Morphometric analysis of untreated adult skulls in syndromic and nonsyndromic craniosynostosis.

The aim of this study was to perform a morphometric analysis of untreated adult skulls displaying syndromic and nonsyndromic craniosynostosis. We analyzed, in detail, 42 adult craniosynostoses (18 scaphocephaly, 11 anterior plagiocephaly, 2 trigonocephaly, 9 oxycephaly, and 2 brachycephaly) from archeological (three skulls) and pathoanatomical samples (39 skulls). The univariate and bivariate measurements from the pathological skulls were compared with 40 anatomical skulls with normal cranial vault morphology. Bony signs of chronic elevated intracranial pressure (ICP) are (1) diffuse beaten copper pattern, (2) dorsum sellae erosion, (3) suture diastasis, and (4) abnormalities of venous drainage that particularly affect the sigmoid-jugular sinus complex. The mean cranial length was significantly greater in scaphocephaly than in anatomical skulls (20.3 vs 18.0 cm), and the sagittal suture was also longer (14.3 vs 11.8 cm). There were three types of suture course in the bregma region in scaphocephaly: anterior spur (28%), normal configuration (61%), and posterior spur (11%). The plagiocephaly measurements showed nonsignificant differences, and there was no correlation between the length of the anterior and middle skull base (ipsilateral anterior-posterior shortening of the skull) and incomplete or complete suture synostosis. Bony signs of chronic elevated ICP were found in 82% of cases of oxycephaly and brachycephaly. In three such cases of oxycephaly, we found a marked (1.8-2.1 cm) elevation of bregma region. One skull (Saethre-Chotzen syndrome) yielded human DNA sufficient for polymerase chain reaction (PCR)-based amplification procedures. Mutation analyses in the FGFR3 gene revealed nucleotide alterations located in the mutational hot spot at amino acid residue 250 (g.C749). The mean cranial length in adult scaphocephaly was 12% greater than anatomical skulls. A unilateral complete or incomplete coronal synostosis can be found with or without plagiocephalic deformation. Elevation of the bregma region is a bony sign of chronic elevated ICP. These data on adult craniosynostosis could be of interest for physicians dealing with craniosynostotic children.

Palaeopathological and variant conditions of the Homo heidelbergensis type specimen (Mauer, Germany).

Although early Homo specimens are now known from a number of African, Asian and European Middle Pleistocene sites, the taxon Homo heidelbergensis was initially introduced for the Mauer jaw recovered in 1907. Fossil hominids from the earlier Middle Pleistocene of Europe are very rare and the Mauer mandible is generally accepted as one of the most ancient, with an age of approximately 700 kyr. A new preparation of the mandible was conducted in 1996 and gave rise to the detailed palaeopathological examination which is presented here. Based on comparative analyses, the extreme breadth of the mandibular ramus and its flat intercondylar incision, in conjunction with the flattening and broadening of the coronoid process tip, results either from an idiosyncratic pattern of the course and insertion of the temporalis muscle on the coronoid process or from the temporalis possessing an accessory head. The incidence of periodontal pocketing, together with a vertical reduction of the alveolar margin to approximately 3.00 mm, and a slight protuberance formed in vicinity of the right M(2)can safely be interpreted as pathognomonic indications of periodontal disease. The short distance between the enamel-dentine junction of the teeth and the horizontal alveolar margins could either be an inherited variant or may result from incipient osteoporosis. In addition, an arthrotic condition with slight osteophytic peripheral exostoses and an arthrolit (i.e. an articular calculus or "joint mouse") on the left condylus articularisand a depression in the medial part of the left mandibular condyle extending into the inferior part of the ramus are present. These features are indicative of a trauma-induced osteochondrosis dissecans. The diagnosis therefore suggests that the observed depression results from a well-healed fracture. This traumatic event illustrates the demanding living conditions endured by humans during the European Middle Pleistocene. The variations and pathological conditions observed in Mauer do not question the mandible's role as type specimen for the taxon Homo heidelbergensis.

[Parasagittal meningioma in a skull dated 32500 years before present from southwestern Germany]. / Parasagittales Meningeom bei einem 32500 Jahre alten Schädel aus dem Südwesten von Deutschland - Neue Erkenntnisse über den Umgang mit Krankheit in der Altsteinzeit.

Summary. During excavation in 1931 by Riek in the cave of Vogelherd close to Stetten in the Lone Valley in southwestern Germany there was found an anatomically modern human skull (called: "Stetten 2") dated 32500 years before present. The skull was excavated without postcranial skeleton in the cave and showed no signs of burial. Paleopathological examinations of the calvarium reveals skeletal abnormalities that indicate parasagittal meningioma next to the bregma. Paracentral Meningiomas cause seizures and focal weakness, followed by headache. These observations are discussed in the context of modern medical knowledge. Our theory integrated archaeological, anthropological and paleopathological knowledge and helped to create the understanding of Paleolithic and earliest modern man knew regarding the "brain" and illness.

[Paleopathology of the lumbar spine in the early medieval period]. / Paläopathologie der Lendenwirbelsäule im frühen Mittelalter.

AIM: The lumbar spine of people from ancient civilizations can provide a large amount of information about these individuals and their physical condition through paleopathological investigation. METHOD: This study was conducted on a sample of 185 lumbar spines from southwestern Germany dating back in the early medieval period. The skeletons came from the row graves from Nusplingen, Schretzheim, Neresheim, and Pleidelsheim. RESULTS: Examples of congenital malformations, degenerative processes, infections and traumatic diseases were discovered. The most common pathological findings were degenerative changes of the lumbar spine in 24 %. Congenital anomalies and spondylolysis were relatively common in this population. Examples of traumatic injuries and infections of the spine were rare. Metastatic lesions on the vertebral bodies were identified in no case. CONCLUSION: Most diseases of the lumbar column in the ancient inhabitants of southwestern Germany were similar to those that affect the present-day population of that area.

Trepanations from the early medieval period of southwestern Germany--indications, complications and outcome.

Of the 384 skulls from the early medieval period, 8 (2.1%) exhibited trepanations. Three skulls showed trepanations in the proximity of fractures. One case of infection after borrhole trepanation that resulted in death is identifiable. Seven skulls showed clear evidence of healing and survival after trepanation. The mortality and infection rates for trepanation were low during the 6th to 8th centuries in southwestern Germany.

Hominid skull fragments from Late Pleistocene layers in Leine Valley (Sarstedt, District of Hildesheim, Germany).

Three cranial fragments were recovered from coarse-grained deposits dug up by a suction dredge from gravel pits on the Leine river flats in the vicinity of Sarstedt (northwestern Germany). Also recovered were a number of artefacts which, upon careful inspection, could be assigned to the Middle Paleolithic. The geological pattern of the Leine Valley in this region suggests that these fragments were deposited in the lower terrace during a yet undetermined warm period-possibly Brörup or Odderade-during the Weichsel glaciation. However, attribution to the Eemian period or a Saale interstadial cannot be ruled out. The features of the Sarstedt (Sst) I infant temporal are known from Neanderthals (e.g., Weimar-Ehringsdorf, Engis, Krapina 1) and can be seen in specimens from the European late- Homo erectus group as well. Subadult individuals do not always exhibit full development of features characteristic for adults and-to some extent-anticipate the succeeding developmental stage (i.e., neoteny). The Neanderthal autapomorphies characterizing the fragments of the occipital and the parietal are certainly consistent with assigning both unequivocally to the species H. neanderthalensis. The presence of Middle Paleolithic artefacts recovered from the same deposits are commensurate with the presence of Neanderthals. However, there is no clear contextual association of any archaeological and fossil human material. Future DNA research will hopefully add up to the established morphological picture.

Brief communication: neurotraumatological aspects of head injuries resulting from sharp and blunt force in the early medieval period of southwestern Germany.

Approximately 10% (33 of 304) of the predominantly male skulls from the 6th through 8th centuries in southwestern Germany exhibit cranial fractures derived from blunt or sharp force trauma. No evidence of fracture healing characterizes 24% (n = 8) of these individuals. All nonhealed fractures were caused by sharp force, and four of these wounds cross the sagittal sinus. The lengths of these straight-edged wounds, produced exclusively by sword blows, measure around 8.0 cm for fatal, and about 5.0 cm for nonfatal wounds. Seventy-six percent (n = 25) of these skulls exhibit some healing, which indicates that these injuries did not lead to immediate death. In this group are all depressed fractures resulting from blunt force blows. Two thirds of the 45 cranial injuries noted on these 33 skulls are located on the left side of these individuals, with a concentration in the frontoparietal region. Bony indications of wound infection occur in four cases (12%). Three crania exhibit circular trepanations in association with fractures. These phenomena are discussed in the context of modern neurotraumatological knowledge.

[Classification of a 300,000-year-old dental crown of the upper loamy deposit of the Bad Canstatter travertine zone]. / Klassifizierung einer 300.000 Jahre alten Zahnkrone aus dem oberen Lehmhorizont des Bad-Cannstatter Travertin.

Hominid dental remains were recovered in association with fossil bones and artifacts during systematic excavations in a loamy deposit located between the two travertine zones T4 and T5 at Stuttgart-Bad Cannstatt, Southwest Germany. Direct dating of a hominid tooth crown with thermoluminescence resulted in a date of 300 kya, which is in agreement with the Holstein Interglacial floral and faunal composition of this layer. The specimen is a lower left canine with hypoplastic morphology. This interpretation is supported by thorough assessment of its overall morphology, comparative metric evaluation, and by scanning electron microscopy analyses of the enamel prisms. Additional microstructural comparison of these dental remains with a tooth from the same site, but derived from a Cervidae specimen supported the distinct differences between both teeth. Here we discuss both the classification and significance of the specimen's evolutionary position as well as compare this specimen with stomatologic results from previous palaeopathological research.

Genomic differentiation of Neanderthals and anatomically modern man allows a fossil-DNA-based classification of morphologically indistinguishable hominid bones.

Southern blot hybridizations of genomic DNA were introduced as a relatively simple fossil-DNA-based approach to classify remains of Neanderthals. When hybridized with genomic DNA of either human or Neanderthal origin, DNA extracted from two Neanderthal finds-the Os parietale, from Warendorf-Neuwarendorf, Germany, and a clavicula, from Krapina, Croatia-was shown to yield hybridization signals that differ by at least a factor of two compared to the signals obtained with the use of fossil DNA of an early Homo sapiens from the Vogelherd cave (Stetten I), Germany. When labeled chimpanzee DNA was used as a probe, Neanderthal and human DNA, however, revealed hybridization signals of similar intensity. Thus, the genome of Neanderthals is expected to differ significantly from the genome of anatomically modern man, because of the contrasting composition of repetitive DNA. These data support the hypothesis that Neanderthals were not ancestors of anatomically modern man.

The form of the supraorbital margin as a criterion in identification of sex from the skull: investigations based on modern human skulls.

Sexual dimorphism in the shape of the supraorbital margin was reported by Broca and various subsequent authors, but no consistently applied, precise definition has been established. In this study of modern human skulls, the value of our definition of the sex-related difference in this area in the identification of sex from the skull was investigated. It was found that this feature can be assessed reliably, is strongly related to sex, and is independent of the side. The accuracy of identification of sex using this method alone was found to be about 70%.

[CCL-tensulae in the skeleton as part of a hydrodynamic skeletal system]. / Die CCL-Tensula im Skelettsystem als möglicher Teil eines hydrodynamisch wirkenden Faktors.

Previous morphological studies on human bone have demonstrated that veil-like structures ('tensulae') occur in highly stressed regions, i.e. the interface between cartilage and bone. In the present report we describe the distribution of tensulae within various types of human bone by means of scanning electron microscopy and light microscopy. Tensulae were predominately located within bone tissue adjacent to mineralized cartilage. The surface diameter of tensulae ranged from minimal 50 to maximal 400 microns. Occasionally, collagen fibers extended from the interface between cartilage and bone to tensulae. Frequently, the latter were attached to fat cells as well as bone marrow cells. An elemental analysis of tensula revealed high levels of calcium and phosphorus of equal concentrations. However, bone tissue contained higher levels of calcium compared to phosphorus. Additionally, a monoclonal antibody was generated by immunizing rats with bone marrow of mice. Within bone tissue this monoclonal antibody selectively stained membrane-like structures which were clearly identified as tensulae. From our investigations we conclude that the function of tensulae in bone may be to absorb stress in regions where large forces are applied.

[Detection of hydrodynamically operative tissue in the substantia spongiosa of the femoral head in Bos taurus and Ovis aries]. / Nachweis der hydrodynamisch wirkenden Tensulae in der Substantia spongiosa des Caput femoris bei Bos taurus und Ovis aries.

The authors show the presence of CC-Tensulae in Bos taurus and Ovis aries. They define CC-Tensulae as tense membranes in openings between the trabeculae of spongy bone. These structures were interpreted in man as a hydrodynamic subsystem which serves the flow and the impulses of mechanical forces. The authors point especially to the similarity that exists between their findings and what has been seen in man.

[Ultrastructure of the substantia spongiosa of the femur head and talus]. / Substrukturen in der Substantia spongiosa des Caput femoris und des Talus.

The results of the SEM examination of the zone between the cartilage and the spongeous substances are described precisely. For the first time, W. Lierse examined the 'tensulae' of calcium-collagen lamellae by light microscopy. The examination of this zone was initiated by the fact that the hydrodynamic flow can take place in the calcified zone of the cartilage which is filled with synovial fluid and that the calcified zone adheres to the subchondral substantia corticalis. The subchondral corticalis is characterized by funnel-like indentations with a high number of calcium-collagen and chondrocyte 'tensulae' which are up to now uncounted. The special aim was to locate the separation of the space of adipose and arterial supplies.

[The hydrodynamic components in joints: proof of a membrane-cistern system within the calcified zone of the femur head cartilage]. / Die hydrodynamische Komponente im Gelenk: Nachweis eines Membranen-Zisternen-Systems in der kalzifizierten Zone des Knorpels am Femurkopf.

The theoretical postulate of a hydrodynamic system for the transmission of forces at the hip joint led to the discovery of a two-membrane system. Within the calcified cartilaginous zone of the femoral head there exists a system of small spaces and cisterns which can only be understood in the postulated sense as an overall acting hydrodynamic system. A correlation between the destruction of the calcified zone, i.e. the hydrodynamic system, and arthrosis is indicated. Ongoing studies and deliberations will help to discover the true model of the transmission of forces and impulses and to solve the problems of treating arthrosis.