Findings in ancient Egyptian mummies from tomb KV64, Valley of the Kings, Luxor, with evidence of a rheumatic disease.

OBJECTIVE: In 2011, a spectacular find was made in the Valley of the Kings, Egypt - a well-known archaeological site, where pharaohs were buried during the New Kingdom (ca. 1500-1100 BCE). A team from the University of Basel's Kings' Valley Project discovered a tomb (KV64) containing two mummies that were buried in different time episodes (unidentified elite burial, 18th dynasty, and Nehemesbastet, 22nd dynasty). METHOD: Anthropological investigations of the mummies were performed using portable X-ray and photographic documentation. RESULTS AND CONCLUSION: The first burial was an adult individual with bilateral pathological changes at the temporomandibular joints (TMJs), most likely of inflammatory origin, possibly psoriatic arthritis. Investigations of the second burial revealed an intact body of a younger female individual.

The "Queen of the Moors". Paleopathological investigation of a natural mummy from Scicli, South-Eastern Sicily.

A natural, well-preserved mummy belonging to a 45-55 year old female was found in the Church of Santa Maria della Consolazione in Scicli, south-eastern Sicily. The body was submitted to external examination, digital radiology, and computed tomography scanning. Paleopathological investigation allowed us to detect pulmonary pathology related to tuberculosis, atherosclerosis, and phleboliths. The presence of the latter, along with good dental condition with focal caries and obesity indicates a subject belonging to a high social class in good nutritional status. Along with other examples, this case allows to infer that tuberculosis was a common disease in that area, if not in the whole island, prior to the antibiotic era. Mummies need to be properly surveyed and protected, but also adequately studied by multidisciplinary teams of experts. The presence in such a team of at least one skilled anatomic/surgical pathologist, as long as well trained in the study of ancient human remains, represents an undeniable condition.

Metagenomic analysis of Ancient Egyptian canopic jars.

Ancient Egyptian remains have been of interest for anthropological research for decades. Despite many investigations, the ritual vessels for the internal organs removed during body preparation-liver, lungs, stomach, and intestines, of Egyptian mummies are rarely used for palaeopathological or medical investigations. These artifacts, commonly referred to as canopic jars, are the perfect combination of cultural and biological material and present an untapped resource for both Egyptological and medical fields. Nevertheless, technical challenges associated with this archeological material have prevented the application of current ancient DNA techniques for both the characterization of human and pathogenic DNA. We present shotgun-sequenced metagenomic profiles and ancient DNA degradation patterns from multiple canopic jars sampled from several European museum collections and enumerate current limitations and possible solutions for the future analysis of similar material. This is the first-ever recorded evidence of ancient human DNA found in Ancient Egyptian canopic jars and the first associated metagenomic description of bacterial taxa in these funerary artifacts. OBJECTIVES: In this study, our objectives were to characterize the metagenomic profile of the Ancient Egyptian funerary vessels known as canopic jars to retrieve endogenous ancient human DNA, reconstruct ancient microbial communities, and identify possible pathogens that could shed light on disease states of individuals from the past. METHODS: We applied ancient DNA techniques on 140 canopic jars to extract DNA and generate whole-genome sequencing libraries for the analysis of both human and bacterial DNA. The samples were obtained from museum collections in Berlin (DE), Burgdorf (DE), Leiden (NE), Manchester (UK), Munich (DE), St. Gallen (CH), Turin (IT), and Zagreb (HR). RESULTS: Here we describe the first isolated DNA from the Egyptian artifacts that hold human viscera. No previous work was ever conducted on such material, which led to the first characterization of human DNA from Ancient Egyptian canopic jars and the profiling of the complex bacterial composition of this highly degraded, challenging, organic material. However, the DNA recovered was not of enough quality to confidently characterize bacterial taxa associated with infectious diseases, nor exclusive bacterial members of the human microbiome. DISCUSSION: In summary, we present the first genomic survey of the visceral content of Ancient Egyptian funerary artifacts and demonstrate the limitations of current molecular methods to analyze canopic jars, such as the incomplete history of the objects or the presence of uncharacterized compounds that can hamper the recovery of DNA. Our work highlights the main challenges and caveats when working with such complicated archeological material - and offers sampling recommendations for similarly complex future studies, such as incrementing the amount of starting material and sampling from the less exposed parts of the jar content. This is the first-ever recorded evidence of ancient human DNA found in Ancient Egyptian canopic jars, and our results open new avenues in the study of neglected archeological artifacts.

Giant cell tumor of bone in an eighteenth-century Italian mummy.

Giant cell tumor (GCT) of the bone is a locally aggressive and rarely metastasizing neoplasm. It is composed of neoplastic mononuclear stromal cells with a monotonous appearance admixed with macrophages and osteoclast-like giant cells. In a small subset of cases, GCT is malignant. Terminology previously related to this entity, and which is no longer supported by the World Health Organization, includes osteoclastoma and benign fibrous histiocytoma (BFH). Giant cells occur in numerous other pathologic conditions of the bone, which accounts for the misrepresentation of these non-GCT tumors in the early literature. Non-ossifying fibroma (NOF), aneurysmal bone cyst, and chondroblastoma have been erroneously labeled GCT for this reason. A single description of an ancient GCT was reported by Brothwell and Sandison and subsequently mentioned by Aufderheide and Rodrìguez-Martìn who were astonished that more of these tumors had not been identified in archaeological cases. To the best of our knowledge, no other cases of ancient GCT have been cited in the paleopathology literature. The study of this type of neoplasm in antiquity can be used as a means to better understand its characteristics and behavior and to expand the depth of time of the etiology of these lesions. We report a case of GCT of the left femur observed following the total body CT imaging of a partially mummified adult female, dating to eighteenth century.

Chronic active non-lethal human-type tuberculosis in a high royal Bavarian officer of Napoleonic times-a mummy study.

In paleopathology, morphological and molecular evidence for infection by mycobacteria of the M. tuberculosis complex (MTC) is frequently associated with early death. In the present report, we describe a multidisciplinary study of a well-preserved mummy from Napoleonic times with a long-standing tuberculous infection by M. tuberculosis senso stricto who died at the age of 88 years of focal and non-MTB related bronchopneumonia. The well-preserved natural mummy of the Royal Bavarian General, Count Heinrich LII Reuss-Köstritz (1763-1851 CE), was extensively investigated by macro- and histomorphology, whole body CT scans and organ radiography, various molecular tissue analyses, including stable isotope analysis and molecular genetic tests. We identified signs for a long-standing, but terminally inactive pulmonary tuberculosis, tuberculous destruction of the second lumbar vertebral body, and a large tuberculous abscess in the right (retroperitoneal) psoas region (a cold abscess). This cold abscess harboured an active tuberculous infection as evidenced by histological and molecular tests. Radiological and histological analysis further revealed extensive arteriosclerosis with (non-obliterating) coronary and significant carotid arteriosclerosis, healthy bone tissue without evidence of age-related osteopenia, evidence for diffuse idiopathic skeletal hyperostosis and mild osteoarthrosis of few joints. This suggests excellent living conditions correlating well with his diet indicated by stable isotope results and literary evidence. Despite the clear evidence of a tuberculous cold abscess with bacterioscopic and molecular proof for a persisting MTC infection of a human-type M. tuberculosis strain, we can exclude the chronic MTC infection as cause of death. The detection of MTC in historic individuals should therefore be interpreted with great caution and include further data, such as their nutritional status.

Radiological and histological findings in ancient salt mummies from the salt mine of Douzlakh, Iran.

Computed tomography studies and histological analyses were performed on the mummified remains found in the Chehrabad salt mine in northwestern Iran. The ancient salt mummies are dated to the Achaemenid (550-330 BC) and Sassanid (3rd-7th century AD) time period and died in mining incidents. The aim of the study was to describe the radiological and histological findings of several ancient Iranian salt mummies with special interest in pathological and postmortem changes. The mummified remains show multiple traumatic alterations, such as fractures and signs of massive compression. Histological analyses can clearly differentiate soft tissue, however the preservation status is variable. These Iranian salt mummies are a rare example of the ancient Iranian population. The soft tissue and organs are well preserved, however in different degrees due to the varying conditions.

Advances in paleopathology in context: A focus on soft tissue paleopathology.

Skeletal and mummified remains from South America have had a significant impact on the progress of paleopathological research. In 1997, John Verano synthesized the state of paleopathological research, identifying trends and highlighting future potentials. The goal of this contribution is to consider Verano's observations on advances in soft tissue paleopathology within the context of the development of the field of mummy studies. As his article was published near the midpoint between the present and the early 1970s, when the modern form of mummy studies began to form, considering his observations in this context allows researchers the opportunity to consider how the field has progressed since the late 1990s.

Ongoing tissue changes in an experimentally mummified human leg.

Artificial mummification has been used since antiquity and is best known from ancient Egypt. Despite ancient Egyptian mummies being studied for several decades, the mummification techniques of that time are not well understood. Modern mummification experiments involving animal and human tissues have contributed additional insights relevant to a broad field of research. In the current study, we present follow-up results of an experiment on artificial mummification, which began in 2009. A human leg was artificially mummified and monitored for almost a year with histological, molecular, and radiological techniques. Since then, it has remained in a dry, natron salt blend for 9 years. The current analyses show further progression of dehydration and tissue alterations, as well as DNA degradation, suggesting an ongoing process. Our results add new insights into the mechanisms of tissue mummification. Taking into account that the process is still ongoing, further research is required, including a re-evaluation of the human leg in the future.

Growing up different in Neolithic China: A contextualised case study and differential diagnosis of a young adult with skeletal dysplasia.

This paper presents a case study of a young adult from the late Neolithic Yangshao cultural period site (∼3300-2900 years BC) of Guanjia () located in Henan Province on the Central Plains of China, who has evidence for skeletal dysplasia characterised by proportional stunting of the long bones and a small axial skeleton, generalised osteopenia, and non-fusion of epiphyses. We provide a detailed differential diagnosis of skeletal dysplasia with paediatric onset and conclude that this is likely a form of hypopituitarism or hypothyroidism, an extremely rare finding within the archaeological context. This paper highlights the issues of distinguishing the forms of proportional dwarfism in palaeopathology because of the considerable variation in manifestation of these conditions. Finally, we assess whether there were any health and social implications for this person and community through the consideration of a bioarchaeology of care approach across the lifecourse, burial context, and information on social perceptions of 'difference' in the community. ：： （3300～2900）。，，，，。，，。。，。，、、""，。.

What's that big thing on your head? Diagnosis of a large frontoparietal lesion on an Eastern Zhou skull from Henan, China.

We carried out a differential diagnosis of a large frontoparietal lesion on a human skull from a Late Bronze Age archaeological site located on the Central Plain of China, dating to between 771 and 476 BC. The head of this individual was covered in cinnabar, a mercury-based pigment that later was used for medicinal purposes in China. The lesion was well-circumscribed and involved the outer and inner tables of the skull, slight diploë thickening, and coarsening of bone trabeculae with expansion of intertrabecular spaces. We show that the observed changes are most consistent with cavernous hemangioma of the skull, a benign vascular malformation that preferentially affects older adults. Hemangiomas are often neglected in the paleopathological literature because of their benign nature - they tend to be asymptomatic and do not affect quality of life to a significant degree. Nevertheless, they produce characteristic lesions that can be confused with several other conditions with unrelated etiologies, including congenital hemoglabinopathies, traumas, malignant or benign neoplasms, and Paget's disease. We outline the diagnostic criteria that distinguish cavernous hemangioma from other conditions affecting the skull.

Use of Computed Tomography scanning in a 'virtual' bioarchaeology of care analysis of a Central Coast Peruvian mummy bundle.

BACKGROUND: CT scanning was utilized to investigate an intact mummy bundle within the bioarchaeology of care framework. The project sought to ascertain whether a 'virtual' analysis was feasible, thereby avoiding physical disturbance to bundle structure and contents. METHODS: The bundle selected for this study contained an adult male (FA 54), Ichma culture, Peru, displaying evidence for two pathologies: chronic osteomyelitis of the right tibia, and cranial trauma. CT images provided the basis for bioarchaeology of care analysis, which followed Index of Care protocols. RESULTS: CT images enabled description and diagnosis of FA 54, and revealed human neonate remains and material artifacts within the bundle. Probable disease impacts were identified, and likely forms of care provided were inferred. CT scanning was of limited value in identifying characteristics of textile wrapping (a clue to cultural identity) and in resolving questions regarding funerary treatment (primary vs. secondary burial), and this constrained consideration of wider social implications of caregiving. CONCLUSION: 'Virtual' examination of FA 54 achieved an advanced stage of bioarchaeology of care analysis, but building on this would require physical examination of bundle elements. Further investigation of CT imaging potential for bioarchaeology of care research in mummy studies is recommended.

Mummy studies and the bioarchaeology of care.

The bioarchaeology of care is a framework through which researchers can begin to infer the level of care an individual may have required based on the presence of paleopathological evidence. To date, all of the research that has employed the framework has been based on evidence derived from skeletal material. This special issue was organized in order to highlight how the analysis of mummified soft tissue, as well as other sources of data commonly associated with mummified remains, such as coprolites and intestinal contents, has the potential to provide valuable insight into the reconstruction of care in the past.

A 'cold case' of care: Looking at old data from a new perspective in mummy research.

In 1973, analysis of the mummified remains of a young boy dated to 700AD and from the Late Nasca period (Peru) identified (i) chronic Pott's disease, leading to loss of lower body mobility, and (ii) acute miliary tuberculosis, affecting most organs and the immediate cause of death (Allison et al., 1973). This report was the first to establish, beyond dispute, the presence of tuberculosis in the Americas before the arrival of Europeans. Here, we revisit the 'Nasca Boy' from a bioarchaeology of care perspective. Contextualising the original study's results within what is known of contemporary lifeways, we apply the bioarchaeology of care methodology in considering the Nasca Boy's experience of living with tuberculosis; the type of care he required and how this may have evolved over a period of deteriorating health; and what such caregiving may suggest both about social organisation within his community and some of the more everyday aspects of Nasca existence. Up to now, the bioarchaeology of care approach has been employed almost exclusively with skeletal evidence; in this analysis of the Nasca Boy's remains, and in the accompanying wider-ranging discussion, we illustrate the potential of preserved soft tissue evidence to contribute to research into disability and care in the past. Although this report functions as a stand-alone case study, to obtain maximum benefit it should be read in conjunction with the Introduction to the special International Journal of Paleopathology issue on 'mummy studies and the bioarchaeology of care' (Nystrom and Tilley, 2018).

The Skiles Mummy: Care of a debilitated hunter-gatherer evidenced by coprolite studies and stable isotopic analysis of hair.

The Skiles Mummy (SMM), a naturally mummified adult male from the late archaic period of Lower Pecos Canyonlands of South Texas, represents a unique case of care. SMM is an exceptional mummy within this region due to both the retention of a full head of hair, and having a diagnosed case of megacolon, a complication commonly associated with Chagas disease caused by Trypanosoma cruzi. Stable isotopic analysis of his hair is consistent with a diet incorporating of C4/CAM plants with some C3 plants, freshwater resources, and higher trophic level animals. However, the segments of hair most proximal to the scalp exhibited elevated δ15N values. Data from previous research indicate starvation and malnutrition can cause δ15N values to rise. The presence of large fecal boluses in the digestive tract suggest peristalsis ceased in the last four to five months of life, and this, together with results from coprolite analysis, indicate he would not have been able to adequately absorb protein and nutrients during this time. His condition would have rendered him immobile. Following Tilley's index of care, someone would have had to bring him food resources, as well as attending to his daily needs.

Using evidence from hair and other soft tissues to infer the need for and receipt of health-related care provision.

The Bioarchaeology of Care approach developed by Tilley is usually applied to skeletalized human remains, given the usual constraints of preservation bias that are seen with archaeological assemblages. However, other tissues, such as hair are sometimes preserved and can provide a wealth of information that can supplement the skeletal data. Archaeological hair has been analysed for drug compounds for almost thirty years. This article integrates data from hair analyses for coca metabolites, stable light isotope analysis and aDNA to expand the potential of the Bioarchaeology of Care approach using the example of a spontaneously mummified adult female from northern Chile.

The earliest known case of frontal sinus osteoma in man.

Frontal sinus osteoma is a relatively common finding in the modern clinical setting. Although, its paleopathological record is not in dispute, its presence in Ancient Egypt has never been clarified. The aim of this article is to contribute to the debate. An Egyptian mummy head from the Musée d'Éthnographie de Neuchâtel (Switzerland) was studied radiologically and the obtained evidence was contextualized in the wider frame of multidisciplinary paleopathology. A 128-slice CT scanner was used for further investigation; datasets were processed with OsiriX-64 bit (version 5.8.5), and multiplanar (MPR) and volumetric reconstructions were performed. A small hyperdense and well-defined structure, most likely an osteoma, was identified in the right frontal sinus. Frontal sinus osteoma definitely existed in Ancient Egypt. Finally, this represents the oldest case in anatomically modern humans so far reported. Clin. Anat.32:105-109, 2019. © 2018 Wiley Periodicals, Inc.

Using micro computed tomography to investigate a fetal mummy with possible situs inversus: A case report.

OBJECTIVES: Computed tomography (CT) is commonly used to noninvasively examine mummified remains, but can have resolution limitations when analyzing smaller mummified specimens, such as fetal mummies. This short report determines if the enhanced resolution of micro CT improves the anatomical analysis of mummified fetal anatomy. METHODS: A fetal mummy from an anatomical collection was scanned by a micro CT at a resolution of 0.08 mm slice thickness. The mummy was also scanned at a resolution of 0.6 mm slice thickness to mimic the approximate minimum resolution of a conventional CT scanner. The anatomy was virtually reconstructed at both resolutions to compare anatomical detail for determining sex, gestation, and the presence of congenital/ pathological conditions. RESULTS: The anatomical reconstructions based on the micro CT were significantly more detailed than the conventional CT data. This resulted in improved identification of sex and the presence of a congenital/ pathological condition. CONCLUSION: Micro CT should be considered when examining fetal mummies, because of the enhanced resolution resulting in improve anatomical analysis.