Microstructural analysis of bony alterations in a historic case of actinomycosis

OBJECTIVE

Actinomycosis infection of bone is rare and its diagnosis challenging. Here, we aim to identify and verify its microstructural features and the potential value for differential diagnosis.

MATERIALS

We investigated the dry preparation of the lumbar vertebrae and pelvic ring of a purported case of actinomycosis documented by a post-mortem examination in 1891.

METHODS

Macroscopic inspection, conventional radiology, μCT, 3D reconstruction, and histological examination were employed.

RESULTS

All approaches revealed new periosteal bone deposition with increased vascularisation of the os coxa, vertebrae, and sacrum. The μCT revealed cortical loss underneath the new bone formation; the 3D reconstruction and histological examination revealed plexiform bone and granular structures.

CONCLUSIONS

The plexiform bone is the result of reactive rapid growth and remodelling processes, and is consistent with pathomorphological findings summarised in the autopsy report (soft tissue abscesses and formation of fistulas caused by "Actinomycosis intestine et ossis ilei sin.").

SIGNIFICANCE

This is the first case of a historically documented case of actinomycosis infection investigated by μCT and histology. Different degrees of tissue damage and inflammatory reaction in form of plexiform bone, which has not been reported previously, was identified.

LIMITATIONS

The noted bone tissue modifications are not solely pathognomic of actinomycosis; they characterise other diseases, as well. Histological evaluation is not appropriate for identifying the aetiology of the granular structures observed here; but clinically such aggregations appear in tissue affected by actinomycosis.

SUGGESTIONS FOR FURTHER RESEARCH

Histochemical and molecular-genetic analyses are obligatory to affirm the diagnosis based on micromorphological features.

Cross-population analysis of the growth of long bones and the os coxae of three Early Medieval Austrian populations

Inter-population variability in long-bone and pelvic-bone growth during the Early Medieval period is examined. The materials comprise four archaeological populations: two Slavonic (Gars-Thunau, Zwentendorf, Austria, 10th-century AD), one Avar (Zwölfaxing, Austria, 8th-century AD), and one Anglo-Saxon (Raunds, England, 10th-century AD). Bone measurements are analyzed against dental age estimates in order to assess inter-population differences in growth rates for long-bone and os coxae bone dimensions. Growth curves of the upper and lower extremities of additional archaeological populations and a modern North-American population are also assessed. The expectation was that the greatest differences in growth patterns would be found between the Anglo-Saxon and the Austrian samples, due to their distinct genetic and biocultural background. Minimal differences were expected between the two Slavonic populations, as these were approximately contemporaneous, recovered from geographically close locations, and shared relatively similar archaeological contexts. Growth curves were estimated for each bone dimension by fitting least-squares fourth-order polynomials (which allowed testing of population differences by analysis of covariance), and iteratively estimating Gompertz growth curves. The results showed differences between bones in the extent of inter-population variability, with diaphyseal long-bone growth showing equivalent patterns across the four populations, but significant differences between populations in the growth patterns of distal diaphyseal dimensions of the femur and humerus and the dimensions of the ilium. Varying growth patterns are therefore associated with inter-population differences in absolute dimensions in relation to age as well as variations in growth velocities. Inter-population variability in growth curves in the case of femoral and humeral dimensions were most pronounced during infancy (0-2 years). The most consistent differences in bone growth and related dimensions are between Zwölfaxing and the other samples. No significant differences in growth were detected between the Anglo-Saxon and the Austrian populations.

Human remains from the Austrian Gravettian: the Willendorf femoral diaphysis and mandibular symphysis

Early excavations at the Willendorf site complex in Austria yielded a femoral diaphysis collected between 1883 and 1887 and a mandibular symphysis discovered in 1908--1909. The femoral section, Willendorf 1, derives from the Willendorf I site and direct AMS (14)C dating (24,250+/-180 years B.P.) assigns it to layer 9. The Willendorf 2 mandibular piece was excavated from layer 9 of the Willendorf II site, which is AMS (14)C dated to 24,000--23,900 years B.P. The Willendorf 1 femoral piece is relatively small and exhibits a pronounced pilaster and linear aspera, moderately elevated relative cortical area, and a level of diaphyseal robusticity in the middle of the European earlier Upper Paleolithic human range of variation, assuming similar body proportions. The Willendorf 2 mandibular symphysis has an inferior lingual torus, a planum alveolare, and a mental trigone with indistinct lateral tubercles, a clear fossa mentalis and a midline basilar rounding. In these features it is close to the majority of European earlier Upper Paleolithic mandibles.

Differential diagnosis on ancient skeletal remains: conventional methods and novel application of the BSE-mode in SEM on a skull tumor of the early Bronze Age

Tumor-like lesions on skeletal remains put relatively high demands on paleopathological diagnostic methods. In addition to conventional anthropological determination and non-invasive methods of macroscopical description and radiodiagnostic examination, bony lesions can be analyzed more accurately, but also more elaborately by light microscopy of invasive section preparations. In this study an irregular new bone formation on the excavated skull of a juvenile individual was also investigated by scanning electron microscopy (SEM). A cut-out block of the lesion was first observed in the secondary electron-mode (SE-mode), and then methylmethacrylate-embedded ground and polished sections were for the first time also evaluated in the back-scattered electron-mode (BSE-mode). Thereby, new insights into the bone structure and the development of this tumor-like lesion could be obtained which led to the diagnosis of a meningioma.

Evidence of genocide 7000 BP--Neolithic paradigm and geo-climatic reality

The early Neolithic fortified settlement of Schletz, Lower Austria is emerging as one of the most interesting sites of Linear Pottery culture excavation in Austria. In the course of systematic investigations carried out since 1983, a plethora of unexpected results have been obtained. Specifically, the human skeletal remains of 67 individuals have been found at the base of an oval trench system. Without exception, these remains are characterized by multiple traumatic lesions as well as carnivore gnaw marks. Demographic analysis presents the picture of the entire population of this early farming settlement having been extinguished. Further, the findings suggest that a genocide scenario may have been responsible for the final demise of this settlement. The age and sex distribution reveals a lack of young females, who are interpreted as having been abducted by aggressors. There is however no direct skeletal evidence of aggressors at the site; in fact, the uniformity of Strontium isotope ratios (HR-ICP-MS analysis) implies that all 67 individuals, who were left unburied for months, were indigenous. Supporting evidence of increased levels of inter-human aggression--possibly caused by a broad wave of migration--comes from other contemporary end linear pottery sites in Germany. Such findings are here discussed in the context of a dramatic geological event in the region of the Black Sea shelf at this time (7.550 BP), which led to the submergence of some 100.000 square kilometers of fertile land, and which might have been responsible for subsequent gradual population movements into the interior of Europe.

The Ice Man's diet as reflected by the stable nitrogen and carbon isotopic composition of his hair

Establishing the diets of ancient human populations is an integral component of most archaeological studies. Stable isotope analysis of well-preserved bone collagen is the most direct approach for a general assessment of paleodiet. However, this method has been limited by the scarcity of well-preserved skeletal materials for this type of destructive analysis. Hair is preserved in many burials, but is often overlooked as an alternative material for isotopic analysis. Here we report that the stable carbon and nitrogen isotope values for the hair of the 5200 year-old Ice Man indicates a primarily vegetarian diet, in agreement with his dental wear pattern. Whereas previous investigations have focused on bone collagen, the stable isotope composition of hair may prove to be a more reliable proxy for paleodiet reconstruction, particularly when skeletal remains are not well preserved and additional archaeological artifacts are unavailable.

Cancellous bone structure in the growing and aging lumbar spine in a historic Nubian population

There is abundant data on cancellous bone in the aging human spine, but little relating to the growing vertebral cancellous bone in childhood an adolescence. The purpose of this study was to map vertebral cancellous bone in a growth and age series of historic skeletal samples and to make comparisons with data published on recent material. Lumbar vertebral bodies were collected from 65 skeletons (0-60 years) from a medieval Nubian population. Ethnohistoric information was collected to interpret conditions that might have influenced bone structure and metabolism. The cancellous bone was studied three dimensionally, using stereophotography and scanning electron microscopy and morphometrically by performing a semiautomatic structural analysis on digitized backscattered electron images of polymethacrylate-embedded material. The cancellous bone structure in the children consisted mainly of a densely packed, uniform network of small rodlike trabeculae. The greatest bone volume fraction with small, more platelike trabeculae was observed during adolescence. In young adults, larger platelike trabeculae were present in the central zone and smaller trabeculae in the superior and inferior zones, as described for modern skeletal material. Structural changes associated with aging were observed much sooner than in modern man. by the estimated age of approximately 50-60 years, the predominant architectural elements were slender rarified rods in both sexes. The ethnohistorical data suggest that this was essentially a black African population of physically active peasants, not likely to suffer Vitamin D insufficiency or deficient calcium intake. Thus an earlier onset of the biological age changes in cancellous bone found in modern populations was probably relevant.

Protein oxidation of a hair sample kept in Alaskan ice for 800-1000 years

Ancient finds of organic matter are not only of the highest value for palaeochemists and palaeobiologists but can be used to determine basic chemical reactions, such as protein oxidation, over long time periods. We studied oxidation of human hair protein about one thousand years old of an Alaskan child buried in ice, ten hair samples of copts of comparable age buried in graves of hot dry sand and compared the results to ten recent hair samples. Protein oxidation parameters o-tyrosine and cysteic acid of the Alaskan child were comparable to recent samples whereas they were higher in the coptic specimen. N-epsilon-carboxymethyllysine, a parameter for glycoxidation, however, was as high in coptic specimen. We conclude that ice in contrast to soil prevented protein oxidation but failed to inhibit glycoxidation, a reaction initiated by autooxidation of glucose. This study therefore has implications for the interpretation of oxidation and glycoxidation as well as preservation mechanisms of proteins.

[Age and sex specific differences in bone density of 4,000-year-old individuals. Bone density measurement of early Bronze Age femurs from excavations in Unterhautzenthal, Lower Austria]

Bone density measurements of 14 individuals (early Bronze Age, 2200-1600 BC), analyzed by dual-energy absorptiometry, showed a distinct difference between women and men. In men, there was a high bone density (+17.9%-0.290 g/cm2 difference). In females, a constant decrease in bone density was found after the age of 20-25 years (from 1.2 g/cm2 at 20 years to 0.8 g/cm2 at 40 years of age). With caution, the results are comparable with those of the present time.

Age- and sex-dependent cancellous bone changes in a 4000y BP population

We studied cancellous bone loss in a 4000y BP population, using several methods designed to detect age-related changes, in order to investigate the pattern of cancellous bone loss in this ancient population and to compare the results deriving from different methods used on identical specimens. We used 10-mm sections of fourth lumbar vertebral bodies and left femoral necks of 18 individuals of both sexes with estimated ages from 20 to 60 years of a 4000y BP bronze-age population. Stereoscopic photographs were used for three-dimensional analysis and trabecular number (TN) counting. After embedding, the following parameters were measured in different image analysis systems using plane parallel block samples: bone mineral density (BMD) in water by DEXA, and by evaluation of standardized radiographic images; fractional bone volume (BV/TV) in backscattered electron images of the trabecular surface layer and in optical images of trabeculae in a surface-stained layer; and trabecular bone pattern factor (TBPf) in the latter images. There was a high correlation between the results of morphological methods for measuring fractional bone volume. Reasonable correlations were found between the x-ray photon methods and poor correlations between these and the morphological methods. These poor correlations may be due to the diagenetic substitution occurring in archaeological skeletons, which would strongly influence x-ray-based density measurements. However, all the methods demonstrated that the most dramatic loss of quantity and quality in cancellous bone occurred in females between 40 and 60 years.(ABSTRACT TRUNCATED AT 250 WORDS)

[Evidence of nicotine in scalp hair of naturally mummified bodies from the Christian Sayala (Egyptian-Nubian)]

The investigations of hair samples obtained from human skeleton from the Christian cemetery of Sayala demonstrate the presence of nicotine. 12 of 39 individual hair samples were positive. These results indicate the use of plants containing nicotine as principal or secondary alkaloid.

Some anthropological aspects of the prehistoric Tyrolean ice man

The corpse of a Late Neolithic individual found in a glacier in Oetztal is unusual because of the intact nature of all body parts that resulted from the characteristics of its mummification process and its protected geographical position with regard to glacier flow. Anthropological data indicate that the man was 25 to 40 years old, was between 156 and 160 centimeters in stature, had a cranial capacity of between 1500 and 1560 cubic centimeters, and likely died of exhaustion.

[Sexual dimorphism of tooth crown diameters. A contribution to the determination of the sex of subadult individuals from the early bronze age graveyard of Franzhausen I, lower Austria]

In this paper, the sexual differences between mesio-distal and bucco-lingual diameters of deciduous and permanent teeth of an Early Bronze Age population from Franzhausen are presented. Data from a total of 172 (85 male and 87 female) subadult individuals was collected. The presumptive sex determination needed for this investigation could be achieved because of specific burial rites that characterize the Unterwölbling culture south of the Danube. The averages of both the deciduous and permanent teeth show that female individuals possess altogether teeth of smaller dimensions. The differences are, for a few permanent teeth, statistically highly significant. Using these to calculate discriminant analyses based on differing variable sets, a correct sex assignment was achieved in 81% to 75% of all cases. For the purposes of sexual diagnosis, a function combining only three measurements (MD and BL diameters of upper canine and BL diameter of the first upper molar) was 80% successful.

Observations on hair shaft morphology in mucopolysaccharidoses

Scalp hair samples were obtained from 11 children with mucopolysaccharidosis (MPS, types I, II and III) in order to study the micromorphological structure of the hair shafts. To evaluate the morphological variation longitudinal hair preparations and cross-sections were investigated by light microscopy and additionally scanning electron microscopy was employed to demonstrate the surface structure. It is shown that the mean hair shaft diameter in MPS-patients, separated into two age groups, is not significantly different from the mean value in normal children of the same age, whereas the wider range of diameters and, in connection with it, the increased medulla content seems to be a characteristic feature of MPS. The most striking deviations were observed in the cross-sections, particularly in MPS III/A patients: varying polygonal shapes and an abnormal pigment distribution. According to these cross-sections the hair surface exhibited severe deformities in the scanning electron microscope, i.e. distortions of hair, irregular nodes and longitudinal grooves. In MPS I and II similar abnormalities were found.

[Fracture of the mandibular condyle in a skeleton dating from the early middle ages (author's transl)]

The skeleton of a 45 to 50 year-old man dating from the early Middle Ages (discovered at Schwechat in Lower Austria) was examined. In addition to numerous pathological findings with respect to the masticatory apparatus such as caries, severe crown abrasion, pulp necrosis and inflammatory and degenerative alterations in the areas near the teeth, an exceptionally rare findings was observed, namely that of a deformation of the right mandibular condyle. The differential diagnosis on the basis of the radiological findings showed the presence of post-traumatic transformation processes with functional adaptation. Since anatomical specimens of completely healed jawbone fractures are exhibited only rarely in recent case histories, this findings takes on a special significance from the medical as well as from the archeological and anthropological points of view.