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Arkiv for kategorien ‘Paleopatologi’

The diagnosis and context of a facial deformity from an Anglo-Saxon cemetery at Spofforth, North Yorkshire [en]

søndag den 29. september 2013

The diagnosis and context of a facial deformity from an Anglo-Saxon cemetery at Spofforth, North Yorkshire by Elizabeth Craig-Atkins and Geoff Craig. International Journal of Osteoarchaeology, John Wiley & Sons, Ltd (2012)

An individual aged between 6 and 7 years at death from a 7th to 9th century cemetery at Village Farm, Spofforth, North Yorkshire, presented significant pathological swelling to the left facial bones. The ectocranial surface was bulbous and uneven, and the expanded diploë was densely packed with a mass of thick trabeculae. Radiographic and histological analysis, in combination with the macroscopically observed pathological changes, supported the differential diagnosis of fibrous dysplasia. The skeletal changes to the left face and jaw would have resulted in a significant facial deformity. Examples of individuals with physical impairments or disfigurements from Anglo-Saxon cemeteries are rare.

Nevertheless, it seems that a significant proportion are afforded unusual burial practices more often associated with deviancy, for example, at the edge of cemeteries or on a reversed orientation, seemingly indicating that their diminished physical capabilities or altered physical appearance had a detrimental effect on their social status. The child from Spofforth was, however, buried in a normative manner, extended, supine and in a plain earth-cut grave, with no indication that their facial deformity had prompted unusual funerary provision. This example of facial disfigurement contributes to a growing corpus of potentially disabled individuals from early medieval England.

Click here to read this article from the International Journal of Osteoarchaeology

Diffuse Idiopathic Skeletal Hyperostosis (DISH) [da]

lørdag den 16. februar 2013

A 'Spine Lecture' I found on YouTube by Spiro Antoniades, M.D.

I am sure that in the future you will here more of DISH here on the blog!

Diffuse idiopathic skeletal hyperostosis (DISH) is a spondyloarthropathy also known as Forestier's disease and ankylosing hyperostosis. It is a noninflammatory disease, with the principal manifestation being calcification and ossification of spinal ligaments and the regions where tendons and ligaments attach to bone (entheses). The whole spine may be involved, and bony ankylosis occurs, although the disc spaces and facet joints remain unaffected. In advanced stages, the disease may look like melted candle wax. The calcification and ossification is most common in the right side of the spine. In people with dextrocardia and situs inversus this calcification occurs on the left side, which confirms the role of the descending thoracic aorta in preventing the physical manifestations of DISH on one side of the spine. (Wikipedia)

Leprogenic odontodysplasia [da]

tirsdag den 29. januar 2013

New Open Access Article: Vítor M.J. Matos & Ana Luísa Santos: Leprogenic odontodysplasia: new evidence from the St. Jørgen’s medieval leprosarium cemetery (Odense, Denmark)

Leprogenic odontodysplasia
Leprogenic odontodysplasia

The old cemetary belonging to the leprosy hospital here in Odense was excavated between 1980 and 1981. It was in use from 1270 to 1560. The 1544 skeletons from the cemetary are stored at our anthropological department (ADBOU) at the University of Southern Denmark. A wonderful collection of approx. 15,000 primarily medieval skeletons.

You can see pictures of a mother and her unborn child, also from St. Jørgen’s leprosarium in Odense here.

Severe rotoscoliosis with gibbus deformity [da]

mandag den 28. januar 2013

Severe rotoscoliosis with gibbus deformity

35 Y/O male with congenital spinal anatomical abnormalities (kyphosis and scoliosis due to formation and segmentation failure). This deformity exaggerated with trauma at childhood.

The left scoliotic curve is angular and the kyphosis is extreme (Gibbus deformity). Bone detail is characteristically confused at the deformity. Multiple formation and segmentation failures with old collapse and compression fractures are noted at T11-L1 levels. Severe rotational deformity also is seen. Spinal canal is narrowed at the angle of the deformity.

A Diaphyseal Giant Cell Tumor of Bone Involving Radius [da]

mandag den 28. januar 2013

A Diaphyseal Giant Cell Tumor of Bone Involving Radius

This is one of the rare presentations of the giant cell tumor of bone, a lesion that can be rather difficult to deal with even in its typical form. It is normally seen at the ends of the long bones and it is purely lytic (radiolucent) in most cases.

The above example is accompanied by secondary aneurysmal bone cyst and prominent periosteal new bone formation making a radiological diagnosis almost impossible. Microscopy (apart from the presence of too much osteoid) was typical, however. The patient, a 50-year-old man, had no lesions in the other bones.

Source: Medical School

Ovarian tumour, with teeth and a bone fragment inside, found in a Roman-age skeleton [da]

torsdag den 24. januar 2013
Calcified ovarian teratoma
Calcified ovarian teratoma

A team of researchers led by the UAB has found the first ancient remains of a calcified ovarian teratoma, in the pelvis of the skeleton of a woman from the Roman era.

The find confirms the presence in antiquity of this type of tumour – formed by the remains of tissues or organs, which are difficult to locate during the examination of ancient remains. Inside the small round mass, four teeth and a small piece of bone were found.

Teratomas are usually benign and contain remains of organic material, such as hair, teeth, bones and other tissues. There are no references in the literature to ovarian teratomas in ancient remains like those found in this study, led by the researcher Núria Armentano of the Biological Anthropology Unit of the UAB and published in the International Journal of Paleopathology.

The tumour in question is rounded in shape, with a wrinkled surface, of the same colour as the bones, about 43 mm long and 44 mm in diameter. It was found in the right-hand part of the pelvis of a woman of between 30 and 40 years of age and who lived around 1,600 years ago, and came from the Roman cemetery in the archaeological site of La Fogonussa (Lleida). A macroscopic examination and a scan revealed four teeth of anomalous morphology inside the tumour, two of which were adhering to the inside wall of the tumour, and a small bone fragment.

Read more here

Original article: Núria Armentano, Mercè Subirana, Albert Isidro, Oscar Escala, Assumpció Malgosa, "An ovarian teratoma of late Roman age", International Journal of Paleopathology, Volume 2, Issue 4, December 2012, Pages 236-239, ISSN 1879-9817, 10.1016/j.ijpp.2012.11.003. (pdf)

The Gladiator Graveyard [da]

tirsdag den 8. januar 2013

Read presentation here

Thanks to Morbid Curiosity for this link

“The procession of the cripples” [da]

fredag den 28. december 2012
The procession of the cripples by Hieronymus Bosch, 1500 (Albertina Museum, Vienna)
The procession of the cripples by Hieronymus Bosch, 1500 (Albertina Museum, Vienna)

In the article “Hieronymus Bosch (1450-1516): Paleopathology of the Medieval Disabled and its Relation to the Bone and Joint Decade 2000-2010” (pdf) by Jan Dequeker, Guy Fabry and Ludo Vanopdenbosch (Isr Med Assoc J. 2001 Nov;3(11):864-71.) you can find what they believe to be most likely diagnosis for each of the persons in the drawing.

Acute Osteomyelitis – Historically known as “Bone Fever” [da]

fredag den 28. december 2012

Via biomedicalephemera:

Acute Osteomyelitis

Osteo-: Bone
-myelo-: Marrow
-itis: Fever

Top: Acute supperative osteomyelitis in femur - note the purulent cavities and pus-filled medullary canal at A, B, and C. In this case, the epiphysis (E) and conjunctive cartilage (D) are uninfected.

Center Left: Acute osteomyelitis of tibia, cicatrices showing common position of sinuses in bone.

Center Right: Acute epiphysial separation due to osteomyelitis following typhoid fever.

Bottom: Early stage of acute osteomyelitis in tibia. Note site “A” - where the infection passed from the periosteum to the interior of the bone. The articular cartilages (C) are sodden with pus from the infected joint.

Acute osteomyelitis is most commonly seen in children and those with diabetes. It is rarely “spontaneous” - the bacteria that infect the subperosteum and marrow have to be introduced into the bloodstream somehow, and there is usually a known source.

Systemic infection or traumatic injury are the most common ways that bacteria (today, most commonly Staphylococcus aureus) can get to the bones. Historically, scarlet fever (caused by group A Streptococcus pyogenes) and typhoid fever (Salmonella typhi) were known to cause a large number of osteomyelitis cases in their wake.

When children develop osteomyelitis, the long bones of the body (the femur, humerus, etc.) are most often affected, whereas the spine and pelvis are most commonly affected in adults. This is because there is much greater bloodflow to the growing long bones in kids, and as such there’s much more opportunity for bacteria in the blood to infect the site.

Early symptoms of what used to be called “bone fever” are fever and bone pain (as one might assume), as well as local warmth and swelling, and an overall malaise. The bone infection usually presents after a patient appears to have recovered from a disease or wound, as it takes several days to become established enough to cause symptoms. Later on, if left untreated, extreme pain and open, often purulent, wounds above the infection may occur, as the bacteria bore canals through the affected bones.

Without treatment, osteomyelitis can lead to sepsis, complete breakdown of affected bones, or gangrene. When the epiphysis is affected by the infection, growth of that bone can be significantly stunted.

Today, the condition is usually treated with long-term, high-dosage, IV antibiotic therapy. If it’s not caught at the start of the infection, debridement of the bone (removing the infected tissue) may be required, and in extreme cases, bone resection (cutting out an entire chunk of infected bone) or amputation may be required. Prior to antibiotics, resection was the most common cure.

Source: Diseases of the Bones, their pathology, diagnosis, and treatment. Thomas Jones, 1887.

Cures against syphilis through history [da]

lørdag den 22. december 2012

From a paleopathological point of view syphilis is a wonderful disease since it is so easy to diagnose from the remaining bones. To the diseased however a much dreaded fate awaited: If the disease did not kill you the cure propably did. From early on mercury was used in an attempt to cure syphilis. This should come as no surprise since the application of the mercury had been used to treat skin conditions from the 1300’s. As early as in 1496 Giorgio Sommariva of Verona is reported to have used mercury against syphilis and in 1502 Jacob Carpensic should have made himself a fortune by using mercury as a treatment against the disease. In 1936 Paracelsus proclaimed that mercury was the only propper cure against syphilis.

The mercury was administered in various fashions, including by mouth, by rubbing it on the skin, and by injection. One of the more curious methods was fumigation, in which the patient was placed in a closed box with his head sticking out. Mercury was placed inside the box and a fire started under the box, causing the mercury to vaporize. It was a grueling process for the patient and the least effective for delivering mercury to the body.

In the sixteenth and seventeeth centuries German candidates for the doctor's degree were made to take an oath that they would under no conditions prescribe mercury for their patients.

In 1905, Fritz Schaudinn and Erich Hoffmann discovered Treponema pallidum, the spiral shaped bacterial cause of syphilis. Researchers now had a target to use in a search for an even more effective therapy. One year later, the first effective test for syphilis, the Wassermann test, was developed.

As the disease became better understood, more effective treatments were found. An antimicrobial used for treating disease was the organo-arsenical drug Arsphenamine, developed in 1908 by Sahachiro Hata in the laboratory of Nobel prize winner Paul Ehrlich. The drug was originally called "606" because it was the sixth in the sixth group of compounds synthesized for testing; it was marketed by Hoechst AG under the trade name Salvarsan in 1910.

In 1928 Alexander Fleming discovered the anti-bacterial qualities of the mold penicillin, and the development of penicillin for use as a medicine is attributed to the Australian Nobel laureate Howard Walter Florey, together with the German Nobel laureate Ernst Chain and the English biochemist Norman Heatley. From the early 1940ies penicillin was mass-porduced and this led to a dramatic drop in the prevalence of syphilis as well as many other previously serious infectious diseases. It was introduced in a time when less than one out of every one hundred syphilis patients ever recovered. Penicillin is still used today to treat syphilis.

Mercurial cream
No. 1: Mercurial cream
Mercurous chloride tablets
No. 2: Mercurous chloride tablets
Salvarsan treatment kit
No. 3: Salvarsan treatment kit
Bottle of Salvarsan
No. 4: Bottle of Salvarsan

Photo No. 1: Mercurial cream used to treat syphilis, England, 1880-1941

Mercury was used as a common treatment for the sexually transmitted disease syphilis. Mercury had been a popular ‘cure’ for syphilis since the 1400s, although we now regard it as too toxic to use. The label reads "Made in accordance with the most recent formula as used by Col[onel] Lambkin, R.A.M.C." The R.A.M.C. stands for the Royal Army Medical Corps. In 1891 almost seven per cent of all medical discharges from the army were caused by venereal diseases and their effects. Venereal disease affected the health of soldiers who needed to be in top condition to face the enemy. Colonel Lambkin researched widely on syphilis and other STIs such as gonorrhoea, both in Britain and in the colonies of the British Empire.

Photo No. 2: Packet of mercurous chloride tablets, Kassel, Germany, 1914-1917

Mercurous chloride (HgCl) is also known as calomel. It was a popular drug from the 1800s onwards as it contained mercury, a chemical that was claimed to cure many illnesses. However, it slowly poisoned those who used it because mercury is toxic. Many of those taking such a drug would have been experiencing a venereal disease (VD) - probably syphilis. Calomel was used as an antiseptic and laxative during the First World War, but given the high rates of VD in the military it clearly proved useful in that context too. The packet contains calomel in tablet form to be taken orally. This packet was supplied by the 11th Army Corps of the German Army to its medical personnel and soldiers.

Photo No. 3: Salvarsan treatment kit for syphilis, Germany, 1909-1912

Salvarsan was a synthetic drug produced to treat the STI syphilis. The drug was developed by Paul Ehrlich (1854-1915), a German medical scientist, and his team in 1909 after three years of research. Ehrlich coined the phrase ‘magic bullet’ to describe this new wonder drug. The diluted yellow Salvarsan treatment was difficult and painful to inject and it did not cure syphilis overnight. As it was an arsenic based compound, it was also toxic. Salvarsan would later be replaced by antibiotics such as penicillin. The drug in the kit was made by a German manufacturer Farbwerke vorm Meister Lucius & Bruning AG and is stamped with the date "3 February 1912". It was sold by a British chemist, W Martindale, who added all the equipment to prepare injections.

Photo No. 4: Bottle of Salvarsan treatment for syphilis, London, England, 1909-1914

Salvarsan was a synthetic drug produced to treat the STI syphilis. The drug was developed by Paul Ehrlich (1854-1915), a German medical scientist and his team in 1909 after three years of research. German manufacturers had the monopoly on producing this wonder drug. With the outbreak of the First World War, British companies had to develop manufacturing techniques to supply the demand for Salvarsan. The only company with the capability to do so was Burroughs, Wellcome & Co. They produced Salvarsan under the brand name ‘Kharsivan’ from 1914 onwards.

Image source: sciencemuseum.org.uk/broughttolife/