unassociated human bones are a particular problem during the exhumation of mass graves and a factor that limits anthropological and paleopathological analyses from archaeological contexts. Extensive anthropological literature has focused on the complex taphonomic factors that influences bone assemblages, but little attention has been paid to postmortem tooth loss and factors affecting this process. The following study focuses upon the influence of different factors on postmortem tooth loss. Three samples were investigated in the study: a medieval church cemetery containing 110 individual skeletal remains, and two samples from a series of mass graves made within the same time period in 1999, containing 402 bodies. The frequency of postmortem tooth loss was analyzed relative to postmortem interval for each sample, excavation methods, age distribution, and presence of bone loss associated with periodontal disease. Our results indicate that the degree of alveolar bone loss significantly affected both antemortem and postmortem tooth loss and that the frequency of postmortem tooth loss has the strongest correlation to time since death. These findings suggest that additional care should be taken when exhuming remains from older contexts.

Adolescent↗
PubMed2006

"Virtual unwrapping" of a mummified hand.

The purpose of this work is to demonstrate the feasibility of medical virtual reality technologies in the investigation of a mummified hand. The Ulster Museum obtained the mummy hand, which originated from Thebes, without any identifying information. The mummified hand was investigated using conventional X-ray and 3D multi-slice Computed Tomography (CT). Imaging revealed a range of fractures of the wrist, metacarpals and phalanges whilst 3D CT demonstrated internal structures using volume rendering. The absence of any features of bone healing at the fracture sites would imply that they occurred just prior to death or in the mummified state possibly during excavation. Conventional X-ray imaging indicated that the hand, although small, was likely to have originated from an adult. Medical imaging and virtual reality display will enable us to produce a rapid prototyped model using fused deposition technology. Therefore, further paleopathological research can be performed on the replica without the need to handle the original specimen.

Computer Simulation↗
PubMedDate not supplied

[Pathologic, morphologic and anthropologic characteristics of Avarian teeth and jaws from graves in Becej].

During the reconstruction of the water pipe lines, in Pionirska street, at Bechej in 1989, a part of a large graveyard was uncovered. Human remains were found in graves, below the level of the underground water, so that the most of the human skeletons were either completely destroyed, or partly preserved. A few graves were damaged during excavations in previous ears and some of the graves were robbed also at an earlier period. Paleopathological and anthropological investigation carried out at the Department of Anatomy, Faculty of Medicine in Novi Sad, revealed that these remains belong to an Avarian population which had similar epigenetic and anthropometric characteristics as the Avarian population found at the well known site at Kiskoros Vagohid, in Hungary, precisely the skeleton from the grave No. XXXV. Study of the teeth and jaws complete these results. At six mandibles, which belong to the mature skeletons, was found narrowness in the frontal region of the mandibular alveolar arch was recorded. Degree of narrowness of the frontal mandibular dental arch, deficient in space at mandibles was different, and varied from 2 mm to 8.5 mm, or 3 to 24.38%, which is necessary to set the teeth in the correct line in a mandible.

Dentition↗
PubMed1991

[Ethnomedicine--history of medicine. Sciences of medical thinking and behavior of man].

Ethnomedicine and the history of medicine have in common the description of medical systems, whereby the separation is geographical in the former case and historical in the latter case. As experts in both fields are not at the same time practitioners of these medical systems, they depend on source material. The interpretation of these sources is largely subordinated to the subjective personal structure of the scientist on the one hand, and is closely related to epistemiological problems, coloured by the spirit of the times, on the other hand. Above all, many medical historians even today fall victim to an unjustified cultural evolutionism, according to which ethnomedical research work in the field of "primitive medicine" may be employed to reconstruct a fictive paleopathology. The cooperation which is nowadays established between ethnomedicine and the history of medicine concerns the common structures of medical systems in their social and cultural context--so-called pattern--with the aim of establishing a theory of medical thinking and behaviour of man.

Anthropology, Cultural↗
PubMed1990

Traumatic injuries of prehistoric teeth: new evidence from Baluchistan and Punjab Provinces, Pakistan.

Traumatic lesions of the dentition are rarely reported, while skeletal trauma constitutes a significant portion of the paleopathology literature. The purpose of this paper is to show how meticulous analysis of traumatic dental lesions can provide insights into patterns of behavior in prehistory. Two cases of dental trauma from prehistoric Pakistan illustrate some crucial problems in diagnosing the etiology of traumatic lesions. Bio-behavioral insights derived from the analysis of dental trauma compliment inferences gleaned from more traditional approaches, including the study of dental attrition and dental morphology.

Adult↗
PubMed1994

-Malaria in the eastern Mediterranean in prehistory and antiquity-.

Paleopathological data support the hypothesis that malaria recrudescences in Greece occurred at the Mesolithic, at the top of the classic period and at the beginning of the Turkish conquest. Malaria due to Plasmodium falciparum did not appear until the 5th century B.C.

Greece, Ancient↗
PubMed1994

[Traces and evidence of pathology in the figurative arts].

This study is interested in figurative works of the past in which the artist had seemingly no purpose to illustrate pathological manifestations and their display was merely casual. It deals with both scientific and humanistic aspects and is of relevance to pathologists, in that it provides further insights into the epidemiology of some disease. Also, it contributes to an ever increasing progress of knowledge of historical and geographical pathology. The author has been carrying out this study without following a definite pattern, guided only by chance and curiosity, and discovering that artists could sometimes portray to perfection malformations and morbid conditions which would later be identified and classified in medicine, thus anticipating and even emphasizing the expressiveness of descriptions in scientific works. In his study, referring to paleopathology (therefore, not necessarily only very ancient), the author intends to illustrate briefly different cases found and to dwell in particular on two conditions, dwarfishness and endemic goitre, whose representation is particularly frequent in figurative arts. Representations of dwarfishness, in several of their genotypic and phenotypic variations, exist particularly in ancient Egyptian, Assyrian, Greek, Roman and, in the American continent, pre-columbian art; and then, again in Europe, mostly in 15th and 16th century art, but also in the following centuries, in which statues of dwarfs and malformed people were placed even in public and private gardens as ornaments. There are mainly representations of primary digenetic dwarfishness (total or partial chondrodysplasia, Lobstein type osteopsathyrosis, Hurler and Morquio diseases and other thesaurismoses), but also secondary (dysendocrinous-hipopituitaric and hypothyroid-, and due to different types of rickets and to vertebral tuberculosis of Pott). Representations of dwarfs of different types are shown and commented, from the most ancient, through the masterpiece portraits of Spanish 17th century, up to modern times. As to the goitre, a set of its most significant portrayals in figurative arts is presented in chronological order beginning with the most ancient ones and focussing on Italian representations of the Nativity and the Passion of Christ, where the most striking infirmities and disabilities were mirrored and commonly accepted. As far as pathology is concerned, it is pointed out how, for a long time in the past, the goitre appears frequent and widespread. This condition reached such an extent that it could almost represent another type of people, playing at times the main characters not only, as said, in Christian iconography, which for many centuries was almost the only one to exist, but also in every day life.

Disease↗