A re-examination of parturition scars on the human female pelvis

Pits, cavities and depressions located on the dorsal surface of the pubic symphysis of females have been attributed to the trauma of parturition. Earlier research based on human skeletal remains provides inadequate information on the individual's obstetrical history. The 68 female pubic bones that were studied had comprehensive medical records indicating whether or not each female had given birth. Fourteen and one-half percent of the females who had not given birth exhibited trace to small scarring of the pubic symphysis and 23.4% of the females who had not given birth exhibited medium to large scarring. It is suggested that bony changes previously used as an indicator of child bearing must be re-examined in light of the fact that “birth scarring” has been found in women known not to have had children.     

Knee meniscal extrusion in a largely non-osteoarthritic cohort: association with greater loss of cartilage volume

We conducted a longitudinal study (duration 2 years), including 294 individuals (mean age 45 years, 58% female), in order to examine associations between meniscal extrusion, knee structure, radiographic changes and risk factors for osteoarthritis (OA) in a largely non-osteoarthritic cohort. Meniscal extrusion, tibiofemoral cartilage defect score and cartilage volume, and tibial plateau bone area were determined using T1-weighted fat-saturated magnetic resonance imaging. At baseline the presence of medial meniscal extrusion was significantly associated with body mass index (odds ratio [OR] per kg/m2 = 1.13, 95% confidence interval [CI] = 1.02-1.25), past knee injury (positive versus negative history: OR = 3.73, 95% CI = 1.16-11.97), medial tibial bone area (OR per cm2 = 1.37, 95% CI = 1.02-1.85), and osteophytes (OR per grade = 4.89, 95% CI = 1.59-15.02). Two-year longitudinal data revealed that medial meniscal extrusion at baseline was associated with a greater rate of loss of medial tibiofemoral cartilage volume (extrusion versus no extrusion: -1.4%/year; P < 0.05) and greater risk for increased medial femoral cartilage defects (OR = 2.59, 95% CI = 1.14-5.86) and lateral tibial cartilage defects (OR = 2.64, 95% CI = 1.03-6.76). However, the latter two associations became nonsignificant after adjustment for tibial bone area and osteophytes. This study suggests that increasing body mass index and bone size, past knee injury, and osteophytes may be causally related to meniscal extrusion. Most importantly, meniscal extrusion at baseline is associated with greater loss of knee cartilage over 2 years, and this seems to be mediated mostly by subchondral bone changes, suggesting extrusion represents one pathway between bone expansion and cartilage loss.     

The function of Meckel's and secondary cartilages in the histomorphogenesis of the cat mandibular symphysis

Cat mandibular symphysis was investigated with histological methods in animals of ages between 3 weeks of intra-uterine life and 56 days post-natal. As in rodents, carnivores and insectivores, Meckel's cartilages fuse in the midline and form a cartilaginous nodule which persists in the symphysis until birth. This nodule, which we have called the symphyseal Meckelian islet, is isolated from Meckel's cartilage, of which only very small calcified islets are left as intramandibular traces after endochondral ossification. Both hemimandibles are bordered by secondary cartilage, which undergoes endochondral ossification, and by chondroid tissue, which is less abundant than in man. At birth, secondary cartilage of both hemimandibles forms a synchondrosis, the lingual part of which undergoes gradual resorption in the 4-week-old cat. The vestibular part is still present at 8 weeks.     

Parturition and pelvic changes

A detailed analysis of the female bony pelvis in relation to parity status was made. A total of 198 complete pelves were inspected for five features considered to be associated with pregnancy and parturition. During final analysis two features were eliminated. Three remaining features - dorsal pubic pitting, pre-auricular grooves, and grooves located at the site of interosseous ligament insertion were found to be significantly related to partirution. Other findings of interest were: (1) pits and grooves acquired through pregnancy and parturition appear to become obliterated in old age, (2) the preauricular groove is the most sensitive indicator of pregnancy and parturition, (3) moderate-large pitting in the dorsal pubic region rarely occurs in nulliparous females, and (4) it is doubtful that more precise statements than "no children" and "one or more children" can be made on the basis of skeletal remains alone.     

Evaluation of the suchey–brooks method of age estimation in an Australian subpopulation using computed tomography of the pubic symphyseal surface

Despite the prominent use of the Suchey–Brooks (S–B) method of age estimation in forensic anthropological practice, it is subject to intrinsic limitations, with reports of differential interpopulation error rates between geographical locations. This study assessed the accuracy of the S–B method to a contemporary adult population in Queensland, Australia and provides robust age parameters calibrated for our population. Three‐dimensional surface reconstructions were generated from computed tomography scans of the pubic symphysis of male and female Caucasian individuals aged 15–70 years (n = 195) in Amira® and Rapidform®. Error was analyzed on the basis of bias, inaccuracy and percentage correct classification for left and right symphyseal surfaces. Application of transition analysis and Chi‐square statistics demonstrated 63.9 and 69.7% correct age classification associated with the left symphyseal surface of Australian males and females, respectively, using the S–B method. Using Bayesian statistics, probability density distributions for each S–B phase were calculated, providing refined age parameters for our population. Mean inaccuracies of 6.77 (±2.76) and 8.28 (±4.41) years were reported for the left surfaces of males and females, respectively; with positive biases for younger individuals (<55 years) and negative biases in older individuals. Significant sexual dimorphism in the application of the S–B method was observed; and asymmetry in phase classification of the pubic symphysis was a frequent phenomenon. These results recommend that the S–B method should be applied with caution in medico‐legal death investigations of Queensland skeletal remains and warrant further investigation of reliable age estimation techniques. Am J Phys Anthropol, 2013. © 2013 Wiley Periodicals, Inc.     

The pubic scars of gestation and parturition in a group of pre-Columbian and colonial Peruvian mummies

The pubic scars of pregnancy and parturition as reported in the anthropological literature are a variant of the recognized clinical entity, osteitis pubis. The os pubis from 86 pre-Columbian and colonial Peruvian mummies were examined for this entity. Osteitis pubis was found in 13 pre-Columbian females (72.3%) and 19 colonial Indians (57.6%). Four of the colonial women were buried with newborn children and one had a four-month-old fetus in utero. This type of study has application in paleopathology and forensic medicine to show possible frequency of pregnancy in a population, but must be refined and quantitated to achieve any more than this. This study is of further interest as it demonstrates that racial groups have apparently a wide difference in frequency of this particular lesion of the pubic symphysis, a matter for further investigation.     

Age changes in the pubic symphysis of Macaca mulatta.

Age changes in the pubic symphyses of 142 Cayo Santiago rhesus monkeys (known age, sex and maternal genealogy) are described. Symphyseal development is sexually dimorphic. Males generate a ridge and furrow system which is gradually replaced by a solid ankylosis at the mid-sagittal plane. Female development parallels that of the male until puberty. With pregnancy and delivery, relaxation and reaggregation of pelvic ligaments binding the symphysis destroy the symphyseal face. Continued bearing of offspring inhibits mid-sagittal ankylosis. Limited estimates of skeletal age can be made by using symphyseal development as an indicator of senescence.     

Anatomic study of vaginal width in male-to-female transsexual surgery

Despite the recent improvement in the design of male-to-female sex reassignment operations to enlarge the vaginal vault and depth, the size of the neovagina remains somewhat limited and the exterior of the neovagina may be compressed by the bony structure of pubic rami. The purpose of this study was to determine by anatomic study the possible cause of this limitation. Eighteen male and 10 female cadavers were dissected to measure the distance between the bilateral bony pubic rami (interramic distance) at a level that corresponds to the same level in the vaginal canal of females. At the same level of the vaginal canal in the female, which corresponds to the lower border of the prostate in the male, empirically 3 cm below the bony symphysis pubis, the mean value of the interramic distance was 3.95 +/- 0.25 cm in the male and 5.20 +/- 0.36 cm in the female (p = 0.000). The interramic distance in the male and female is significantly different. In those who have undergone the male-to-female transsexual operation, the newly structured vagina may be ventrolaterally limited. Several factors cause narrowing of the vaginal orifice in male-to-female transsexuals. On the basis of this study, it seems that the bony structure of the pubic rami compresses the vagina ventrolaterally. This finding may suggest refinements of the structural design of the neovagina and prompt procedural changes in male-to-female sex reassignment operations. Future investigation should be directed toward modifying vaginoplasty so that neovaginal width can be increased to the patient's satisfaction.     

Sexually dimorphic mandibular morphology in the first few years of life

Sex differences in the youngest skeletons are very subtle, and any method that can separate males and females significantly better than chance will be of value. Compounding the problem is a paucity of immature skeletons of documented age and sex. In 1992, S.R.L. examined 62 juvenile mandibles of white and black South Africans of known age and sex (from birth to 19 years) from the Dart Collection to determine if the sexes could be differentiated by morphologic traits. By age 6 years, adult chin shapes were already recognizable. Prior to that age, differences were observed in the shape of the inferior border of the symphysis and outline of the body. The male chin base extends steeply downward relative to the adjacent body, coming to a point or squaring off at the symphysis. In females, the symphysis descends gradually to a more rounded base, and even when pointed, the transition is not abrupt. On the outer border of the corpus, the sides diverge sharply to form a \_/ shape from a roughly horizontal anterior region in males, while the female contour is rounded, reflecting the smoothly curved transition from front to sides. These traits were manifest from the eruption of the central incisors until about 4 years of age. The features were tested on all 19 Dart Collection mandibles in that age range. Average accuracy for three different testers was 81%, and males were consistently identified more accurately than females. This new method was then tested on a known sex sample of 11 individuals from 0 to 7 years of age. These included CT scans of 9 French children and the remains of 2 South African black forensic cases. Sexing accuracy was 82% (9/11). The only two missexed cases were both female and over age 6 years. In conclusion, the results of this study indicate that it is possible to determine the sex of very young mandibles. The new sexually dimorphic morphologic configurations introduced here have demonstrated repeatable discrimination with the highest level of accuracy (81%) reported and tested for this age group. Preliminary research indicates that both the male and female shapes are clearly recognizable in archaeologic and premodern hominids as well as chimpanzees.     

Nocturnal behaviour of female Mythimna convecta

Nocturnal behaviour of Mythimna convecta (Walker) (Lepidoptera: Noctuidae) virgin females was studied in the laboratory under 20 °C and 16:8 LD conditions. The periodicity of activity, feeding, calling, pre-oviposition extrusion and oviposition varied with female age and hour of the scotophase. Females called for the first time between the 2nd and 11th scotophases with the peak in the 4th scotophase. Maximum calling occurred on the 7th hour of the scotophase. Young moths called more frequently with shorter bouts while old moths called less often but with longer bouts. In the presence of older females, moths spent significantly more time in pre-oviposition extrusion and resting and less in activity and feeding than they did when only females of the same age or younger were present. There were no significant differences for calling suggesting that pheromones of older calling females did not affect calling of younger females.     

Correlation between MRI evidence of degenerative condylar surface changes, induction of articular disc displacement and pathological joint sounds in the temporomandibular joint

Objectives: The relationship of bony changes in the condylar surfaces in articular disc displacement without reduction in temporomandibular joint (TMJ) was investigated using diagnostic imaging. The study also evaluated whether the bony changes in the condylar surfaces limit disc and condyle motion, and produce pathological joint sounds. Materials and methods: Thirty‐seven joints in 28 patients diagnosed with degenerative bony changes in the condylar surfaces radiographically and anterior disc displacement without reduction using magnetic resonance imaging (MRI) were studied. The bony changes were assessed by radiographic examination and classified into two types: pathological bone changes (PBCs) including erosion, osteophyte formation and deformity, and adaptive bone changes (ABCs) including flattening and concavity. MRI was performed on the TMJ to examine the configuration and position of the discs. Joint sounds in the TMJ were determined using electrovibratograghy with a joint vibration analysis. Results: The articular disc motion to the condyle in the PBC group was smaller than in the ABC group irrespective of the configuration of the disc, even though there were no significant differences between the two types of bony changes in the disc position during jaw closing. The joint vibration analysis of the TMJ showed that joint sounds with a higher frequency were observed in the PBC group than in the ABC group. High energy levels needed to produce the higher frequencies (over 300 Hz) were observed only in the PBC group.     

Analysis of dorsal pitting in the os publis in an extensive sample of modern American females

Pubic bones from 486 modern American females between the ages of 13 and 99 were studied in an attempt to explore the relationship between the degree of dorsal pitting and the following variables: (1) number of full term pregnancies, (2) inteval since last pregnancy, (3) age of decedent.A statistical association was found between the number of full term pregnancies and the degree of dorsal pitting. However, the correlation is not strong; 17 females reported as being nulliparous have "medium to large" dorsal changes whereas 22 females having from one to five full term pregnancies have an absence of dorsal changes. Females who had their last child 15 or more years prior to death are more apt to have "medium to large" dorsal changes than are females who have more recently given birth. This effect appears to be independent of the number of full term pregnancies, but is probably related to age. When the data are analyzed by multiple regression analaysis, it is found that age and number of pregnancies are most important in predicting the degree of pitting and the effect of the interval on pitting is not significant. Age is found to be an important variable independent of the number of full term pregnancies. In nulliparas, an absence of dorsal pitting is far more frequently found in females younger than 30 than in those over 30.     

Shape of the craniofacial complex in 45,X females: cephalometric study

The shape of the craniofacial complex was analysed cephalometrically in sixty-four adult 45,X females (Turner syndrome) using lateral skull radiographs, and the subjects were compared with first-degree female relatives and control females. The results showed that 45,X females have marked changes in relatively few craniofacial areas compared to the controls. Most of the changes are located in the cranial base, so that the face is retrognathic. The mandible is short, whereas the maxilla is of normal length. The results support the view that the morphology of the cranial base is markedly affected in 45,X females, whereas most other craniofacial changes could be considered secondary to the cranial base abnormality. It is suggested that retarded cartilage growth may be a factor leading to the present findings.     

Nasal reconstruction using both cranial bone and ear cartilage

In this article, an anatomic reconstruction is described using cranial bone graft for the bony part of the nose while reconstructing the cartilaginous part with ear cartilage. This modification provides protection of the nose from the traumatic forces creating a flexible nasal tip. A modification is described and compared with the nasal reconstruction by calvarial bone itself.     

Biomechanical implications of degenerative joint disease in the apophyseal joints of human thoracic and lumbar vertebrae

An experimental technique for quantifying load-sharing in cadaveric spines is used to test the hypothesis that degenerative changes in human apophyseal joints are directly related to high levels of compressive load-bearing by these joints. About 36 cadaveric thoraco-lumbar motion segments aged 64-92 years were subjected to a compressive load of 1.5 kN. The distribution of compressive stress was measured in the intervertebral discs using a miniature pressure transducer, and stress measurements were summed over area to give the compressive force resisted by the disc. This was subtracted from the applied 1.5 kN to indicate compressive load-bearing by the apophyseal joints. The cartilage of each apophyseal joint surface was then graded for degree of degeneration. After maceration, each joint surface was scored for degenerative joint disease (DJD) affecting the bone. Results demonstrated that the apophyseal joints resisted 5-96% (mean 45%) of the applied compressive force. A significant positive correlation was demonstrated between age and cartilage degeneration, age and DJD bone score, apophyseal joint load-bearing and bone score, and cartilage score and load-bearing. The latter correlation was strongest for load-bearing above 50%. Ordinal regression showed that the variables describing bone DJD (marginal osteophytes, pitting, bony contour change, and eburnation) were significantly correlated with degree of cartilage degeneration. It is concluded that in elderly individuals apophyseal joint load-bearing above a threshold of 50% is associated with severe degenerative changes in cartilage and bone, and that markers of DJD observed palaeopathologically may be used as predictors of such loadingin life.     

Prenatal repair of experimentally induced clefts in the secondary palate of the rat

A refined technique of amniotic sac puncturing at day 16.2 (i.e., 16 + 2/10 days) of gestation was employed in order to produce a series of total clefts and rare forms of partial clefts in Sprague-Dawley rat fetuses. From a total of 410 fetuses of a precise, individually determined age, 95 upper jaws were examined in the scanning electron microscope and, in part, in serial Epon sections. All fetal heads were examined macroscopically. Total clefts were found in 48.9% of a total of 184 viable rat fetuses examined at day 17.8 of smear age and in 21.8% of a total of 211 fetuses examined at day 19.3. Partial clefts were observed in 14.1% and 18.5% of fetuses at days 17.8 and 19.3 of smear age, respectively. At day 19.3, 16.1% of the viable fetuses showed a very inconspicuous, small abnormality (with residual clefting and incomplete fusion with the nasal septum) in the region of the palatine foraminae. Morphological observations suggested that under conditions of detained palatal closure (1) fusion of the soft palatal shelves commences independently from and prior to fusion of the hard palate, (2) delayed palatal shelf fusion proceeding in the anterior direction may occur with or without remaining sickle-shaped clefts in the anterior hard palate, and (3) in fetuses with small sickle-shaped clefts, fusion of the palatal shelves with the nasal septum does not occur. The present data imply that an almost total prenatal repair and delayed closure of the secondary palate may occur in rats that, at day 16.2 of multiple analysis age, most certainly had a total palatal cleft resulting from tongue resistance.     

Determinants of adolescent pregnancy in an urban area in Turkey: a population-based case-control study

The aim of this study was to determine the degree to which socioeconomic status is a risk factor for first birth at age 19 or younger in married women in an urban area of Turkey. The research was a population-based case-control study. The study group comprised all married and pregnant women aged 15-19 (adolescent pregnancies) attending primary care centres (144 subjects). Married women between 20 and 29 years of age, experiencing their first pregnancy (adult pregnancies), were determined as the control group (144 subjects). A questionnaire was completed for each subject during face-to-face interviews. Adolescent pregnancy was more frequent in women from families with a low socioeconomic status, as determined by occupation (class) and income; both were associated with adolescent pregnancy. Multiple logistic regression analysis identified seven factors associated with adolescent pregnancy: exposure to violence within the family prior to marriage; families partially opposed or unopposed to adolescent marriage; secondary school or lower education level; lack of social security; living in houses in which the number of persons per room was over 1; unemployed women; and having sisters with a history of adolescent pregnancy.     

Paleopathology of the Late Roman-Early Byzantine cemeteries at Sayala,Egyptian Nubia

The paleopathological pattern of three large burial complexes CI-CIII and of cemetery N (but not of cemetery A) at Sayala, Egyptian Nubia, shows a predominance of traumatism over other pathologies. Males compared with females were more often afflicted by injuries. In the skull, mostly the frontal and parietal regions, and more often the left than the right side, show traumatic changes. Cuts are most common, suggesting their origin from swords and daggers. Also traumatism of the vertebral column is high, comprising more compression fractures than post-traumatic synostoses of vertebrae, and afflicting mostly the lumbar, lower thoracic and lower cervical regions. This suggests falls in a sitting position, probably while riding camels. In the remaining postcranial skeleton, mostly fractures are present, most often afflicting the antebrachial bones, especially on the left side. The majority of the ulnar fractures are typical parry fractures. Most injuries are well healed, only some showing quick death after affliction. The overall pattern suggests fighting as the leading cause of the traumatism. Among other pathologies, osteophytosis, especially in males, occurs rather commonly and more intensively than with the comparative sample of the C-Group people. Evidence of inflammations and tumours is rare. Some senile changes, many congenital anomalies, occasional orthopaedic deviations, and affections of unknown origin complement the paleopathological picture. Some functional changes disclose overloading of both extremities. According to these findings, the way of life and the question of ethnic identification of the people are discussed.     

Reduction in orofacial clefts following folic acid fortification of the U.S. grain supply

BACKGROUND: Folic acid fortification in the United States became mandatory January 1, 1998, to reduce the occurrence of neural tube defects (NTDs). We evaluated the impact of folic acid fortification on orofacial clefts using United States birth certificate data for 45 states and the District of Columbia. METHODS: Prevalence ratios (PRs) were calculated comparing orofacial cleft prevalence among births prefortification (1/1990-12/1996) and postfortification (10/1998-12/2002), based on fortification status at conception. The JoinPoint Regression Program and exponentially weighted moving average charts (EWMA) were used to assess the timing of any statistically significant changes in prevalence. Data were stratified by maternal race/ethnicity, age, smoking, and timing of prenatal care. RESULTS: Orofacial clefts declined following folic acid fortification (PR=0.94; 95% CI: 0.92-0.96). The EWMA chart flagged a significant decrease in the fourth quarter of 1998. The JoinPoint graph had one change in slope, with a significant quarterly percent change (-0.34) between 1996 and 2002. The decline in orofacial clefts occurred in non-Hispanic Whites but not other racial/ethnic groups, nonsmokers but not women who reported smoking during pregnancy, and women who received prenatal care in the first trimester but not women who began receiving care later in pregnancy. CONCLUSION: Folic acid fortification in the United States was associated with a small decrease in orofacial cleft prevalence, with the timing of the decline consistent with the introduction of fortification. The decline is much smaller than that observed for NTDs, but nonetheless suggests an additional benefit of this public health intervention.     

The Ultrastructure of Schmidt-Lanterman Clefts and Related Shearing Defects of the Myelin Sheath

Schmidt-Lanterman clefts in frog sciatic nerves have been studied in thin sections by electron microscopy utilizing permanganate fixation and araldite embedding. It is shown that they are shearing defects in myelin in which the lamellae are separated widely at the major dense lines. Each lamella consisting of two apposed Schwann cell unit membranes ~ 75 A across traverses the cleft intact. The unit membranes composing each lamella sometimes are slightly (~ 50 to 100 A) separated in the clefts. The layers between the lamellae contain membranous structures which may be components of the endoplasmic reticulum. These layers are continuous with the outer layer of Schwann cytoplasm and the thin and inconstant cytoplasmic layer next to the axon (Mauthner's sheath). Each of these layers in perfect clefts constitutes a long helical pathway through the myelin from the axon. One of these is connected with Schwann cytoplasm and the other directly with the outside. A type of cross-sectional shearing defect, not hitherto recognized, is described and shown to be a kind of Schmidt-Lanterman cleft. Incomplete clefts are seen and interpreted as representing stages in a dynamic process whereby the myelin lamellae may be constantly separating and coming together again in life.