Simona Minozzi

Palaeopathology of Human Remains from the Roman Imperial Age

The increasing attention of archaeological and anthropological research towards palaeopathological studies has allowed to focus the examination of many skeletal samples on this aspect and to evaluate the presence of many diseases afflicting ancient populations. This paper describes the most interesting diseases observed in skeletal samples from five necropolises found in urban and suburban areas of Rome during archaeological excavations in the last decades, and dating back to the Imperial Age. The diseases observed were grouped into the following categories: articular diseases, traumas, infections, metabolic or nutritional diseases, congenital diseases and tumors, and some examples are reported for each group. Although extensive epidemiological investigation in ancient skeletal records is impossible, palaeopathology allowed highlighting the spread of numerous illnesses, many of which can be related to the life and health conditions of the Roman population.

An investigation of Etruscan cremations by Computed Tomography (CT)

The cremation urn is a tiny archaeological site of its own, with finds, features, stratification and structure. The old prescription was to take the pot apart, or slice it, and micro-excavate with inevitable damage and loss. Here is a new methodology – the application of a CT scan as used in medicine. The authors evaluate the results on 35 Etruscan cremations, finding that CT not only provides an excellent guide for micro-excavation, but allows the degree of fragmentation to be appreciated inside the pot and maps those metal objects that have corroded to a crust and do not survive excavation. They emphasise the value of the method in making a ‘first resort’ primary record especially in commercial archaeology.

A subject with abnormally short stature from Imperial Rome

In spite of the rich iconographic and literary documentation from ancient sources, the skeletal evidence concerning individuals of abnormally short stature in the Greco-Roman world is scarce. The necropolis of Viale della Serenissima/Via Basiliano in Rome, mostly referable to the II century AD, recently yielded the skeleton of an individual characterized by proportionate short stature, gracile features suggesting female gender, and delayed epiphysial closure, associated with full maturation of the permanent dentition. These characteristics could be compatible with the phenotype associated with female gonadal dysgenesis. The skeletal individual described here, although poorly preserved, represents the first evidence of a paleopathologic condition affecting skeletal growth documented for the population of ancient Rome.

Pituitary disease from the past: a rare case of gigantism in skeletal remains from the Roman Imperial Age.

verytallskeleton,foundduringarchaeologicalex-cavationsnearRome(Italy)anddatedbacktotheImperial Age (3rd century AD), was affected by pitu-itary gigantism, a rare growth disease seldom docu-mented in ancient times. This case represents the firstdescriptionofthisendocrinediseaseinacompleteskel-eton from the past.The skeleton T.30 was found in the Imperial Age ne-cropolis of Torre Serpentana (7 km north of Rome) andbelonged to a young male (age range, 16–20 yr) with avery tall but normally proportioned stature estimatedaround202cm(1).Somelongbonesandvertebralbodiesdidnotshowcompleteepiphysealunion,andthereforethestature would probably have been taller if he had livedlonger.TheaveragemaleRomanstaturewasaround167cm during the Imperial Age, and the difference with T.30is35cm(21%overtheaveragestatureofthepopulation),indicating an overgrowth syndrome (2); all the main longbone lengths are over 5

Autoptic practices in 16th–18th century Florence: Skeletal evidences from the Medici family

During the late Middle Ages and the Renaissance autopsy started to be practised for medico-legal purposes in order to investigate the causes of death. The other reason for dissecting a body was embalming, a diffused custom typical of the elitarian classes. The exploration of the Medici tombs in the Basilica of San Lorenzo in Florence offered the opportunity to investigate the practice of autopsy on these aristocratic personages of the Renaissance and Early Modern Age. A total of 25 currently skeletonized individuals, almost all of whom formerly artificial mummies, were exhumed. Accurate examination of the skeletons revealed evident signs of autoptic practices such as horizontal and oblique craniotomies, longitudinal and transversal cuts of the sternum, and sectioning of the sternal extremities of the ribs. In this group, women were treated differently to men at autopsy, as only men underwent craniotomy; autopsy and embalming were carried out also for the illegitimate members of the family and for subaldults. The extremely rich documentary archives of the Medici family confirm that the corpses were in several cases submitted to autopsy. The present study offers important direct information on the 16-18th century autoptic practices that the court surgeons in Florence performed on the members of the elite class.

Renal Calculosis of Pandolfo III Malatesta (1370-1427)

Renal Calculosis of Pandolfo III Malatesta (1370-1427) Valentina Giuffra, PhD, Luca Ventura, MD, Simona Minozzi, PhD, Agata Lunardini, Raimondo Quaresima, Lorenzo Arrizza, Gino Fornaciari, MD Division of Paleopathology, History of Medicine and Bioethics, Department of Oncology, Transplants and Advanced Technologies in edicine, University of Pisa, Italy; Department of Pathology, San Salvatore Hospital, L’Aquila, Italy; Department of Chemistry, hemical Engineering and Materials, University of L’Aquila, Italy; Centre of Electronic Microscopy, University of L’Aquila, Italy.

Italian Iron Age Cremations

The current study addresses the anthropological study of the burned skeletal remains recovered in 92 cinerary urns of Apuan Ligurian tombs discovered in the Apuan mountains of Liguria and Tuscany (Italy), dating to the end of the Iron Age (IV–I century bc ). The results indicate that most of the urns contained remains of one individual; those who were cremated included males and females and people of all ages, although subadults were particularly well-represented. The chromatic changes of the remains indicate cremation temperatures between 300°C and 700°C. Despite the bone fragmentation, it was possible to detect skeletal alterations due to pathological events or episodes of nutritional stress, such as dentoalveolar disease, bacterial infections, porotic hyperostosis, osteoarthritis and traumatic lesions, which revealed poor conditions of life and health.

A Case of Gout from Imperial Rome (1st-2nd Century AD)

The study of pathological alterations in ancient skeletal remains may contribute to the reconstruction of the history of diseases and health conditions of ancient populations. Therefore, in recent research palaeopathology provides an important point of view in bioarchaeology and medicine. This work describes the bone alterations observed in the skeleton of an adult woman found during archaeological excavations in the greatest necropolis of the Imperial Age in Rome. The skeletal remains showed some pathological anomalies and the most evident alterations consisted of multiple osteolytic lesions involving mainly the small bones of the feet, which presented round cavitations and scarce signs of bone repair. Differential diagnosis suggests that this individual was affected by gout, probably associated with hypothyroidism that determined her short stature.

Multislice computed tomography (MSCT) and 3D reconstruction of Etruscan funerary urns in archaeology

Purpose Existing operating room concepts do not meet modern technological opportunities anymore. There is a growing gap between the technological potential and the surgeon’s possibility to use it effectively. The ‘‘Surgical Deck’’ is supposed to represent a prototype for a new operating room generation. The overall objective of the project is to achieve a better integration of functions and to develop an innovative concept for a highly developed surgical workstation. Methods The Electronic Surgery Instrument System (ESIS) links technical functions with devices. The Surgical Management and Guidance System (SMGS) comprises all navigation functions and provides additional opportunities for active control and support. Three working areas are defined for the Surgical Deck. They are referred to as Surgical Cockpit, Airway Cockpit and Technical Cockpit (Fig. 1). The evaluation of the Surgical Deck was conducted on a total of 284 surgeries carried out in the period from 9th September 2011 to 31st January 2012. The evaluation team consisted of 6 surgeons, 3 surgery nurses, 3 anesthesiologists and 4 anesthesia nurses. Within a detailed analysis, the data of 50 FESS surgeries were compared to those of a control group. In the context of another ergonomic study, an additional number of 244 other ENT surgeries were included. Results The Surgical Deck could be used for all surgeries documented herein. No complications were registered during the evaluation period. Within the FESS group, the average slot time was reduced by 13 %. On average 8.3 % of all FESS surgery interactions were carried out by using one of the systems of the Surgical Cockpit. With 73.8 % of the slot time, eye interaction was mainly concentrated on the Primary Surgical Display, followed by 6.6 % on the Navigation Display and 1.6 % on the MCDU. 88.2 % of those questioned assessed ergonomics as being better than in the conventional operating room. 71.5 % stated that the Surgical Deck provided an added value with regard to the surgical procedure. 91.3 % confirmed that system control required additional training. From the user’s point of view, 79.3 % described the cost-benefit-ratio as appropriate. For 96 % of the surgeries, respondents said that they were feeling adequately supported by the technology. Conclusion The results show a clear advantage of the Surgical Deck work station and system architecture in comparison to existing solutions. The Surgical Deck may present a solid foundation with regard to the transfer of the system into the clinical practice. This is particularly relevant for new assistance functions such as process control software, navigation-based collision warning systems or telemanipulators. However, the Surgical Deck requires additional and modified training of all surgical team members. It is to be expected that the project will significantly contribute to further develop the future surgical workstation and its standardization.

Computer models and applications for the management of anthropological data.

Recent developments in the excavation and osteological studies of human skeletal remains have shown the need to adopt a computer and digital approach, which is both practical and methodological, and able to integrate the knowledge and skills acquired in recent years by different branches of archaeoantropological studies, using modern and innovative tools. JASs has repeatedly promoted a “renewal” of the practices related to information management, both through the creation of the forum “Sharing databases in digital Anthropology” (Bruner, 2009), and through the publication of many international works linked to this topic (Canals et al., 2008). To this aim, it is clear that the first step consists in creating a set of integrated applications, capable of managing the various areas investigated in this widespread field. In order to address the management of large amounts of anthropological and paleopathological data and their subsequent processing and interpretation, the Division of Paleopathology of the University of Pisa has created an extensive project relating to excavation and laboratory activities designed to develop a number of data storage protocols and subsequent inclusion into a GIS system (for an extended version of this project see Coschino, 2009). This project has been essentially organized into a tripartite structure; the information system includes two main protocols designed by the research team of the Division of Paleopathology (University of Pisa) which work on an OS WindowsTM: 1. the software SIUS manages the skeletal unit computer records, which aim to store all the archaeological, taphonomic and anthropological data recorded on the field during archaeological excavation; 2. the software BONES stores and handles the dozens of anthropological and paleopathological records compiled during the examination of the skeletal remains in the laboratory. The GIS system allows interaction between the protocols using the two types of software.