Evolution of orthopaedic diseases through four thousand three hundred years: from ancient Egypt with virtual examinations of mummies to the twenty-first century.

PURPOSE: This study conducts a comprehensive comparative analysis of bone pathologies between ancient Egypt and today. We aim to elucidate the prevalence, types, and potential aetiological factors influencing skeletal disorders in these two distinct temporal and cultural contexts. METHODS: The research employs a multidisciplinary approach, integrating osteological, paleopathological, and historical data to understand bone pathologies in mummies and the actual world. Applying radiographs and CT scans as noninvasive techniques has shed new light on past diseases such as fractures, dysplasia, osteoarthritis, surgery, and tuberculosis. Virtual inspection has almost replaced classical autopsy and is essential, especially when dealing with museum specimens. RESULTS: Findings indicate no significant disparities in the prevalence and types of bone pathologies through 4300 years of evolution. Moreover, this study sheds light on the impact of sociocultural factors on bone health. Examination of ancient Egypt's burial practices and associated cultural beliefs provides insights into potential behavioral and ritualistic influences on bone pathologies and the prevalence of specific pathologies in the past and present. CONCLUSION: This comparative analysis illuminates the dynamic of bone pathologies, highlighting the interplay of biological, cultural, and environmental factors. By synthesizing archeological and clinical data, this research contributes to a more nuanced understanding of skeletal health's complexities in ancient and modern societies, offering valuable insights for anthropological and clinical disciplines.

New Data on the Ecology of the Fossil Don Hare Lepus tanaiticus Gureev, 1964.

A spore and pollen research was performed for the first time to study the contents of the gastrointestinal tracts (GITs) and sediments containing frozen mummies of the fossil Don hare from the Upper Pleistocene ice complex of the Verkhoyansk district of Yakutia. Radiocarbon dating (C14) revealed that the hares lived during the Karginian Interstadial of the Late Pleistocene, 32.5 thousand years ago (calibrated date). The results expanded the understanding of the ecology of extinct Lepus tanaiticus. The species was assumed to live in cold steppes dominated by xerophytic communities, as well as in grass-forb and sedge-forb meadows. Herbaceous plants mostly constituted the winter diet of Don hare in contrast to the modern mountain hare L. timidus, which feeds mainly on branches and bark of trees and shrubs in winter.

Rethinking the Process of Animal Mummification in Ancient Egypt: Molecular Characterization of Embalming Material and the Use of Brassicaceae Seed Oil in the Mummification of Gazelle Mummies from Kom Mereh, Egypt.

The study of animal mummification in ancient Egypt has recently received increasing attention from a number of modern scholars given the fact that this part of ancient Egyptian funerary and religious history is a practice yet to be fully understood. In this study, nine samples of embalming matter were extracted from six gazelle mummies from the archaeological site of Kom Mereh (modern village of Komir), dated to the Roman period of dominance in ancient Egypt. All samples were analyzed for the presence of inorganic and organic matter applying a multi-analytical approach based on Fourier transform infrared spectroscopy (FT-IR) and gas chromatography-mass spectrometry (GC-MS). Furthermore, in order to identify more specific compounds such as bitumen and beeswax in studied balms, each sample was subjected to a solid phase extraction (SPE) and saponification separation process, respectively. The results of this study revealed that the majority of the analyzed embalming substances sampled from six gazelle mummies from Kom Mereh were complex mixtures of plant oils, animal fats, conifer resin, and beeswax. In this regard, this study was able to report a practice until now unmentioned in the scientific literature, namely, the use of cruciferous oil, derived from seeds of Brassicaceae plants, in animal mummification.

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.

Five thousand years of bellyaches: Exploring boron concentration in ancient populations of the Atacama Desert.

OBJECTIVES: This study explores whether ancient Atacama Desert populations in northern Chile were exposed to endemic boron contamination. MATERIALS AND METHODS: Using Laser Ablation-Inductively Coupled Plasma-Mass Spectrometry (LA-ICP-MS), we studied 144 strands of ancient mummy hair, ranging from 3000 B.C. to 1500 A.D., excavated from the Lluta, Azapa, and Camarones valleys in northern Chile. We tested whether these ancient populations showed signs of significant boron concentration in hair tissue. RESULTS: On average, all individuals from these valleys showed high boron concentrations, ranging from 1.5 to 4 times above the average boron concentration in contemporary hair (baseline <0.85 µg/g). The boron concentration in mummy hair varied according to the main geographic areas mentioned above. CONCLUSIONS: The rivers of northern Chile have high geogenic boron concentrations. They contain 38 times above the recommended limit for human consumption. Geogenic boron contamination likely played a role in population morbidity and the types of crops that were cultivated in antiquity. The ancient populations were chronically affected by boron overexposure, suggesting that ancient geogenic water contamination should be considered when discussing the biocultural trajectories of ancient populations.

Analysis of balms taken from Egyptian human mummies using solid-phase extraction and gas chromatography-mass spectrometry.

The aim of this paper is to establish a protocol by solid-phase extraction-gas chromatography-mass spectrometry leading to a wide and fine qualitative chemical characterization of the several natural substances present in human mummies' balms, using a minimal quantity of samples. In this study, nine samples were analyzed from mummies dating back from the Third Intermediate Period to the Roman Period, and were provided by the Confluences Museum (Lyon, France). Using solid-phase extraction, three fractions were examined in this protocol. The first one, eluted with hexane, concerned chemical families of hydrocarbons of bitumen. The second, eluted with ethanol, enabled terpenic compounds to be characterized and beeswax. The last one, composed of diethyl ether with 2% acetic acid, extracted carboxylic acids with a long aliphatic chain (fatty matter) and glycerides. This study also allowed the characterization of non-saponified compounds from beeswax to be obtained while excluding the common saponification step. The analyzed mummification balms were shown to contain fatty matter, beeswax, bitumen, and diterpenic resinous material. This one-pot solid-phase extraction-gas chromatography-mass spectrometry method was efficient in reducing both the number of analytical steps and the complexity of the archaeological balms subsequently analyzed by gas chromatography-mass spectrometry.

Ancient DNA and paleogenetics: risks and potentiality.

Paleopathology, the science that studies the diseases of the past, has always been addressed to the future in the use of new diagnostic methods. One of its relatively recent branches is paleogenetics, which is the study of genetic material from the past. Nuclear and mitochondrial DNA recovered from archaeological and paleontological specimens is called ancient DNA (aDNA), which can be extracted from a large variety of biological materials, of different origin, state of preservation and age, such as bones, teeth, coprolites, mummified tissues and hairs. There are many applications for ancient DNA research in the field of archaeology and paleopathology: population demography, genealogy, disease studies, archaeological reconstruction of plant vegetation, calibration of the molecular clock, phylogenetic relationship between different mammals and interpretation of the paleoclimate. However, the study of ancient genetic material is extremely difficult due to its poor quality and quantity, as well possible contamination with modern DNA. New advanced methods will allow extracting DNA from a greater variety of materials, and improvements in sequencing techniques will unveil data that are currently concealed.The aim of this paper is to provide initial insights into paleogenetics and ancient DNA study and to illustrate the limits, risks and potentiality of the research on the genetic material of ancient specimens, whose results have a strong impact on the present and future medicine.

CT examination and 3D analysis of Egyptian animal mummies.

AIM: To report our experience on CT investigation of animal mummies, focusing on the practical and radiological aspects of the study, the acquisition parameters and the different reconstruction techniques. MATERIALS AND METHODS: Thirteen mummies underwent CT examination on the same CT scanner (Siemens sensation) with the following acquisition parameters: 120 kV; 140 mAs; slice thickness: 1 mm; reconstruction interval: 0.7 mm; and rotation time: 0.75 s. All datasets were reconstructed with both bone and soft tissue algorithms and archived on our picture archiving and communication system using their catalogue number as an identifier. Images were then transferred on IntelliSpace Portal (Philips Healthcare) for post-processing multiplanar and 3D reconstructions. The acquired data were submitted to anthropological analysis. RESULTS: CT enabled the identification of the bundles content: four cats with complete skeleton, one upper part of a cat mummy, one lower part of a cat mummy, one cat head with four cervical vertebrae, two crocodiles, two raptors, skeletons from one or more snakes and one mummy with dog appearance, containing long bones. All cats and hawks showed cervical fractures; in one cat, the skull was collapsed inwards, and in another cat, the head was turned backwards; one cat presented a skeleton more radiopaque than normal with evidence of cracks related to the use of the resins for mummification that were poured directly over the corpse. CONCLUSIONS: CT is a valuable noninvasive technique to study Egyptian mummies, enabling in-depth analysis while preserving the integrity of the mummy bundles, ensuring protection of a valuable archaeological resource.

First-time complete visualization of a preserved meningeal artery in the mummy of Nakht-ta-Netjeret (ca. 950 BC).

The preservation of the meningeal artery in ancient mummified bodies, particularly in anthropogenic Egyptian mummies, is a highly controversial topic in neuroscience and anthropological research. A recent (2015) debate between Wade and Isidro, based on the interpretation of the meningeal grooves and cast in a skull from the necropolis of Kom al-Ahmar Sharuna (Egypt), highlighted both the necessity of having clear radiological descriptions of this anatomical structure and of assessing large collections of mummified crania. Here, we present for the first time an instance of extremely well-preserved middle meningeal artery in the mummy of the ancient Egyptian dignitary Nakht-ta-Netjeret (ca. 950 BC), still inside the meninx, using paleo-radiological techniques. We finally link this find with experimental data from the neurological literature on the methodology of excerebration implemented by ancient Egyptian embalmers.

Cytochrome C Oxidase Subunit 1, Internal Transcribed Spacer 1, Nicotinamide Adenine Dinucleotide Hydrogen Dehydrogenase Subunits 2 and 5 of Clonorchis sinensis Ancient DNA Retrieved from Joseon Dynasty Mummy Specimens.

We analyzed Clonorchis sinensis ancient DNA (aDNA) acquired from the specimens of the Joseon mummies. The target regions were cytochrome C oxidase subunit 1 (CO1), internal transcribed spacer 1 (ITS1), nicotinamide adenine dinucleotide hydrogen (NADH) dehydrogenase subunits 2 (NAD2) and 5 (NAD5). The sequences of C. sinensis aDNA was completely or almost identical to modern C. sinensis sequences in GenBank. We also found that ITS1, NAD2 and NAD5 could be good markers for molecular diagnosis between C. sinensis and the other trematode parasite species. The current result could improve our knowledge about genetic history of C. sinensis.

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.

Lessons from the Past: Some Histories of Alpha-1 Antitrypsin Deficiency Before Its Discovery.

A1AT deficiency- a genetically inherited autosomal codominant disease with more than 120 identified alleles- was first identified by Laurell and Eriksson in 1963. The most common hereditary disorder in adults, A1AT causes an increased risk of developing pulmonary emphysema and liver disease. In A1AT patients, lung disease generally presents at a younger age than "usual" chronic obstructive pulmonary disease (COPD) and it may be misdiagnosed as asthma. Because A1AT deficiency patients can show the same clinical features as non-deficient COPD (including increased evidence of bronchiectasis, frequent exacerbations, impaired health status and a degree of reversibility of airflow obstruction), the World Health Organization recommend to test every patient with a diagnosis of COPD or adult-onset asthma for A1AT deficiency. Despite these recommendations, the epidemiology of A1AT deficiency remains uncertain. Although recently discovered A1AT deficiency has affected human populations since antiquity. By using scientific data and recently studied skeletons and historical cases, we show that it is now possible to reconstruct the natural history of pathological processes, whether due to genetic, infectious or environmental factors. We believe that the evolution of disease in patients and research to elucidate the relationship between social science and environmental are pertinent contemporaneous subjects.

Friar Leopold Mandic (1866-1942): the computed tomography of the body of a saint.

PURPOSE: In forensic clinical anatomy computed tomography (CT) is used in post-mortem radiological investigation as an objective nondestructive documentation of the body surface and of the interior of the body. This technique is applied also in paleopathology, in particular in mummy studies, with the aim of providing a permanent record of the mummy's features, investigating the embalming procedure employed and analyzing the extent of the preservation in detail. METHODS: For the Extraordinary Jubilee of Mercy, the mortal remains of Saint Leopold Mandic and Saint Pio da Pietralcina, as examples of Mercy known by everyone, have been brought to Rome in February 2016. During the survey that preceded the preparation for transport to Rome, a whole-body CT was performed on the mummified corpse of Leopold Mandic, Capuchin Saint of Padova, Italy. RESULTS: The CT examination demonstrated the presence of osteoarthritis at the level of the vertebral column, of the left knee and of the left hand. Moreover, CT showed the preservation of skeleton and partial preservation of the some viscera, such as remnants of the brain, heart, oesophagus, urinary bladder, plexuses and spinal nerves, ear ossicles, major arterial vessels (aorta and carotid arteries). It is to emphasize the fact that Saint Leopold was not subjected before the CT to any conservative treatment. CONCLUSIONS: Computed tomography demonstrated to be a non-destructive method to investigate Saint Leopold, in order to maintain the integrity of the body and to acquire data on his pathologies and on his preservation. CT allows not only the acquisition of sectional images but also, thanks to dedicated software, the post-processing and reconstruction of three-dimensional models, that can be used also for public displays.

Erosive effects of a posterior mediastinal mass in a 18th to early 19th c. Spanish child mummy.

During the 2011 restoration works in the central nave of the church of the Assumption of Our Lady, known as "The Piquete", in the village of Quinto (about 50 kms southwest of Zaragoza, Spain), the remains of 70 individuals were uncovered. Of these there were 32 mummified bodies, four of which have been investigated with CT scans. Here we report on the findings in one such individual, namely a child of between 7 and 8 years of age, whose sex is debatable but may well be female. The main pathological finding is the presence of pressure erosion and distortion of the upper thoracic spine, the cause of which is discussed with the conclusion that this may well represent a neurenteric duplication cyst. The possible consequences of such a lesion are considered.

Recovery of Toxoplasma gondii DNA in experimentally mummified skin and bones: Prospects for paleoparasitological studies to unveil the origin of toxoplasmosis.

Paleoparasitology studies parasite infections by finding the parasites' remains in preserved organic remains such as natural or artificial mummy tissues, skeletons, teeth, and coprolites, among others. However, some currently important infections like toxoplasmosis have not been studied by paleoparasitology. The reasons include this parasite's complex life cycle, the resulting difficulties in locating this protozoan in the intermediate host tissues, and the limitation of coprolite studies to felines, the protozoan's definitive host. The current study thus aimed to produce an experimental model for molecular diagnosis of toxoplasmosis, prioritizing its study in bones and skin, the most abundant materials in archeological collections and sites. The study demonstrated the feasibility of recovering Toxoplasma gondii DNA from desiccated material, including bones and skin, in experimental models both with circulating tachyzoites (RH strain), characteristic of acute infection, and with cysts (ME49 cystogenic strain), characteristic of chronic infection. At present, most individuals with T. gondii infection are in the chronic phase, and the same was probably true in the past. The current study thus expands the odds of finding the parasite in archeological material, enhanced by the nature of the material in which the diagnosis was made. Finding the parasite may help answer questions that are widely debated in the literature on this protozoan's origin (Old World versus New World). In addition, when conditions do not allow ideal storage of samples for molecular tests, the methodology creates the possibility of testing oven-dried samples transported at room temperature.

Archaeological, radiological, and biological evidence offer insight into Inca child sacrifice.

Examination of three frozen bodies, a 13-y-old girl and a girl and boy aged 4 to 5 y, separately entombed near the Andean summit of Volcán Llullaillaco, Argentina, sheds new light on human sacrifice as a central part of the Imperial Inca capacocha rite, described by chroniclers writing after the Spanish conquest. The high-resolution diachronic data presented here, obtained directly from scalp hair, implies escalating coca and alcohol ingestion in the lead-up to death. These data, combined with archaeological and radiological evidence, deepen our understanding of the circumstances and context of final placement on the mountain top. We argue that the individuals were treated differently according to their age, status, and ritual role. Finally, we relate our findings to questions of consent, coercion, and/or compliance, and the controversial issues of ideological justification and strategies of social control and political legitimation pursued by the expansionist Inca state before European contact.

Organic chemistry of balms used in the preparation of pharaonic meat mummies.

The funeral preparations for ancient Egyptian dead were extensive. Tomb walls were often elaborately painted and inscribed with scenes and objects deemed desirable for the afterlife. Votive objects, furniture, clothing, jewelry, and importantly, food including bread, cereals, fruit, jars of wine, beer, oil, meat, and poultry were included in the burial goods. An intriguing feature of the meat and poultry produced for the deceased from the highest levels of Egyptian society was that they were mummified to ensure their preservation. However, little is known about the way they were prepared, such as whether balms were used, and if they were used, how they compared with those applied to human and animal mummies? We present herein the results of lipid biomarker and stable carbon isotope investigations of tissues, bandaging, and organic balms associated with a variety of meat mummies that reveal that treatments ranged from simple desiccation and wrapping in bandages to, in the case of the tomb of Yuya and Tjuia (18th Dynasty, 1386-1349 BC), a balm associated with a beef rib mummy containing a high abundance of Pistacia resin and, thus, more sophisticated than the balms found on many contemporaneous human mummies.

Palaeopathology: Current challenges and medical impact.

Palaeopathology is the science which studies ancient human diseases. Throughout its relatively young history it underwent tremendous technological and methodological improvements (from pure morphology and histology to CT scanning) that have constantly reshaped its scientific rationale. Among other achievements, the study of mummies and fossilized hominids has allowed to effectively extract ancient DNA, prove the existence of atherosclerosis in ancient times, demonstrate the presence of disease vectors, better clarify the etiology of infectious diseases otherwise only postulated on the basis of ancient accounts as well as to show the presence of spine pathology in our hominid ancestors. The research levels in this discipline are three: basic research, individual cases, population. The first and the third levels contribute most to the discipline, while the second is the one more appealing to the general public on account of its description of important cases reports. In addition, a recently introduced sub-specialty of palaeopathology, pathography is aiming to use an interdisciplinary approach to find traces of diseases in ancient literary sources and artistic representations. In spite of its discoveries, palaeopathology is not always viewed positively by clinicians because certain old-fashioned techniques are still due to technical restrictions. The authors provide a set of suggestions on how to strengthen the scientific recognition of this subject and explain at length how it could contribute to the progress of medical research. Clin. Anat. 29:816-822, 2016. © 2016 Wiley Periodicals, Inc.

[A sarcophagus with a surprise: computed tomography of a mummy from the Late Period of ancient Egypt]. / Un sarcófago con sorpresa: estudio con tomografía computarizada de una momia egipcia de Baja Época.

INTRODUCTION: Diagnostic imaging techniques, at present especially computed tomography (CT), have become the most important noninvasive method for the study of mummies because they enable high resolution images and three-dimensional reconstructions without damaging the mummified subject. We present a sarcophagus with a mummy hidden inside that was acquired by a gallery in Barcelona. MATERIAL AND METHODS: The sarcophagus and mummy were examined by CT at the Hospital Universitari Sagrat Cor in Barcelona. A flexible clamp was used to obtain tissue samples for further study. RESULTS: The results showed the presence of an anatomically intact female human subject albeit with a destructured thorax and upper abdomen. Various metal objects were detected, corresponding to amulets, artificial eyes, and an external wooden brace. CONCLUSION: CT is an excellent noninvasive imaging technique for the detailed study of mummies, as it enables not only the anatomic identification of the mummified subject but also the obtainment of tissue samples for complementary analyses. The description of these findings enables us to know the major radiologic landmarks for the paleopathologic study of mummies.