Mirko Traversari

CT Scan of Thirteen Natural Mummies Dating Back to the XVI-XVIII Centuries: An Emerging Tool to Investigate Living Conditions and Diseases in History

Objectives To correlate the radiologic findings detected with computed tomography scan with anthropological data in 13 naturally mummified bodies discovered during works of recovery of an ancient church in a crypt in Roccapelago, in the Italian Apennines. Methods From a group of about sixty not-intentionally mummified bodies, thirteen were selected to be investigated with volumetric computed tomography (CT). Once CT scan was performed, axial images were processed to gather MPR and Volume Rendering reconstructions. Elaborations of these images provided anthropometric measurements and a non-invasive analysis of the residual anatomical structures. For each body the grade of preservation and the eventual pathological changes were recorded. Furthermore, in order to identify nutritional and occupational markers, radiologic signs of bone tropism and degenerative changes were analysed and graded. Results Mummies included seven females and six males, with an estimated age ranging from 20 to 60 years. The first relevant finding identified was a general low grade of preservation, due to the lack of anatomic tissues different from bones, tendons and dehydrated skin. The low grade of preservation was related to the natural process of mummification. Analysing bone degenerative changes on CT scan, the majority of the bodies had significant occupational markers consisting of arthritis in the spine, lower limbs and shoulders even in young age. Few were the pathological findings identified. Among these, the most relevant included a severe bilateral congenital hip dysplasia and a wide osteolytic lesion involving left orbit and petrous bone that was likely the cause of death. Conclusions Although the low grade of preservation of these mummies, the multidisciplinary approach of anthropologists and radiologists allowed several important advances in knowledge for the epidemiology of Roccapelago. First of all, a profile of living conditions was delineated. It included occupational and nutritional conditions. Moreover, identification of some causes of death and, most importantly the definition of general living conditions.

A likely case of goiter in the Madonna col Bambino dormiente (1465/1470) by Andrea Mantegna (1431-1506).

the Boston Museum of Fine Arts by one of Mantegna’s followers has also been identified as a representation of goiter, which highlights how the painter and his school have not The Gemälde Gallerie in Berlin exhibits the famous painting Madonna col Bambino dormiente (Eng. Madonna with sleeping child, Fig. 1) painted around 1465/1470 by Andrea Mantegna (1431–1506). A common theme of the Italian Renaissance, the Madonna with child was often studied and represented by Mantegna throughout his life. In comparison with previous representations characterized by a stiff and awkward rendering of shapes, this is a more intimate and private interpretation of the divine duo with a softer pictorial and more harmonious compositional quality. The particular attention paid to representing reality reveals that the Virgin Mary shows an enlarged neck, with a protruding ovoidal mass. Elsewhere identified lobulations being absent, the pictorial evidence alone would not allow to formulate a clearcut semeiological diagnosis of goiter and more differential diagnoses could be considered, e.g., lipoma, cyst, abscess, lymphadenopathy, carotid artery aneurism, etc. Nonetheless, the very suggestive anatomical position and the fact that several more examples by different artists of Renaissance [1, 2] have been identified as portrayed with the typical pathological morphology of a goitrous enlargement strongly point in that interpretative direction. Another Madonna with child in

The “Lost Caravaggio”: a probable case of goiter in seventeenth-century Italy

Most human cancers, including myeloma, are preceded by a precursor state. There is an unmet need for in vivo models to study the interaction of human preneoplastic cells in the bone marrow microenvironment with non-malignant cells. Here, we genetically humanized mice to permit the growth of primary human preneoplastic and malignant plasma cells together with non-malignant cells in vivo. Growth was largely restricted to the bone marrow, mirroring the pattern in patients with myeloma. Xenografts captured the genomic complexity of parental tumors and revealed additional somatic changes. Moreover, xenografts from patients with preneoplastic gammopathy showed progressive growth, suggesting that the clinical stability of these lesions may in part be due to growth controls extrinsic to tumor cells. These data demonstrate a new approach to investigate the entire spectrum of human plasma cell neoplasia and illustrate the utility of humanized models for understanding the functional diversity of human tumors.

Three cases of developmental dysplasia of the hip on partially mummified human remains (Roccapelago, Modena, 18th Century): a study of palaeopathological indicators through direct analysis and 3D virtual models

Developmental dysplasia of the hip (DDH) is caused by a delay in the development of the acetabular cavity, leading to an anomaly in the angle of the acetabular roof. As a result, the femoral head and the acetabular cavity do not interact normally. The identification of three cases of DDH among the remains discovered in the most recent unit from the crypt at Roccapelago (Modena, Italy) enabled us to discuss the presence of DDH in this region during the 18th century. All three cases are bilateral and Dunn class I, two have been identified as male and one as female. These DDH cases are very likely mainly due to mechanical factors such as the breech position of the foetus, perhaps associated with birth order. But given their overall similarity, they may also have resulted from the practice of swaddling new-borns. In addition, current data from the Italian Ministry of Health suggests that the incidence of DDH has remained stable in this region from the 18th century to the present. The ongoing study of remains from earlier units should bring a better understanding of the particular prevalence of DDH at Roccapelago.RésuméLa dysplasie développementale de la hanche (DDH) résulte d’un retard dans le développement de la cavité acétabulaire conduisant à une altération de l’inclinaison du toit acétabulaire. En conséquence, la tête fémorale et la cavité cotyloïdienne n’interagissent pas normalement. L’identification de trois cas de DDH parmi les restes découverts dans l’unité stratigraphique la plus récente de la crypte de Roccapelago (Modène, Italie) nous permet de discuter de la présence de DDH dans cette région au cours du 18e siècle. Dans les trois cas, identifiés comme deux hommes et une femme, la pathologie est bilatérale et de classe Dunn I. Ces cas de DDH sont vraisemblablement principalement dus à des facteurs mécaniques tels que la position en siège du foetus, probablement associée au rang de naissance. Mais compte tenu de leur similitude globale, ils peuvent avoir été causés par l’utilisation de langes chez les nouveau-nés. En outre, les données actuelles du ministère italien de la Santé suggèrent que l’incidence de la DDH est demeurée stable dans cette région, du 18e siècle jusqu’à nos jours. L’étude en cours des restes des unités stratigraphiques antérieures favorisera une compréhension plus profonde de la particularité de la prévalence de DDH à Roccapelago.

Transhumance pastoralism of Roccapelago (Modena, Italy) early-modern individuals: Inferences from Sr isotopes of hair strands

OBJECTIVES In this work, we use Sr isotopes to analyze human hair and determine short-term movements of a contemporary human traveler and of early-modern individuals from an archaeological site (Roccapelago, Modena, Italy, 16th-18th century). MATERIALS AND METHODS Analyses were performed using a Neptune MC-ICP-MS. We first set up and tested the procedure on scalp hair of a contemporary human, who spent some time between Brazil and Italy. We then analyzed the 87 Sr/86 Sr ratios of eight exceptionally well-preserved archaeological hair specimens associated with human mummies from Roccapelago. Trace elements were analyzed by LA-ICP-MS on single-hair specimens to check the preservation of the archaeological samples. RESULTS The strontium isotope composition of modern human hair varies from 0.7087 to 0.7093. The 87 Sr/86 Sr ratios of the Roccapelago hair strands range from 0.7082 to 0.7137, with an average of 0.7093 ± 0.0031 (2σ), revealing also intra-individual differences in isotopic composition along the length of the hair shaft. Data were compared with local archaeological rodent bones and teeth and with published isotopic values of water and outcropping rocks. Trace element abundances of archaeological and modern human hair are similarly low in terms of Rare Earth Element (REE) and metal contents, in particular after HNO3 leaching. DISCUSSION The variable modern human hair 87 Sr/86 Sr ratios show that high-resolution hair sampling tracks the movements of this individual between the two continents. The Sr isotope composition of the mummy hair is consistent with sub-annual human movements from Roccapelago to an area with different 87 Sr/86 Sr ratios. Historical sources indicate that individuals from Roccapelago travelled with their herds to Tuscany for transhumance pastoralism practices. The high radiogenic 87 Sr/86 Sr ratios (>0.71) found in some of the hair are possibly consistent with the Tuscan Magmatic Province and the Tuscan Metamorphic Complex isotope signature. To our knowledge, this is the first study in an archaeological context where the Sr isotope evidence of mobility is corroborated by historical documents.

Francesco M. Galassi and Hutan Ashrafian: Julius Caesar’s disease: a new diagnosis

The great Julius Caesar probably already knew the concept of death so well postulated by Foucault 2000 years after his death: disease as a boring exercise to deal with, an inevitable step to be made. Caesar was ill, perhaps, but this did not prevent him from becoming a deity, sanctified by the hands of his murderers, in the theater (i.e., the Senate) of his rise. Only a few are granted this privilege and, for example, I think of Moliere. The heinous murder committed has effectively removed the legend from that mortal body dying on the floor. The same diagnosis, now historical, of epilepsy, for Caesar’s character, has perhaps suffered the weight of the legend rather than really focusing on Caesar the man; the ‘‘sacred disease’’ was better suited to the public profile rather than the private one. Yet before becoming a god, Caesar was a man, and the ancient authors knew this quite well, as they repeatedly wrote about his physical aspects. In this theoretical context, the new book, Julius Caesar’s disease: a new diagnosis by Francesco M. Galassi (Institute of Evolutionary Medicine, University of Zurich) and Hutan Ashrafian (Imperial College London), finds its place. It is an investigation stemming from an article published in this journal in 2015 [1]. Chronologically rediscovering the salient quotations about Caesar’s disease, this books really focuses on the facts and provides for the first time in classical and medical scholarship a complete picture of the situation. The thorough analysis is not only medical, as one with be tempted to anticipate, but also philological. The ancient authors did not write their accounts with a strictly medical purpose, so today physicians cannot discuss the ancients only from their angle. Authors Francesco Maria Galassi and Hutan Ashrafian give valuable evidence for this, approaching the issue with a multidisciplinary methodology, in the very spirit of modern physical anthropological research [2]. This can be seen when history becomes an evaluation tool, like a modern radiological or laboratory analysis, during the authors’ formulation of the differential diagnosis. The result obtained by this method is extraordinary, and the conclusions based on solid anamnestic interpretations bring Caesar back to his human condition, closer to us through a cerebrovascular disease still present nowadays. Caesar’s prominent figure does not emerge weakened from this process, debased or deprived of its divine attributes; the authors indeed give us a new man, much closer to us, like us, without scratching his noble profile, his eternity. We will never know for sure whether Caesar actually suffered from TIA, which the authors themselves acknowledge, but thanks to them a thorough biomedical profile has finally been made available for paleopathologists, historians, philologists and neurologists alike, who will then be able to expand their researches on the matter. For the ordinary history lovers, however, this book allows them to feel closer to Caesar, the real man who lived before his myth, and like him perhaps dreaming of eternity. & Mirko Traversari mirko.traversari2@unibo.it

Trois cas de dysplasie développementale de la hanche chez des individus partiellement momifiés (Roccapelago, Modène, 18e siècle): étude des indicateurs paléopathologiques par analyses directe et virtuelle

Developmental dysplasia of the hip (DDH) is caused by a delay in the development of the acetabular cavity, leading to an anomaly in the angle of the acetabular roof. As a result, the femoral head and the acetabular cavity do not interact normally. The identification of three cases of DDH among the remains discovered in the most recent unit from the crypt at Roccapelago (Modena, Italy) enabled us to discuss the presence of DDH in this region during the 18th century. All three cases are bilateral and Dunn class I, two have been identified as male and one as female. These DDH cases are very likely mainly due to mechanical factors such as the breech position of the foetus, perhaps associated with birth order. But given their overall similarity, they may also have resulted from the practice of swaddling new-borns. In addition, current data from the Italian Ministry of Health suggests that the incidence of DDH has remained stable in this region from the 18th century to the present. The ongoing study of remains from earlier units should bring a better understanding of the particular prevalence of DDH at Roccapelago.RésuméLa dysplasie développementale de la hanche (DDH) résulte d’un retard dans le développement de la cavité acétabulaire conduisant à une altération de l’inclinaison du toit acétabulaire. En conséquence, la tête fémorale et la cavité cotyloïdienne n’interagissent pas normalement. L’identification de trois cas de DDH parmi les restes découverts dans l’unité stratigraphique la plus récente de la crypte de Roccapelago (Modène, Italie) nous permet de discuter de la présence de DDH dans cette région au cours du 18e siècle. Dans les trois cas, identifiés comme deux hommes et une femme, la pathologie est bilatérale et de classe Dunn I. Ces cas de DDH sont vraisemblablement principalement dus à des facteurs mécaniques tels que la position en siège du foetus, probablement associée au rang de naissance. Mais compte tenu de leur similitude globale, ils peuvent avoir été causés par l’utilisation de langes chez les nouveau-nés. En outre, les données actuelles du ministère italien de la Santé suggèrent que l’incidence de la DDH est demeurée stable dans cette région, du 18e siècle jusqu’à nos jours. L’étude en cours des restes des unités stratigraphiques antérieures favorisera une compréhension plus profonde de la particularité de la prévalence de DDH à Roccapelago.