DISH and the monastic way of life

Diffuse idiopathic skeletal hyperostosis (DISH) is common condition and its prevalence increases markedly with age. This paper describes the pathology and aetiology of the condition; DISH seems to be related to obesity and type II diabetes and is probably a multisystem hormonal disorder. DISH occurs frequently in human skeletal remains, particularly in those recovered from monastic sites. Evidence is presented to confirm this association and the causes are discussed. We also present criteria for the diagnosis of DISH in human remains, which we suggest would permit valid inter‐study comparisons. Copyright © 2001 John Wiley & Sons, Ltd.     

The prevalence of,and the relationship between some spinal diseases in a human skeletal population from London

The prevalence of osteoarthritis, osteophytosis, intervertebral disc disease and diffuse idiopathic skeletal hyperostosis (DISH) was determined in a group of skeletons excavated from the crypt of Christ Church, Spitalfields. Age-specific prevalence rates were calculated from the group of skeletons for which age at death was known from intact coffin plates. Osteoarthritis of the facet joints occurred most frequently in the cervical and upper thoracic regions and was also common in the lower lumbar spine. The disease was more frequently bilateral in the lumbar spine than in upper regions. Osteophytes were common in the thoracic and lumbar spines, whereas intervertebral disc disease was confined almost completely to the cervical region. Diffuse idiopathic skeletal hyperostosis seemed to be underrepresented in this group, but was more common in males than in females. Age correlated significantly with all the conditions except DISH. Multiple regression analysis was carried out using each of the conditions as the dependent variable in turn. Age accounted for more of the variance than any of the other conditions added as independent variables.     

Co‐occurrence of DISH and HFI in the Terry Collection

Diffuse idiopathic skeletal hyperostosis (DISH) and hyperostosis frontalis internus (HFI) are both characterised by abnormal bone growth, a late age of onset, and an association with obesity, acromegaly and various metabolic disorders. In this study we examined the co‐occurrence of DISH and HFI in a sample of 406 black and whites aged 40–102 years old from the Terry Collection, National Museum of Natural History, Smithsonian Institution. Fisher's exact tests showed the co‐occurrence was significant for females. DISH was present in 19.6% of black and 29.6% of white females with HFI versus 4.76% and 2.38% of control females without HFI. A similar frequency of DISH was seen in males with HFI (20% black and 27.3% white), but this was not significantly different from the male controls without HFI (16.8% and 18.9%). The risk of developing DISH for females with HFI was nearly 8.78 times greater (CI = 2.56–30.1) than for females without HFI. Logistic regression of the female data showed HFI was a significant determinant (p = 0.001) of the presence of DISH but age was not (p = 0.744). We suggest that similar metabolic, genetic and environmental risk factors in the pathogenesis of the two conditions explain the observed comorbitity. Copyright © 2010 John Wiley & Sons, Ltd.     

Bioarchaeological Investigation of Possible Gunshot Wounds in 18th Century Human Skeletons from Korea

Notwithstanding the relative abundance of bioarchaeological evidence of pre‐20th century gunshot wounds discovered at European and American archaeological sites, similar findings in East Asian countries have been very rare. In this study, we report evidence of possible gunshot wounds sustained by two individuals buried in Joseon tombs of Korea. The shapes of the trauma seemed to indicate low‐velocity projectiles, most likely musket balls. To our knowledge, this is the first bioarchaeological report specifically concerning possible gunshot‐wound evidence in East Asian skeletons recovered from archaeological fields. Copyright © 2011 John Wiley & Sons, Ltd.     

Diffuse idiopathic skeletal hyperostosis in Late Jomon Hokkaido,Japan

The purpose of this study is to describe and analyse the evidence for diffuse idiopathic skeletal hyperostosis (DISH) in samples of human skeletal material recovered from Late Jomon (ca. 1500–300 BCE) and Okhotsk (CE 500–900) cultural period sites, northwestern Hokkaido, Japan. Two individuals from the Jomon period assemblage (n = 14) exhibited lesions consistent with DISH, while the larger Okhotsk sample (n = 39) was free of this condition. The aetiology of this condition is reviewed with reference to the clinical and bioarchaeological literature, in addition to behavioural and environmental considerations specific to this region and these time periods. Copyright © 2006 John Wiley & Sons, Ltd.     

Skeletal distribution of degenerative changes in vertebral osteophytosis,vertebral osteoarthritis and DISH

In order to comprehend the condition of vertebral osteophytosis, vertebral osteoarthritis and DISH (diffuse idiopathic skeletal hyperostosis) with respect to diagnosis and aetiology, the vertebral and peripheral (appendicular) frequency and distribution pattern of degenerative joint changes of 176 rather affluent citizens were analysed from the late medieval city of Dordrecht in Holland. Patterns of frequencies with respect to age and sex were found to be similar essentially to those of a present-day Dutch suburban village population. Frequencies for vertebral osteophytosis were twice those for vertebral osteoarthritis, and both increased with age in both sexes. The individual pattern of vertebral osteophytosis and vertebral osteoarthritis seems to indicate that each disorder possesses its own progressive identity. From the distribution pattern and frequency of peripheral osteoarthritis it was concluded, with respect to the vulnerability of developing this complication under physically moderate life conditions, that causal factors for vertebral osteophytosis are less important than those for vertebral osteoarthritis. Osteoarthritis presented itself as a systemic disorder, affecting synovial joints in general. Finally it was appreciated that, with increasing age, bony outgrowths from joint degeneration become anatomically masked by para-articular ossifications from DISH.     

Antemortem pathological changes suggestive of reactive and degenerative arthritic disorders

The present case displays severe antemortem skeletal malformations suggestive of antemortem reactive arthritis (ReA), spondyloarthropathies and diffuse idiopathic skeletal hyperostosis (DISH). The ossified anterior longitudinal ligament on the right side of the thoracic vertebral bodies, with the presence of extraspinal enthesophytes, together indicates DISH. Fused lumbar vertebrae with costovertebral and sacroiliac joint fusion, combined with numerous large enthesophytes collectively suggest ankylosing spondylosis and ReA. Finally, some vertebrae showed evidence of age related osteoarthritis. However, the anatomical evidence for these conditions displays some inconsistencies with the known pathogenesis; therefore, a definitive account of this individual's antemortem condition remains uncertain. As no biological or medical information is known about the individual, skeletal morphology, irregular skeletal fusion and the presence of enthesophytes have been collectively used to propose the antemortem disorders that appear to have affected this individual's skeleton. Copyright © 2010 John Wiley & Sons, Ltd.     

Multicentric osteosarcoma associated with DISH,in a 19th century burial from England

Osteosarcoma is a rare type of malignant neoplasm that is most frequent in adolescents and young adults although it can develop at any age. It can metastasize from a primary site in bone to other bones and soft tissues. Usually the disorder causes a single bone‐forming lesion (unicentric) but some cases have multicentric, bone‐forming lesions. Some of these lesions develop at different sites at different times. In a second variant of multicentric osteosarcoma, synchronous bone‐forming lesions develop at multiple sites. Distinguishing between these two types of multicentric osteosarcoma is challenging in a clinical context and the criteria for doing so are unlikely to be met in an archaeological burial. Wolverhampton burial HB 39 was excavated from an early‐nineteenth century cemetery site in England. It consists of the incomplete skeleton of an adult male of at least 45 years of age with multicentric osteosarcoma. The individual represented by this burial also had diffuse idiopathic skeletal hyperostosis (DISH). Three of the bone‐forming lesions associated with osteosarcoma developed on the bony outgrowths related to DISH. Copyright © 2010 John Wiley & Sons, Ltd.     

Health Patterns of the Etruscan Population (6th–3rd Centuries bc) in Northern Italy: The Case of Spina

A sample of 303 skeletons from the Etruscan necropolis of Spina (Ferrara, Italy, 6th–3rd centuries bc ) was examined for paleopathological lesions in order to assess the general health, diseases and quality of life of this Iron Age population. The observed pathologies included porotic hyperostosis, specific and aspecific infections, metabolic and endocrine disorders, tumours and osteoarthritis. A total of 46.7% of adults and 7.7% of subadults showed at least one pathological lesion. Statistical comparisons were made between sexes and adult‐age classes (20–35 years and >35 years) to analyse the prevalence of the lesions. The analysis of porotic hyperostosis and osteoperiostitis allowed to determine the general health status of this group, and the analysis of osteoarthritis allowed to hypothesise a gender division of labour. The results suggest a relatively high‐life expectancy for the time as well as good health and quality of life. The few specific infections and metabolic disorders indicate fairly good nutrition, while the high frequency of porotic hyperostosis can be partly linked to some type of hereditary anaemia. Copyright © 2015 John Wiley & Sons, Ltd.     

Cribra orbitalia and porotic hyperostosis in a Greek colonial population (5th to 3rd centuries BC) from the Black Sea

Cribra orbitalia and porotic hyperostosis in Greek skeletal remains have typically been attributed to a genetic anaemia, most notably thalassemia due to the presence of endemic malaria in the Mediterranean region. This paper reports the results of an analysis of cribra orbitalia and porotic hyperostosis in a Greek colonial population (5th to 3rd centuries BC) from the Black Sea. Archaeological evidence, stable isotopic data, and other skeletal indicators of physiological stress are examined to determine the most likely cause(s) of these lesions. While the possibility that some of the colonists of Apollonia suffered from thalassemia cannot be entirely discounted, the skeletal evidence examined in this study is not consistent with a diagnosis of thalassemia. We must therefore be cautious in assuming that cribra orbitalia and porotic hyperostosis in Greek skeletal remains, and indeed skeletal remains from any region where malaria was endemic in the past, is always indicative of this condition. Nutritional deficiencies and exposure to infectious diseases probably played an equally, if not more, important role in the development of these lesions. Copyright © 2006 John Wiley & Sons, Ltd.     

Health Consequences of European Contact in the Great Plains: A Comparison of Systemic Stress Levels in Pre‐ and Post‐Contact Arikara Populations

The biocultural effects of European contact varied considerably throughout the Americas. Some populations were decimated by colonialism, while others benefited from trade relationships and access to new technologies. It has been suggested that initial contact with European fur traders and explorers was economically favourable for Plains village populations, thereby facilitating a period of cultural florescence. In this study, we evaluate the hypothesis that Plains groups were better off than their predecessors during the initial contact period by comparing frequencies of enamel hypoplasia, cribra orbitalia, and porotic hyperostosis in pre‐ and post‐contact Arikara skeletal assemblages. We included both juveniles and adults in our sample to capture variation in the stress experience of different segments of the population. Our analysis revealed similarly low frequencies of cribra orbitalia in the pre‐ and post‐contact groups and no observed cases of porotic hyperostosis. Enamel hypoplasia, however, was significantly more prevalent among post‐contact Arikara villagers when compared to their pre‐contact counterparts, which suggests that stress levels were higher after European contact. Additionally, enamel hypoplasia was most common among post‐contact juveniles. The elevated frequency of enamel hypoplasia in the post‐contact sample combined with the low frequencies of cribra orbitalia and porotic hyperostosis suggests that disease stress, rather than nutritional deficiencies, was likely responsible for the decline in overall health following European contact. These results also suggest that juveniles are sensitive indicators of systemic stress within a population and should be included in bioarchaeological analyses of prehistoric health when available. Copyright © 2015 John Wiley & Sons, Ltd.     

An Interdisciplinary Human-Environmental Examination of Effects Consistent with the Anthropocene in the Lower Illinois River Valley

Using archaeological and ecological data of animal communities, and fish communities in particular, we test for evidence consistent with the Anthropocene in the lower Illinois River valley across millennia. Environmental impacts by preindustrialized peoples may be minor compared to current alterations; however, this hypothesis is untested and should be assessed. Using the relative abundance of fish taxa, we tested for differences among archaeological and modern time periods, taking advantage of published zooarchaeological data sets and newly analyzed data. Collections from all archaeological time periods differed significantly from modern collections, but the relative abundance of fishes did not differ significantly among archaeological time periods. Sociopolitical context, material culture, plant-based subsistence patterns, and the use of animal classes shifted temporally, but these differences did not extend to the relative abundance of fish families. Our results suggest that dominating human influences on fish communities did not occur prior to the Late Woodland period in the lower Illinois River.     

Dedicated Followers of Fashion? Bioarchaeological Perspectives on Socio‐Economic Status,Inequality, and Health in Urban Children from the Industrial Revolution (18th–19th C), England

The 18th and 19th centuries in England were characterised by a period of increasing industrialisation of its urban centres. It was also one of widening social and health inequalities between the rich and the poor. Childhood is well‐documented as being a stage in the life course during which the body is particularly sensitive to adverse socio‐economic environments. This study therefore aims to examine the relationship between health and wealth through a comprehensive skeletal analysis of a sample of 403 children (0–17 years), of varying socio‐economic status, from four cemetery sites in London (c.1712–1854). Measurements of long bone diaphyseal length, cortical thickness, vertebral neural canal size, and the prevalence of a range of pathological indicators of health stress were recorded from the Chelsea Old Church (high status), St Benet Sherehog (middle status), Bow Baptist (middle status), and Cross Bones (low status) skeletal collections. Children from the low status Cross Bones site demonstrated deficient growth values, as expected. However, those from the high status site of Chelsea Old Church also demonstrated poor growth values during infancy. Fashionable child‐care practices (e.g. the use of artificial infant feeds and keeping children indoors) may have contributed to poor infant health amongst high status groups. However, differing health risks in the lower status group revealed the existence of substantial health inequality in London at this time. © 2016 The Authors International Journal of Osteoarchaeology Published by John Wiley & Sons Ltd.     

Prevalence rates of spondylolysis in British skeletal populations

As an activity‐related pathological lesion, spondylolysis and its prevalence rates are indicative of relative diachronic activity levels in different populations. In this paper we document the prevalence of spondylolytic defects in a series of time‐successive populations with special reference to the recording methods employed, and compare the findings with modern clinical studies. We identify epidemiological trends in expression of the condition through 1500 years in a series of skeletonised human remains from England. This includes a 5th–6th‐century settlement, a 15th‐century mass grave, a 14th to 17th‐century rural parish, a medieval Dominican friary, a medieval leper hospital and an 18th to 19th‐century crypt collection. These skeletal populations sample human groups experiencing considerable social change from an agrarian, non‐centralised early medieval period through the development of the medieval state to the earliest phases of industrialisation in England. A detailed study of all lumbar vertebrae in one of the assemblages highlights discrepancies between clinical prevalence rates for spondylolysis established through radiography, and those resulting from direct osteological analysis of the lumbar region of the vertebral column. Current prevalence rates cited in the osteological as well as the clinical literature are greatly dependent upon the recording methods employed, and the effects of several methods for osteological remains are considered in this treatment. For the populations reported on here, prevalence rates vary from considerably less than 1% to as much as 12%, depending on the method selected. A standardised recording method for spondylolytic lesions is suggested to facilitate accurate prevalence reporting and comparison of activity levels between different populations. Copyright © 2005 John Wiley & Sons, Ltd.     

Possible rheumatoid arthritis found in the human skeleton collected from the tomb of Joseon Dynasty,Korea, dating back to the 1700s AD

We report a possible rheumatoid arthritis (RA) case found in a Korean Joseon Dynasty (1392–1910) tomb encapsulated by a lime‐soil mixture barrier (LSMB). The tomb is thought to have been constructed during the 1700s AD (1760 AD by carbon dating). In our anthropological examination, joint destruction, erosion or fusion (signs of polyarthritis) were identified mainly in the peripheral skeleton. Especially in both sides of the wrist bones, severe destruction/joint fusion possibly caused by polyarthritis was observed. A similar polyarthritis pattern also was seen in the right foot bones, even though we failed to confirm this symmetry due to the missing left foot bones. Despite these findings, signs suggestive of polyarthritis are very rarely seen in axial bones, even though bony fusions are found in the atlanto‐occipital joint or thoracic vertebrae (TV) 9–10. By the osteological signs observed in this case, the individual, a female, might have been suffering from a very late stage of RA and died in her 40s, even though other forms of chronic arthritis could not be ruled out completely. Though the current case could not provide evidence to decisively settle the debates on the antiquity of RA, our report could be a stepping stone for forthcoming studies on RA cases found in East Asian countries. Copyright © 2009 John Wiley & Sons, Ltd.     

Ultramicroscopic investigation of the preservation status of hair collected from a full‐term,intrauterine baby mummy of the Joseon Dynasty,Korea

Our previous studies on the ultramicroscopic structure of mummy hair from Joseon Dynasty (1392–1910) tombs sealed with a lime‐soil mixture barrier (LSMB) have provided initial, basic information on their preservation status. Numerous additional cases of various conditions are required in order to provide data sufficient for establishing Korean mummy preservation patterns on a firm basis, however, and so we performed electron microscopic studies on hair taken from a full‐term, intrauterine baby mummy found in Paju, Korea. The baby mummy was found within the uterus of a 16th‐century mummified woman aged 20–30 years old. Since the labour and delivery stage for this case was 2, and the uterus was found to be ruptured, the cause of death of both the mother and the baby was likely to have been hypovolemic shock occurring during labour. In scanning electron microscopic (SEM) and transmission electron microscopic (TEM) studies, we found that the surface of the hair of the baby mummy was coated with crystalline substances, mainly on the side facing the vaginal orifice. We also observed well‐preserved cuticle, cortex and medullar layers, completely preserved cuticle‐layer scales, as well as macrofibrils and melanin granules evenly spread within the cuticle and cortex layers. Because studies on infant or subadult mummies are very few, and since they have focused mainly on the palaeopathological aspects of those mummies, the preservation pattern of the hair of a full‐term baby mummy could contribute significantly to our knowledge of mummies from around the world. Copyright © 2008 John Wiley & Sons, Ltd.     

Did Children in Medieval and Post‐medieval Poland Suffer from Scurvy? Examination of the Skeletal Evidence

Late‐medieval and post‐medieval writings report that scurvy was a widespread condition in medieval and early historical Poland. Archaeological and historical data indicate that the diet of children was based on foods poor in vitamin C and contained small amounts of raw plant products. Also, historians emphasise that in medieval and post‐medieval Poland, there were seasonal fluctuations in food availability, frequently accompanied by poor harvests. Both resulted in long periods of poor nutrition, which affected children most severely. The aim of this study was to investigate skeletal manifestations of scurvy in subadult remains from medieval and post‐medieval Poland. Following standards described by Ortner and colleagues, anatomical sites pathognomonic of scurvy in subadults (<17 years) were assessed for abnormal porosity and hypertrophic bone among skeletons excavated from three sites: Ostrów Lednicki (dated to the 11th–14th centuries AD), Cedynia (10th–14th centuries AD) and Słaboszewo (14th–17th centuries AD). In total, 3.6% of all examined children were found to bear traces of vitamin C deficiency. The prevalence of scorbutic lesions was 4.5% for Cedynia, 2.6% for Ostrów Lednicki and 3.6% for Słaboszewo. The majority of affected children were less than 7 years of age. Scurvy was likely more widespread in the living populations than it appears from the calculation of skeletal markers, because some individuals might have recovered or died before obvious traces became apparent. Also, in some children, scurvy might not have reached an advanced stage, identifiable in the skeletal material. The prevalence of scurvy reflects not only dietary patterns but also food storage and preparation techniques adopted in the Polish territories during the Middle Ages, which contributed to low intakes of vitamin C. Copyright © 2015 John Wiley & Sons, Ltd.     

Paleo-parasitological study on the soils collected from archaeological sites in old district of Seoul City

A paleo-parasitological study was performed on soil samples from archaeological sites in the old district of Seoul Metropolitan City (Old Seoul City) where the capital of the Joseon Kingdom was constructed about 600 years ago. The sampling sites were the original locations of the Royal Palace Wall, Yukjo Street and the Royal Arsenal. Microscopic examinations showed that parasite eggs of Clonorchis sinensis, Diphyllobothrium latum, Ascaris sp. and Trichuris sp. remained in the soil strata, which were estimated to represent the 14th-19th centuries. We suspect that the medieval citizens of Old Seoul City, numbering around 200,000, might have been made vulnerable to parasite infection by a combination of bad hygiene, inadequate sewer system and seasonal flooding.     

Russia and Norway: Research Collaboration and Comparison of Asymmetrical Relations

Archaeological excavations in 1954, 1958, and 1962 directed by Dr. C.L. Vebaek of The Danish National Museum at the Norse site 0 17a in the modern Greenlandic town of Narssaq revealed a farmstead apparently occupied from the 11th century into the later phases of the Eastern Settlement. The excavations recovered a quantifiable amount of animal bone from well‐defined strata within and immediately around the main structure. These collections were analysed in 1976–77 by the authors and show both continuity and some important changes in subsistence patterns between occupational strata.     

Porotic hyperostosis in a Late Upper Palaeolithic skeleton (Villabruna 1, Italy)

Porotic hyperostosis (PH) is a well‐recognised skeletal indicator of physiological stress occurring during the early years of childhood growth. Although frequently found starting from the Neolithic, PH is poorly documented among earlier Palaeolithic hunter–gatherers. This study reports a case of PH in a Late Upper Palaeolithic skeleton (Villabruna 1) from northern Italy. Macroscopic and radiographic examinations of the skeleton show symmetric porotic lesions of the cranial vault, hair‐on‐end appearance, thinning of the cortical bone, diploic expansion and very slight cribra orbitalia (CO). All lesions are highly remodelled and suggest a condition suffered long before death. A differential diagnosis, carried out in order to discriminate between infectious and acquired conditions, points to anaemia as likely aetiology for the changes observed. Absence of postcranial involvement, lesion healing and survival to adulthood suggest a diagnosis of acquired anaemia. Among acquired anaemias, both dietary and infectious models are discussed in light of the individual's skeletal characteristics, as well as geographic location, paleoenvironmental data, subsistence modality and dietary information. The combined analysis of these data suggests that parasitic infestation resulted in megaloblastic anaemia in this individual. Copyright © 2009 John Wiley & Sons, Ltd.