Investigation of the link between visceral surface rib lesions and tuberculosis in a Medieval skeletal series from England using ancient DNA

Seven human skeletons from a large assemblage from a rural English Medieval burial site show lesions, predominantly proliferative in nature, on the visceral surfaces of the ribs. In order to investigate whether these rib lesions were regularly associated with tuberculous infection, these individuals, together with a group of age- and sex-matched control skeletons without bony signs of infection, were subjected to polymerase chain reaction (PCR) assays aimed at detecting traces of DNA from infecting microorganisms of the Mycobacterium tuberculosis complex. The results provided no evidence for any regular association between visceral surface rib lesions and the presence of M. tuberculosis complex DNA in the study group. The significance of these findings for the paleopathological interpretation of visceral surface rib lesions is discussed.     

The Shanidar 3 Neandertal

The Shanidar 3 Neandertal partial skeleton preserves four teeth, major portions of the thoracic and lumbar vertebrae, sacrum, ribs, clavicles, scapulae, humeri, hand bones, innominate bones, and foot bones, plus fragments of the ulnae, radii, femora, tibiae, and fibulae. Their morphology aligns Shanidar 3 closely with the other Shanidar Neandertals and the European and Near Eastern Neandertals. This is apparent especially in the dentition, scapulae, hand bones, and pubic bones.     

Trauma among the Shanidar Neandertals

Four of the adult Neandertals from Shanidar Cave, Iraq, Shanidar 1, 3, 4, and 5, show evidence of antemortem trauma. Shanidar 1 sustained injuries to the right frontal squama, the left lateral orbit, the right humerus and right fifth metatarsal. Associated with this trauma are hypoplasia or atrophy of the right clavicle, scapula, and humerus, osteomyelitis of the right clavicle, degenerative joint disease at the right knee, ankle, and first tarsometatarsal joint, and remodeling of the left tibia. Shanidar 3 experienced trauma-related degenerative joint disease at the right talocrural and talocalcaneal joints and sustained a penetrating wound across the left ninth rib. Shanidar 4 suffered a fracture of the right seventh or eighth rib, and Shanidar 5 had a scalp wound over the left frontal. A high frequency of antemortem trauma associated with the survival of the injured individuals appears to have been characteristic of the Neandertals.     

Thoracic morphology in Near Eastern Neandertals and early modern humans compared with recent modern humans from high and low altitudes

Paleoanthropologists have long noted the unique "hyper-barrel-shaped" Neandertal thorax as inferred from fragmentary ribs, clavicles, and sterna. Yet scholars disagree whether the Neandertal thorax represents an adaptation to cold climates or elevated activity levels. Given the difficulties of reconstructing overall chest shape from isolated and fragmentary thoracic skeletal elements, it is worthwhile comparing Neandertals and contemporaneous early modern human fossils from the same geographic region to recent modern human skeletons that are known to have enlarged chests. This study compares thoracic skeletal morphology in two Near Eastern Neandertals (Tabūn C1 and Shanidar 3) and two early modern humans from the same region (Skhūl IV and V) with four samples of recent modern human skeletons from the Andes (n=347): two coastal groups and two groups from high altitudes. The two highland groups, similar to their living descendants, exhibit morphological evidence of anteroposteriorly deep and mediolaterally wide chests as part of respiratory adaptations to high-altitude hypoxia. I calculated the percentage of deviation of each Neandertal and early modern human fossil from the means of the four recent modern human samples for clavicle and rib lengths and curvatures. Shanidar 3 and Tabūn C1 exhibit ribs that are slightly larger and less curved than the Andean samples, indicating slightly larger thoracic skeletons than modern humans who are known to have enlarged chests in response to increased respiratory demands. Skhūl IV and V have significantly shorter ribs with greater curvature suggesting especially narrow thoracic skeletons. Comparisons with Andean populations suggest that the enlarged thoraces of Neandertals may reflect high activity levels, although results from this study do not exclude cold adaptation as an explanatory factor.     

the Denver Elephant Project: a Report on Experimentation with Thrusting Spears

Abstract

One aspect of the Denver Elephant Project, the experimental use of thrusting spears, is presented. A recentlydeceased elephant was made available for archaeological experimentation, and as a part of this work the author manufactured and, with the aid of others, employed a series of thrusting spears tipped with Clovis fluted point replicas. It was found that the use of composite thrusting spears permitted penetration of the elephant carcass, but also revealed problems in spear design. The types of projectile point breakage which occurred were found to compare favorably with archaeological specimens. Other implications of the work for the understanding of Clovis elephant procurement strategy and weaponry are presented, and suggestions are made for future experiments.     

Tuberculosis in the New World: a study of ribs from the Schild Mississippian population, West-Central Illinois

Vertebral lesions have been the main evidence for infection by the Mycobacterium tuberculosis complex (MTC) in paleopathology. Skeletal involvement is expected in a small percentage of infected individuals. Recently, several authors report a correlation between rib lesions and tuberculosis (TB) complex infection. This study tests the hypothesis that rib lesions can serve as a useful marker for MTC infection within the Mississippian Schild skeletal collection from West-Central Illinois. Ribs from 221 adults and juveniles were examined, and affected individuals were tested for TB complex infection. DNA from rib samples of affected individuals was amplified with primers targeting the IS6110 insertion element, which is common to all members of the TB complex. Although it cannot allow discrimination between different species of TB, IS6110 is present in many copies within their genomes, and its presence is thus an indication of MTC infection. The results support the use of rib lesions as a marker for TB infection. Additionally, we demonstrate that MTC DNA can be recovered from ribs that lack lesions in individuals who have lesions of other bones. We recommend that an examination of ribs be incorporated into investigations for TB.     

Geometry and respiratory displacement of human ribs

The three-dimensional coordinates of points in the ribs of two supine relaxed males, holding their breath at functional residual capacity (FRC) and with their glottis closed at total lung capacity (TLC), were obtained from volumetric X-ray computed tomographical images. The orientation of planes that best fit the data for each rib at each lung volume and the circular arcs that fit the points in the planes of the ribs were determined, and average values of these geometrical parameters for ribs 3-7 are reported. The planes of the ribs at TLC can be described as displaced from the planes at FRC by a rotation about an axis that passes near the spine. The pump handle and bucket handle components of rotation are 11 and 13 degrees, respectively, for rib 3 and both decrease with increasing rib number to 7 and 10 degrees at rib 7. The angles between the axes of rotation and the midplane are approximately 35 degrees for all 5 ribs. The radii of the circular arcs fit to the data at TLC are slightly larger than those at FRC, and this suggests that there is a small component of rotation normal to the plane of the rib.     

Role of rib cage elastance in the coupling between the abdominal muscles and the lung.

The abdominal muscles expand the rib cage when they contract alone. This expansion opposes the deflation of the lung and may be viewed as pressure dissipation. The hypothesis was raised, therefore, that alterations in rib cage elastance should affect the lung deflating action of these muscles. To test this hypothesis and evaluate the quantitative importance of this effect, we measured the changes in airway opening pressure (Pao), abdominal pressure (Pab), and rib cage transverse diameter during isolated stimulation of the transversus abdominis muscle in anesthetized dogs, first with the rib cage intact and then after rib cage elastance was increased by clamping the ribs and the sternum. Stimulation produced increases in Pao, Pab, and rib cage diameter in both conditions. With the ribs and sternum clamped, however, the change in Pab was unchanged but the change in Pao was increased by 77% (P < 0.001). In a second experiment, the transversus abdominis was stimulated before and after rib cage elastance was reduced by removing the bony ribs 3-8. Although the change in Pab after removal of the the ribs was still unchanged, the change in Pao was reduced by 62% (P < 0.001). These observations, supported by a model analysis, indicate that rib cage elastance is a major determinant of the mechanical coupling between the abdominal muscles and the lung. In fact, in the dog, the effects of rib cage elastance and Pab on the lung-deflating action of the abdominal muscles are of the same order of magnitude.     

Anatomy of a serial killer: differential diagnosis of tuberculosis based on rib lesions of adult individuals from the Coimbra Identified Skeletal Collection, Portugal

The role of new bone formation on visceral surfaces of ribs in the diagnosis of tuberculosis (TB) in past human populations has been explored by many researchers, using both skeletal remains with known causes of death and archaeological samples. This study focuses, firstly, on adult skeletons from the Coimbra Identified Skeletal Collection in Portugal and investigates the skeletal manifestations of individuals known to have died from TB; secondly, this study focuses on the role of rib lesions in the diagnostic criteria for TB. One hundred and fifty-seven males and 106 females aged between 22-87 years were examined; causes of death were assigned as pulmonary TB, extrapulmonary TB, and pulmonary non-TB; a control group, extrapulmonary non-TB, was selected from the remaining individuals. Of individuals with rib lesions, 85.7% (69/81) had pulmonary or extrapulmonary TB as an assigned cause of death, while 17.8% (16/90) of individuals with rib lesions had a non-TB cause of death. Rib lesions were significantly more common in individuals who had died from TB, although the lesions cannot be considered pathognomonic for TB. In individuals dying from pulmonary TB, ribs in the central part of the rib cage were most affected, at their vertebral ends. The lower part of the rib cage may be a marker for peritoneal TB, and "coral-like" new bone formation on ribs may be an indicator of neoplastic disease. Further work on rib involvement in TB in clinical contexts, and the study of further documented skeletal collections, are recommended.     

Blunt Liver Injury with Intact Ribs under Impacts on the Abdomen: A Biomechanical Investigation

Abdominal trauma accounts for nearly 20% of all severe traffic injuries and can often result from intentional physical violence, from which blunt liver injury is regarded as the most common result and is associated with a high mortality rate. Liver injury may be caused by a direct impact with a certain velocity and energy on the abdomen, which may result in a lacerated liver by penetration of fractured ribs. However, liver ruptures without rib cage fractures were found in autopsies in a series of cases. All the victims sustained punches on the abdomen by fist. Many studies have been dedicated to determining the mechanism underlying hepatic injury following abdominal trauma, but most have been empirical. The actual process and biomechanism of liver injury induced by blunt impact on the abdomen, especially with intact ribs remained, are still inexhaustive. In order to investigate this, finite element methods and numerical simulation technology were used. A finite element human torso model was developed from high resolution CT data. The model consists of geometrically-detailed liver and rib cage models and simplified models of soft tissues, thoracic and abdominal organs. Then, the torso model was used in simulations in which the right hypochondrium was punched by a fist from the frontal, lateral, and rear directions, and in each direction with several impact velocities. Overall, the results showed that liver rupture was primarily caused by a direct strike of the ribs induced by blunt impact to the abdomen. Among three impact directions, a lateral impact was most likely to cause liver injury with a minimum punch speed of 5 m/s (the momentum was about 2.447 kg.m/s). Liver injuries could occur in isolation and were not accompanied by rib fractures due to different material characteristics and injury tolerance.     

The rib cage in normal and emphysematous subjects: a roentgenographic approach

The configuration and motion of the bony rib cage were studied from lateral chest roentgenograms in 10 young normal subjects (YN), 12 elderly normal subjects, and 12 hyperinflated emphysematous patients [chronic obstructive pulmonary disease subjects (COPD), mean total lung capacity (TLC) 133% of predicted]. The acute angles formed by the fourth through seventh ribs with an axial reference plane were measured at residual volume, functional residual capacity, and TLC in both supine and standing positions and correlated with corresponding lung volumes. both rib angles (RA) and changes in RA with lung volume were greatest with the fourth rib and decreased progressively going down (caudad) the chest. At TLC the RA of upper ribs was significantly less in EN and significantly greater in COPD than in YN. RA's were greater supine than standing. When RA information was used together with autopsy data on the angles formed by intercostal muscles with adjacent ribs, intercostal muscle lengths in hyperinflation could be calculated. Computed intercostal muscle length data suggested that hyperinflation should not be associated with degrees of intercostal muscle shortening or overstretching, that would interfere seriously with tension generation.     

Broken ribs: Paleopathological analysis of costal fractures in the human identified skeletal collection from the Museu Bocage,Lisbon, Portugal (late 19th to middle 20th centuries)

Although rarely reported in the anthropological literature, rib fractures are commonly found during the analysis of human skeletal remains of past and modern populations. This lack of published data precludes comparison between studies and restricts an accurate understanding either of the mechanisms involved in thoracic injuries or their impact on past societies. The present study aimed: 1) to report rib fracture prevalence in 197 individuals, 109 males, and 88 females, with ages at death ranging from 13 to 88 years old, from the Human Identified Skeletal Collection, Museu Bocage, Portugal (late 19th‐middle 20th centuries); 2) to test the hypothesis that a higher prevalence of rib stress fractures existed in the 133 individuals who died from respiratory diseases, in a period before antibiotics. The macroscopic analysis revealed 23.9% (n = 47) of individuals with broken ribs. 2.6% (n = 124) out of 4,726 ribs observed were affected. Males presented more rib fractures, and a significantly higher prevalence was noted for older individuals. Fractures were more frequently unilateral (n = 34), left sided (n = 19) and mainly located on the shaft of ribs from the middle thoracic wall. Nineteen individuals presented adjacent fractured ribs. Individuals who died from pulmonary diseases were not preferentially affected. However, a higher mean rate of fractures was found in those who died from pneumonia, a scenario still common nowadays. Since rib involvement in chest wall injury and its related outcomes are important issues both for paleopathology and forensic anthropology, further investigations are warranted. Am J Phys Anthropol 2009. © 2009 Wiley‐Liss, Inc.     

On the respiratory function of the ribs.

To assess the respiratory function of the ribs, we measured the changes in airway opening pressure (Pao) induced by stimulation of the parasternal and external intercostal muscles in anesthetized dogs, first before and then after the bony ribs were removed from both sides of the chest. Stimulating either set of muscles with the rib cage intact elicited a fall in Pao in all animals. After removal of the ribs, however, the fall in Pao produced by the parasternal intercostals was reduced by 60% and the fall produced by the external intercostals was eliminated. The normal outward curvature of the rib cage was also abolished in this condition, and when the curvature was restored by a small inflation, external intercostal stimulation consistently elicited a rise rather than a fall in Pao. These findings thus confirm that the ribs play a critical role in the act of breathing by converting intercostal muscle shortening into lung volume expansion. In addition, they carry the compression that is required to balance the pressure difference across the chest wall.     

A model for studies of mechanical interactions between the human spine and rib cage

A three-dimensional mathematical model useful for studies of the mechanics of the human skeletal thorax is described. To construct this model, rib cage elements are incorporated into a previously reported model of the thoracolumbar spine. The vertebrae and bony portions of the ribs and sternum are idealized as rigid bodies. The behavior of the discs, ligaments and costal cartilages are modelled by deformable elements. Appropriate geometric and stiffness property data are assigned to the elements of the model. In constructing the model, it was found that the mechanical response of the costo-vertebral joint is strongly influenced by articulation geometry. Although rigid bodies were used to model calcified portions of the ribs, the model predicted rib cage deformations in close agreement with those measured experimentally. These studies indicate that the rigid body motion of calcified portions of the rib makes a major contribution to the deformation of the rib cage in response to certain types of loadings. Quantitative results are also reported on the roles the rib cage plays in bending responses of the spine, the lateral stability of the spine, and the production and correction of several scoliotic deformities.     

Geometry and kinematics of dog ribs

Five anesthetized supine beagle dogs were scanned using a fast, multislice computed tomographic X-ray technique to determine the orientation of the ribs at total lung capacity (TLC) and functional residual capacity (FRC). A plane was fit to each rib using a coordinate system in which the z-axis was aligned approximately cephalocaudally and the x-z-plane coincided with the sagittal midplane. The orientation of each plane was described by "pump-handle" and "bucket-handle" angles. The ribs rotated downward and inward during a passive deflation of the lungs from TLC to FRC. Rib displacement was not uniform: bucket-handle motion was predominant in the upper ribs, and pump- and bucket-handle motions were equal in the lower ribs. The change in the pump-handle angles between TLC and FRC was approximately 6 degrees for ribs 3-8, and the change in the bucket-handle angles decreased with rib number from 16 degrees for rib 3 to 6 degrees for rib 8. Rib shape was described by fitting an ellipse to the data for each rib; the ribs became larger and more circular with increasing rib number.     

Analysis of quantitative methods for rib seriation using the Spitalfields documented skeletal collection

Accurate rib seriation is essential in forensic anthropology and bioarchaeology for determination of minimum numbers of individuals, sequencing trauma patterns to the chest, and identification of central ribs for use in age estimation. We investigate quantitative methods for rib seriation based on three metric variables: superior (anterior) costo-transverse crest height (SCTCH), articular facet of the tubercle-to-angle length (AFTAL), and head-to-articular facet length (HAFL). The sample consists of complete but unseriated sets of ribs from 133 individuals from the documented (known age and sex) and undocumented skeletal collections of Christ Church Spitalfields, London. This research confirms the results of an earlier study (Hoppa and Saunders [1998] J. Forensic. Sci. 43:174-177) and extends it with the application of two new metric traits and further analyses of sex differences. Analyses of variance showed that SCTCH and AFTAL are significantly associated (P < 0.001) with rib number. Tukey tests of pairwise rib comparisons revealed that for two dimensions (SCTCH and AFTAL), the central ribs (3rd-6th) are significantly distinct from each other (P < 0.05). Using simple ranking of either the SCTCH or AFTAL traits, the proportion of correctly identified ribs within +/-1 position was 80%, compared to initial seriation using morphological methods (Dudar [1993] J. Forensic. Sci. 28:788-797; Mann [1993] J. Forensic. Sci. 28:151-155). Significant sex dimorphism was also identified for these two traits. Analysis of the HAFL trait produced somewhat equivocal results, suggesting that this variable is not reliable for rib seriation. The variable SCTCH proves to be the most useful dimension for seriation, and shows that all but the 7th-9th ribs can be distinguished from others in the sequence, with important results for the 4th rib, where ranking allowed identification in 86% of cases, consistent with morphological methods for intact ribs.     

Lumbar anomalies in the Shanidar 3 Neandertal

Recent examination of the Shanidar 3 remains revealed the presence of anomalous bilateral arthroses in the lumbar region. This paper describes this developmental anomaly, as well as several degenerative changes and offers potential etiologies.The Shanidar 3 remains represent an adult male Neandertal, approximately 35–50 years of age, dating to the Last Glacial. Although the partial skeleton is fragmentary, preserved elements include an almost complete set of ribs, portions of all thoracic vertebrae, all lumbar vertebrae, and the sacrum. Vertebral articulations from S1–T1 can be confidently assigned. The vertebra designated L1 is well preserved but lacks transverse processes. Instead, well defined bilateral articular surfaces, rather than transverse processes, are located on the pedicles. The skeletal elements associated with the anomalous L1 articulations were not recovered.The most likely interpretation is that the arthroses in question represent the facets for a 13th pair of ribs, a rare condition in modern hominid populations. Such lumbar developmental anomalies are an infrequent expression of a larger complex of cranial-caudal border shifting seen in the vertebral column. These shifts result in a change in the usual boundaries between the distinctive vertebral regions and are responsible for the majority of variability present in the vertebral column.     

Adaptive modeling of the human rib cage in median sternotomy

This paper describes a limited computer-analyzed kinematic model of the rib cage that can be adapted to individual subjects. Also described is its validation and use in assessing the changes in chest wall shape after coronary artery bypass graft (CABG) surgery in 12 patients. The positions of a small number of anatomic locations on the thoracic spine, ribs, manubrium, and sternum are measured from lateral and posterior-anterior chest radiographs. The computer program puts these two views together removing the magnification and reconstructs any missing points to give a three-dimensional picture of the rib cage to which mathematical models of the bones are scaled. The patients had chest radiographs taken at total lung capacity (TLC) and residual volume (RV) to investigate the source of the restrictive ventilatory defect that follows CABG. The predictions from the model were tested by comparing full-sized computer plots with the actual chest radiographs. The estimates of the bony structures were accurate to +/- 3 degrees for orientations and +/- 6 mm for positions. We found reduced rib motion both "pump-handle" (theta) and "bucket handle" (psi) going from theta, psi left, psi right = 9 degrees, 10 degrees, 14 degrees to 4 degrees, 10 degrees, 9 degrees, respectively, after surgery with P less than 0.025, 0.42, 0.07. The angles were measured from the horizontal and increased caudally. There was also reduction in the range of angles subtended by the arc of the thoracic vertebrae between TLC and RV, which went from 12 degrees to -1 degrees (P less than 0.015). These data explain the fall in lung volumes that follow CABG and provide insight into the contribution made by the ribs and spine in full inspiration and full expiration.     

Direct observation of protein secondary structure in gas vesicles by atomic force microscopy.

The protein that forms the gas vesicle in the cyanobacterium Anabaena flos-aquae has been imaged by atomic force microscopy (AFM) under liquid at room temperature. The protein constitutes "ribs" which, stacked together, form the hollow cylindrical tube and conical end caps of the gas vesicle. By operating the microscope in deflection mode, it has been possible to achieve sub-nanometer resolution of the rib structure. The lateral spacing of the ribs was found to be 4.6 +/- 0.1 nm. At higher resolution the ribs are observed to consist of pairs of lines at an angle of approximately 55 degrees to the rib axis, with a repeat distance between each line of 0.57 +/- 0.05 nm along the rib axis. These observed dimensions and periodicities are consistent with those determined from previous x-ray diffraction studies, indicating that the protein is arranged in beta-chains crossing the rib at an angle of 55 degrees to the rib axis. The AFM results confirm the x-ray data and represent the first direct images of a beta-sheet protein secondary structure using this technique. The orientation of the GvpA protein component of the structure and the extent of this protein across the ribs have been established for the first time.