International Journal of Paleopathology最新文献_第8页

Zoonotic parasite infection from a funerary context: A Late Antique child case from Cantabrian Spain 丧葬背景下的人畜共患寄生虫感染:来自西班牙坎塔布里亚的一个晚期古董儿童病例

IF 1.2 3区地球科学 Q3 PALEONTOLOGY

International Journal of Paleopathology

Pub Date : 2023-06-01 DOI: 10.1016/j.ijpp.2023.03.003

Ramón López-Gijón , Silvia Carnicero , Miguel C. Botella-López , Edgard Camarós

Objective

To evaluate the presence of Dicrocoelium sp. in a child from a Late Antique funerary context from Cantabrian Spain and discuss whether the infection is true infection or pseudoparasitosis.

Materials

Four skeletons, including one from a 5–7 year old child, have been analysed from the archaeological site of El Conventón, dated between the sixth and seventh centuries AD.

Methods

The paleoparasitological study was conducted through the analysis of soil samples from different parts of the skeleton and funerary context using the rehydration, homogenization, and micro-sieving method, and visualized through brightfield microscopy.

Results

A soil sample from the pelvic region tested positive for Dicrocoelium sp. (possibly D. dendriticum).

Conclusions

The child was infected with Dicrocoelium dendriticum, which based on archaeological and historical contexts may be related to hygiene or dietary behaviour.

Significance

We present one of the few cases of the identification of a Dicrocoelidae parasite directly associated with a human skeleton that provides historical knowledge of a zoonotic disease.

Limitations

The diagnosis of a zoonosis through the identification of ancient parasites is complex. In addition, Dicrocoelium sp. in association with skeletal human remains is rare due to the potential low prevalence of this parasite.

Suggestions for Further Research

Highlight the importance of paleoparasitological analysis to link parasitic infection diseases with socioeconomic issues by using funerary contexts with skeletal remains.

目的评价西班牙坎塔布连地区一名晚期古丧葬儿童中双星绦虫的感染情况，探讨感染是真感染还是假寄生虫病。研究人员对四具骨骼进行了分析，其中一具是一名5-7岁的儿童，这些骨骼来自公元6 - 7世纪的El Conventón考古遗址。方法采用复水化、均质和微筛法对不同部位的土壤样本进行分析，并通过明视野显微镜观察，进行古寄生虫学研究。结果盆腔区土壤样品中检出双棘球蚴(可能为树突棘球蚴)阳性。结论该患儿感染树突双星蚴，根据考古和历史背景，可能与卫生或饮食行为有关。意义:我们提出了与人类骨骼直接相关的棘球绦虫科寄生虫鉴定的少数病例之一，提供了人畜共患疾病的历史知识。通过鉴定古代寄生虫来诊断人畜共患病是复杂的。此外，由于这种寄生虫的潜在低流行率，与骨骼遗骸相关的双星绦虫是罕见的。进一步研究的建议强调古寄生虫学分析的重要性，通过使用与骨骼遗骸的丧葬背景来将寄生虫感染疾病与社会经济问题联系起来。

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引用次数: 1

Corrigendum to “Caring for the injured: Exploring the immediate and long-term consequences of injury in medieval Cambridge, England” [Int. J. Paleopathol. 40 (2023) 7–19] “照顾伤者:探索中世纪英国剑桥受伤的即时和长期后果”的勘误表[Int.][j] .中国生物医学工程学报，2016,27(5):557 - 557。

IF 1.2 3区地球科学 Q3 PALEONTOLOGY

International Journal of Paleopathology

Pub Date : 2023-06-01 DOI: 10.1016/j.ijpp.2023.03.006

Jenna M. Ditmar , Bram Mulder , Anna Tran , Piers D. Mitchell , Peter D. Jones , Sarah A. Inskip , Craig Cessford , John E. Robb

引用次数: 0

Solitary osteochondromas in paleo-oncology: A case report from 4th-century BCE Pontecagnano (southern Italy) 古肿瘤学孤立性骨软骨瘤:公元前4世纪意大利南部Pontecagnano地区一例报告

IF 1.2 3区地球科学 Q3 PALEONTOLOGY

International Journal of Paleopathology

Pub Date : 2023-06-01 DOI: 10.1016/j.ijpp.2023.04.003

Giulia Riccomi , Giacomo Aringhieri , Antonia Serritella , Valentina Giuffra

Objective

This study presents a new case of solitary osteochondroma (SOC) identified on the proximal tibia of a 4th-century BCE individual from Pontecagnano (Salerno, Italy) with an aim to contribute to differential diagnosis of bone tumors in archeological contexts.

Materials

Paleopathological assessment of a male individual with an estimated age-at death of 45.9–62.9 years brought to light during the archaeological excavations in the funerary sector of ‘Sica de Concillis’ within the necropolis of Pontecagnano.

Methods

Macroscopic and radiographic analyses were performed for diagnostic purposes.

Results

The proximal portion of the right tibia exhibited a large exophytic bone formation extending from the anteromedial to the posteromedial portion of the diaphysis. The x-ray confirmed the lesion being characterized by regular trabecular bone tissue with cortico-medullary continuity.

Conclusions

The lesion observed is diagnostic of sessile SOC, a neoplasm that must have had aesthetic and, possibly, neurovascular complications due to its large size.

Significance

By offering a detailed description of a case of tibial osteochondroma and discussing the possible complications the individual might have experienced during life, this study highlights the role and importance of benign bone tumors in paleo-oncology.

Limitations

Histological analysis was not carried out in order to preserve the integrity of the affected tibia.

Suggestions for further research

More attention should be devoted to benign tumors in paleopathology as their occurrence and manifestations in the past will lead to a better understanding of their impacts on the quality of life of affected individuals and to greater knowledge of their natural history.

目的本研究报告了一个来自意大利Salerno Pontecagnano的公元前4世纪个体胫骨近端发现的孤立性骨软骨瘤(SOC)的新病例，旨在为考古背景下骨肿瘤的鉴别诊断做出贡献。在Pontecagnano墓地' Sica de Concillis '墓葬区的考古发掘中，一名男性的死亡年龄估计为45.9-62.9岁。方法采用显微和放射学分析诊断。结果右胫骨近端有大量外生骨形成，从骨干前内侧延伸至骨干后内侧。x线证实病变的特征是有规则的骨小梁骨组织，具有皮质-髓质连续性。结论观察到的病变可诊断为无根性SOC，由于其体积大，必须有美观，可能有神经血管并发症。通过对一例胫骨骨软骨瘤的详细描述，并讨论患者一生中可能经历的并发症，本研究强调了良性骨肿瘤在古肿瘤学中的作用和重要性。限制:为了保持受影响胫骨的完整性，未进行组织学分析。良性肿瘤在古病理学中的发生和表现将有助于我们更好地了解其对患者生活质量的影响和对其自然史的认识，因此应给予更多的关注。

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引用次数: 0

A possible case of orbital osteomyelitis from the medieval cemetery of Sant’ Agostino in Caravate (Varese, Northern Italy) 意大利北部瓦雷泽卡拉瓦特中世纪墓地Sant ' Agostino可能的眼眶骨髓炎病例

IF 1.2 3区地球科学 Q3 PALEONTOLOGY

International Journal of Paleopathology

Pub Date : 2023-06-01 DOI: 10.1016/j.ijpp.2023.02.005

Roberta Fusco , Chiara Tesi , Omar Larentis , Paolo Spina , Monica Campagnolo , Marta Licata

Objectives

This paper aims to present one of the first osteoarchaeological cases of orbital osteomyelitis and provides the best diagnostic criteria to identify its pathophysiological changes.

Materials

A well-preserved skeleton of an adult male from the medieval cemetery of Sant’ Agostino in Caravate, Italy.

Methods

Macroscopic, tomographic, and histological analyses were performed using standard methods.

Results

The skeleton shows irregularities in the architecture of the left supraorbital margin. CT analysis reveals the presence of a radiotransparent area involving the diploe and the external cranial table. This area is lateromedially oval-shaped and bordered by a thick irregular radiodense rim, associated with the presence of a cloaca on the roof of the orbit and surrounding periosteal reaction. Microscopic examination shows the formation of a thin layer of cortical bone and an osteoid-like matrix.

Conclusion

A careful differential diagnosis based on macroscopic, radiological, and histological evidence suggests a case of orbital osteomyelitis.

Significance

This case study represents one of the few osteoarchaeological evaluations of ocular chronic osteomyelitis diagnosed using macroscopic skeletal, computed tomography, and histological analysis. As such, it provides a reference and an investigative criterion for future cases.

Limitations

The diagnosis cannot be stated with certainty, and only probable diagnoses can be proposed. Although we referred especially to clinical literature, it is necessary to consider that the severity of conditions may be modified by modern medical intervention.

Suggestion for further research

This case provides further insights into the presence of this condition in the past.

目的本文旨在介绍第一例眼眶骨髓炎的骨考古病例，并为确定其病理生理变化提供最佳诊断标准。材料一具保存完好的成年男性骨骼，来自意大利卡拉瓦特的Sant’Agostino中世纪墓地。方法使用标准方法进行了显微镜、断层扫描和组织学分析。结果左眶上缘结构不规则。CT分析显示存在一个涉及复叶和外颅台的放射透明区域。该区域呈后内侧椭圆形，边缘有一个不规则的放射密集的厚边缘，与眼眶顶部的泄殖腔和周围的骨膜反应有关。显微镜检查显示形成了一薄层皮质骨和类骨基质。结论根据肉眼、放射学和组织学证据仔细鉴别诊断为眼眶骨髓炎。值得注意的是，本病例研究是少数使用肉眼骨骼、计算机断层扫描和组织学分析诊断的眼部慢性骨髓炎的骨考古评估之一。因此，它为今后的案件提供了参考和调查标准。限制诊断不能确定，只能提出可能的诊断。尽管我们特别参考了临床文献，但有必要考虑到，现代医疗干预可能会改变病情的严重程度。进一步研究的建议这个案例提供了对过去这种情况存在的进一步见解。

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引用次数: 0

Two cases of pelvic trauma with survival in the necropolis of Qubbet el-Hawa (Egypt) 埃及Qubbet el-Hawa墓地盆腔创伤存活2例

IF 1.2 3区地球科学 Q3 PALEONTOLOGY

International Journal of Paleopathology

Pub Date : 2023-03-01 DOI: 10.1016/j.ijpp.2022.12.002

Rosario Guimarey Duarte , Ángel Rubio Salvador , Inmaculada Alemán Aguilera , Miguel C. Botella López

Objective

To evaluate the presence of a trauma that results in pelvic ring disruption and its clinical implications in two individuals from ancient Egypt.

Materials

Two complete skeletons of adult women, dated to the Middle Kingdom (c. 1980–1760 BCE), from two tombs in the necropolis of Qubbet el-Hawa (Aswan, Egypt).

Methods

The anatomical elements were examined macroscopically in Egypt.

Results

Unilateral sacroiliac luxation with disruption of the pubic symphysis was detected in both individuals. The presence of an overlapped symphysis was evident in female QH34aa. A healed fracture of the iliopubic ramus are present in female QH122. Antemortem bone alterations in the pelvis demonstrate that they survived the trauma.

Conclusions

Pelvic trauma due to a lateral compression was detected in the os coxae. Both women survived but probably had severe sequelae that impaired their quality of life. At least one of them might have received some type of medical treatment.

Significance

Both cases shed light on pelvic fractures, their mechanisms of production, and their effects on bone and its functionality, as well as revealing possible associated lesions of soft tissues and vital organs.

Limitations

The pelvis, or at least the pubic symphysis, must be well preserved to allow the correct diagnosis of this type of lesion.

Suggestions for further research

Studies are warranted on the detection of this type of fracture, focusing on the subtle bone changes that indicate its presence. There is also a need to develop methodologies that combine the study of bone and soft tissue alterations.

目的评估两名古埃及个体中导致骨盆环破裂的创伤的存在及其临床意义。材料两具完整的成年女性骨骼，可追溯到中王国（约公元前1980–1760年），在埃及阿斯旺Qubbet el Hawa墓地的两座坟墓中。方法在埃及对解剖元素进行宏观检查。结果两人都检测到单侧骶髂关节脱位伴耻骨联合断裂。女性QH34a中存在明显的重叠联合。女性QH122的髂耻骨支骨折愈合。骨盆的尸检骨骼改变表明他们在创伤中幸存下来。结论髋关节外侧受压致骨盆损伤。两名女性都活了下来，但可能有严重的后遗症，影响了她们的生活质量。他们中至少有一人可能接受了某种类型的治疗。值得注意的是，这两个病例都阐明了骨盆骨折、其产生机制、对骨骼及其功能的影响，并揭示了软组织和重要器官可能的相关病变。限制骨盆，或者至少是耻骨联合，必须得到良好的保护，才能正确诊断这种类型的病变。对进一步研究的建议有必要对这种类型的骨折的检测进行研究，重点关注表明其存在的细微骨骼变化。还需要开发结合骨和软组织改变研究的方法。

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引用次数: 0

Corrigendum to “The Bioarchaeology of Disability: A population-scale approach to investigating disability, physical impairment, and care in archaeological communities”[Int. J. Paleopathol. 38 (2022), 76–94] “残疾的生物考古学:在考古社区中调查残疾、身体损伤和护理的人口规模方法”的勘误表[Int.][j] .古生物学报，38 (2022)，76-94]

IF 1.2 3区地球科学 Q3 PALEONTOLOGY

International Journal of Paleopathology

Pub Date : 2023-03-01 DOI: 10.1016/j.ijpp.2022.12.001

Solange Bohling, Karina Croucher, Jo Buckberry

引用次数: 0

Back-to-back: The co-occurrence of DISH and ankylosing spondylitis from early modern Poland 背靠背:来自波兰早期现代的DISH和强直性脊柱炎的共同发生

IF 1.2 3区地球科学 Q3 PALEONTOLOGY

International Journal of Paleopathology

Pub Date : 2023-03-01 DOI: 10.1016/j.ijpp.2022.11.002

Tracy K. Betsinger , Amy B. Scott

Objective

This case study evaluates an individual with skeletal changes consistent with DISH and ankylosing spondylitis. We present here an evaluation of the individual’s pathological skeletal changes and a review of the potential diagnoses. Finally, we offer a differential diagnosis of co-morbidity infrequently found in the paleopathological record.

Materials

The skeletal remains of a male, aged 50 + years from the early modern Polish (17th-18th century CE) site of Drawsko 1.

Methods

Skeletal remains were examined for the presence of spondyloarthropathies.

Results

The individual presented with anterolateral fusion of the vertebral bodies of T6-T10 with a “dripping candle wax” appearance, fusion of the right costovertebral joint at rib 8, fusion of the left apophyseal joints of T8-T10, and the calcification of the supraspinous ligament at T3-T4. The left sacroiliac joint shows intra-articular and para-articular fusion; the right has bony changes consistent with ongoing fusion. Entheseal reactions were noted on the left clavicle, scapulae, first metacarpals, ulnae, and humerii. Diffuse idiopathic skeletal hyperostosis (DISH), ankylosing spondylitis (AS), reactive arthritis (RA), psoriatic arthritis (PA), and enteropathic arthritis (EA) are considered as differential diagnoses.

Conclusions

Based on the skeletal pattern of involvement, the individual suffered from both DISH and AS, which has previously been reported once in the paleopathological literature since 1950. The clinical literature indicates that co-occurrence of these two conditions is possible, with approximately 40 individuals affected.

Significance

This case study is significant for demonstrating the co-occurrence of DISH and AS in the paleopathological record. Additionally, this case contributes to the understanding of heterogenous frailty and syndemics.

Limitations

No radiographs were taken to confirm the differential diagnosis. No aDNA analysis was conducted.

Suggestions for further research

The remains have been reburied; no further analysis is possible.

目的:本病例研究评估与DISH和强直性脊柱炎相一致的骨骼变化。我们在这里提出了个人的病理骨骼变化的评估和潜在的诊断回顾。最后，我们提供鉴别诊断的合并症罕见的发现在古病理记录。材料:在现代波兰早期(公元17 -18世纪)德鲁斯科1号遗址发现的一具年龄在50岁以上的男性骨骼遗骸。方法对骨骸进行脊柱关节病检查。结果患者表现为T6-T10椎体前外侧融合，呈“滴烛蜡”状，右侧8肋肋椎体关节融合，左侧T8-T10椎体突起关节融合，T3-T4棘上韧带钙化。左侧骶髂关节显示关节内和关节旁融合;右侧骨变化与持续的融合一致。左锁骨、肩胛骨、第一掌骨、尺骨和肱骨均出现骨内反应。弥漫性特发性骨骼增生症(DISH)、强直性脊柱炎(AS)、反应性关节炎(RA)、银屑病关节炎(PA)和肠病性关节炎(EA)被认为是鉴别诊断。结论根据受累的骨骼类型，该患者同时患有DISH和AS，这在1950年以来的古病理学文献中已有报道。临床文献表明，这两种情况可能同时发生，大约有40人受到影响。意义本病例研究在古病理记录中证明了DISH和AS的共同发生。此外，本病例有助于理解异质性虚弱和综合症。局限性:未采用x线片进行鉴别诊断。未进行aDNA分析。对进一步研究的建议遗骸已被重新掩埋;无法进一步分析。

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引用次数: 2

Caring for the injured: Exploring the immediate and long-term consequences of injury in medieval Cambridge, England 照顾伤者:探索中世纪英国剑桥受伤的即时和长期后果

IF 1.2 3区地球科学 Q3 PALEONTOLOGY

International Journal of Paleopathology

Pub Date : 2023-03-01 DOI: 10.1016/j.ijpp.2022.07.004

Jenna M. Dittmar , Bram Mulder , Anna Tran , Piers D. Mitchell , Peter D. Jones , Sarah A. Inskip , Craig Cessford , John E. Robb

Objective

To combine paleopathological and biomechanical analysis to reconstruct the impact that a severe skeletal injury had on an individual’s ability to function and participate in medieval society.

Materials

Three medieval individuals from Cambridge, England with ante-mortem fractures to the lower limb were analyzed.

Methods

Plain X-rays were used to determine the degree of malunion, rotation and overlap of each fracture. Cortical bone architecture of the injured individuals and 28 uninjured controls were analyzed using micro-computed tomography (µCT). Clinical and functional consequences were examined using the Bioarcheology of Care framework.

Results

The mechanism of injury, the secondary complications, and the extent of the care received was reconstructed for each individual. Bilateral asymmetry in the cortical bone architecture revealed the long-term alterations to each individual’s gait.

Conclusion

Each of these individuals survived a severe injury resulting in chronic physical impairment, though not all would have been considered ‘disabled’.

Significance

This research contributes to the discussion about medieval care provision and social constructions of disability by illustrating how an interdisciplinary approach provides insight into the experiences of those with physical impairments. The integration of µCT imaging within the Bioarcheology of Care model is a novel approach with great potential for application across the field.

Limitations

Biomechanical analysis was restricted to cortical geometry.

Suggestions for future research

Further study of bilateral asymmetry in trabecular architecture could complement our understanding of altered loading modalities in past societies.

目的结合古病理学和生物力学分析，重建严重骨骼损伤对个体功能和参与中世纪社会的影响。研究人员分析了来自英国剑桥的三名中世纪人，他们死前下肢骨折。方法采用x线平片测定骨折的畸形愈合、旋转和重叠程度。使用微计算机断层扫描(µCT)分析受伤个体和28名未受伤对照的皮质骨结构。使用护理的生物考古学框架检查临床和功能后果。结果对每个患者的损伤机制、继发并发症和护理程度进行了重建。双侧皮质骨结构的不对称揭示了每个人步态的长期改变。尽管并非所有人都被认为是“残疾”，但这些人都在严重伤害导致的慢性身体损伤中幸存下来。本研究通过说明跨学科方法如何提供对身体缺陷者经历的洞察，有助于讨论中世纪的护理提供和残疾的社会结构。将微CT成像集成到生物考古模型中是一种具有巨大应用潜力的新方法。局限性:生物力学分析仅限于皮质几何。对未来研究的建议进一步研究小梁结构的双侧不对称可以补充我们对过去社会中改变的负荷方式的理解。

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引用次数: 1

Conceptualizing disabilities from antiquity to the middle ages: A historical-medical contribution 从古代到中世纪对残疾的概念化:一个历史医学贡献

IF 1.2 3区地球科学 Q3 PALEONTOLOGY

International Journal of Paleopathology

Pub Date : 2023-03-01 DOI: 10.1016/j.ijpp.2022.11.004

M. Cilione , V. Gazzaniga

Objective

This paper provides some conceptual guidelines for interpreting the phenomenon of impairment-disability between Antiquity and the Middle Ages from an historical-medical perspective. The paper illustrates application of these guidelines in an historical-medical reassessment of a published paleopathological case-study.

Materials and methods

The skeletal remains of a woman who experienced bone fusion and osteoarthritis (Rome, VIII century AD) were selected. We first contextualize her impairments through a paleopathological approach, then locate her experience of disability and care within the cultural and social background to which she belongs.

Results

This study illustrates the difficulty of reconstructing one consistent single model of disability.

Conclusions

The traditional idea of disability as a parameter of exclusion is not appropriate for every historical context.

Significance

The paper attempts an integrated and transdisciplinary approach to historical reconstruction of lifestyle in the presence of impairments between late Antiquity and the Early Middle Ages.

Limitations

The main research obstacle is the difficulty of going beyond documented Christian interpretation of disability and provision of welfare to identify detail of lived experience for individuals with impairments.

Suggestions for further research

The transdisciplinary historical-medical approach can be adapted for inclusion in any bioarchaeological study of impairment in historic times; future applications of this model will lead to its refinement.

目的从历史医学的角度解释古代与中世纪之间的残障现象，提供一些概念性的指导。本文阐述了这些指南在一个已发表的古病理学病例研究的历史医学再评估中的应用。材料和方法选择了一位经历过骨融合和骨关节炎的女性(公元八世纪的罗马)的骨骼遗骸。我们首先通过古病理学方法将她的损伤置于环境中，然后在她所属的文化和社会背景中定位她的残疾经历和护理。结果本研究说明了重建一个一致的单一残疾模型的困难。结论将残疾作为排斥参数的传统观念并不适用于任何历史背景。本文试图以一种综合的、跨学科的方法，在古代晚期和中世纪早期存在损害的情况下，对生活方式进行历史重建。研究的主要障碍是很难超越基督教对残疾和提供福利的解释，以确定残疾个人的生活经历的细节。对进一步研究的建议:跨学科的历史医学方法可以适用于任何历史时期损伤的生物考古研究;该模型的未来应用将导致其细化。

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引用次数: 0

A case of congenital multiple epiphyseal dysplasia from the Late Migration Period graveyard in Drnholec (Czech Republic) 捷克Drnholec地区移民后期墓地先天性多发性骨骺发育不良1例

IF 1.2 3区地球科学 Q3 PALEONTOLOGY

International Journal of Paleopathology

Pub Date : 2023-03-01 DOI: 10.1016/j.ijpp.2022.11.003

Lenka Vargová , Kateřina Vymazalová , Ivana Jarošová , Ivo Mařík , Ladislava Horáčková , František Trampota , Katharina Rebay-Salisbury , Barbara Rendl , Fabian Kanz , Denisa Zlámalová

Objective

To contribute to differential diagnosis of multiple epiphyseal dysplasia (MED) in archeological and clinical contexts.

Materials

A skeleton of a 30- to 45-year-old male (grave no. 806) from the Late Migration Period graveyard in Drnholec-Pod sýpkou (Czech Republic), radio-carbon dated to AD 492–530.

Methods

Morphological and metric analyses.

Results

Significant pathological changes were noted on ossa coxae and proximal ends of the femora, which appear similar to changes associated with Legg-Calvé-Perthes disease. X-ray examination made it possible to rule out pseudoachondroplasia, rickets and metabolic bone diseases.

Conclusions

The finding was evaluated as a probable case of congenital multiple epiphyseal dysplasia.

Significance

This case will contribute to the construction of estimates of the occurrence of this disease in historical populations and can be instructive for diagnostics in current medical practice.

Limitations

The final diagnosis is limited by the lack of genetic analysis.

Suggestion for the future research

Further clarification leading to diagnosis will benefit from genetic analysis and evaluation of skeletal remains throughout Europe.

目的对多发性骨骺发育不良（MED）的考古和临床鉴别诊断做出贡献。材料来自Drnholec Pod sýpkou（捷克共和国）移民晚期墓地的一具30至45岁男性（墓号806）的骨骼，放射性碳年代为公元492-530年。方法形态和度量分析。结果髋关节和股骨近端有明显的病理变化，与Legg-Calvé-Perthes病的病理变化相似。X光检查可以排除假性软骨发育不全、软骨病和代谢性骨病。结论该发现被认为是先天性多发性骨骺发育不良的可能病例。值得注意的是，该病例将有助于构建对该疾病在历史人群中发生率的估计，并对当前医疗实践中的诊断具有指导意义。局限性由于缺乏基因分析，最终诊断受到限制。对未来研究的建议进一步澄清导致诊断将受益于整个欧洲骨骼遗骸的基因分析和评估。

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引用次数: 0