Multiple osteosclerotic lesions in an Iron Age skull from Switzerland (320 - 250 BC) - An unusual case

The single Hochdorf burial was found in 1887 during construction work in the Canton of Lucerne, Switzerland. It dates from between 320 and 250 BC. The calvarium, the left half of the pelvis and the left femur were preserved. The finding shows an unusual bony alteration of the skull. The aim of this study was to obtain a differential diagnosis and to examine the skull using various methods. Sex and age were determined anthropologically. Radiological examinations were performed with plain X-ray imaging and a multislice computed tomography (CT) scanner. For histological analysis, samples of the lesion were taken. The pathological processing included staining after fixation, decalcification, and paraffin embedding. Hard-cut sections were also prepared. The individual was female. The age at death was between 30 and 50 years. There is an intensely calcified bone proliferation at the right side of the os frontalis. Plain X-ray and CT imaging showed a large sclerotic lesion in the area of the right temple with a partly bulging appearance. The inner boundary of the lesion shows multi-edged irregularities. There is a diffuse thickening of the right side. In the left skull vault, there is a mix of sclerotic areas and areas which appear to be normal with a clear differentiation between tabula interna, diploë and tabula externa. Histology showed mature organised bone tissue. Radiological and histological findings favour a benign condition. Differential diagnoses comprise osteomas which may occur, for example, in the setting of hereditary adenomatous polyposis coli related to Gardner syndrome.

BMP-SIGNALING REGULATES A COMMON TRANSCRIPTIONAL PROGRAM TO CONTROL FACIAL FORM AND SKELETAL MORPHOGENESIS

Much of the craniofacial skeleton, such as the skull vault, mandible and midface, develops through direct, intramembranous ossification of the cranial neural crest (CNC) derived progenitor cells. Bmp-signaling plays critical roles in normal craniofacial development, and Bmp4 deficiency results in craniofacial abnormalities, such as cleft lip and palate. We performed an in depth analysis of Bmp4, a critical regulator of development, disease, and evolution, in the CNC. Conditional Bmp4 overexpression, using a tetracycline regulated Bmp4 gain of function allele, resulted in facial form changes that were most dramatic after an E10.5 Bmp4 induction. Expression profiling uncovered a signature of Bmp4 induced genes (BIG) composed predominantly of transcriptional regulators controlling self-renewal, osteoblast differentiation, and negative Bmp autoregulation. The complimentary experiment, CNC inactivation of Bmp2, Bmp4, and Bmp7, resulted in complete or partial loss of multiple CNC derived skeletal elements revealing a critical requirement for Bmp-signaling in membranous bone and cartilage development. Importantly, the BIG signature was reduced in Bmp loss of function mutants indicating similar Bmp-regulated target genes underlying facial form modulation and normal skeletal morphogenesis. Chromatin immunoprecipitation (ChIP) revealed a subset of the BIG signature, including Satb2, Smad6, Hand1, Gadd45g and Gata3 that was bound by Smad1/5 in the developing mandible revealing direct, Smad-mediated regulation. These data indicate that Bmp-signaling regulates craniofacial skeletal development and facial form by balancing self-renewal and differentiation pathways in CNC progenitors.

Toward the Development of Ethical Guidelines for Family Preservation

Family preservation workers need a standard set of ethical guidelines to assist them in providing their service in a proper manner. This paper describes how ethical codes have been developed for the "traditional" mental health care disciplines and why such codes are not sufficient for the type of work done in family preservation. The paper further provides examples of the types of ethical dilemmas family preservation workers encounter as well as suggestions for workers, supervisors, and agencies in dealing with such dilemmas.

Functional studies of homeobox gene {\it Cart1\/} during mouse development

Cart1 is a paired-class homeobox-containing gene that is expressed in head mesenchyme, branchial arches, limb buds, and various cartilages during embryogenesis. To understand the role of Cart1 during mammalian development, I generated Cart1-mutant mice by gene targeting in mouse embryonic stem cells. Cart1-homozygous mutants were born alive but all died soon after birth. Most had acrania (absence of the cranial vault) and meroanencephaly (absence of part of the brain). In situ hybridization studies showed that Cart1 is expressed specifically in forebrain mesenchyme but not in midbrain or hindbrain mesenchyme nor in the neural tube. Developmental studies revealed a transient deficiency of forebrain mesenchyme cells due to apoptosis associated with a delay in neural tube closure in that region. Subsequently, the forebrain region became filled with mesenchyme and closed, however, the midbrain neural tube region never initiated closure and remained open. These results suggest that Cart1 is required for the survival of forebrain mesenchyme and that its absence disrupts cranial neural tube morphogenesis by blocking the initiation of closure in the midbrain region, and this ultimately leads to the generation of lethal craniofacial defects. Prenatal treatment of Cart1 homozygous mutants with folic acid suppressed the development of the acrania/meroanencephaly phenotype. Thus, Cart1 mutant mice provide a novel animal model for understanding the cellular, molecular, and genetic etiology of neural tube defects and for the development of prenatal therapeutic protocols using folic acid. ^

Nötige und unnötige Behandlungen beim Hämorrhoidalleiden: Der Patient bestimmt mit

Up to one third of the general population suffers from symptoms caused by hemorrhoids. Conservative treatment comes first unless the patient presents with an acute hemorrhoidal prolapse or a thrombosis. A fiber enriched diet is the primary treatment option, recommended in the perioperative period as well as a long-term prophylaxis. A timely limited application of topical ointments or suppositories and/or flavonoids are further treatment options. When symptoms persist interventional procedures for grade I-II hemorrhoids, and surgery for grade III-IV hemorrhoids should be considered. Rubber band ligation is the interventional treatment of choice. A comparable efficacy using sclerosing or infrared therapy has not yet been demonstrated. We therefore do not recommend these treatment options for the cure of hemorrhoids. Self-treatment by anal insertion of bougies is of lowrisk and may be successful, particularly in the setting of an elevated sphincter pressure. Anal dilation, sphincterotomy, cryosurgery, bipolar diathermy, galvanic electrotherapy, and heat therapy should be regarded as obsolete given the poor or missing data reported for these methods. For a long time, the classic excisional hemorrhoidectomy was considered to be the gold standard as far as surgical procedures are concerned. Primary closure (Ferguson) seems to be superior compared to the "open" version (Milligan Morgan) with respect to postoperative pain and wound healing. The more recently proposed stapled hemorrhoidopexy (Longo) is particularly advisable for circular hemorrhoids. Compared to excisional hemorrhoidectomy the Longo-operation is associated with reduced postoperative pain, shorter operation time and hospital stay as well as a faster recovery, with the disadvantage though of a higher recurrence rate. Data from Hemorrhoidal Artery Ligation (HAL)-, if appropriate in combination with a Recto-Anal Repair (HAL/RAR)-, demonstrates a similar trend towards a better tolerance of the procedure at the expense of a higher recurrence rate. These relatively "new" procedures equally qualify for the treatment of grade III and IV hemorrhoids, and, in the case of stapled hemorrhoidopexy, may even be employed in the emergency situation of an acute anal prolapse. While under certain circumstances different treatment options are equivalent, there is a clear specificity with respect to the application of those procedures in other situations. The respective pros and cons need to be discussed separately with every patient. According to their own requirements a treatment strategy has to be defined according to their individual requirements.

Evidence of trepanation in Late Iron Age Switzerland (420–240BC)

In Europe the procedure of trepanation is known since the Neolithic and is still practiced today in East African native tribes. Trepanation is the oldest known surgical intervention and is defined as the intentional penetration of the cranial vault with removal of piece of a skull bone. Therefore, it is believed that neurosurgery is one of the world’s oldest professions. In this study two skulls with lesions from the Late Iron Age cemetery of Münsingen (420–240 BC), Switzerland, are presented. Aim of the study was to analyse the lesions and to assess whether they were caused by surgical interventions. Sex and age of the individuals were determined by current morphologic-anthropological methods. Radiological examinations were performed with a multislice CT-scanner. Different trepanation methods and signs of healing are discussed. In Switzerland about 33 skulls with possible trepanations dating from Neolithic to medieval times are known and are presented in a short review. Studies of ancient surgical interventions provide important information of pre- and early historic populations. Trepanations of the skull such as the presented cases prove a profound understanding of the human body in ancient times.

Survival after trepanation—Early cranial surgery from Late Iron Age Switzerland

Trepanation is defined as the intentional perforation of the cranial vault with removal of a piece of skull bone. In Europe, trepanation is known to have been practiced at least since the Neolithic, and it can still be found today in East African native tribes. Two skulls with lesions from the Late Iron Age site Münsingen-Rain (420–240 BC) were investigated. The aim of this study was to analyse the lesions and to determine whether they were caused by surgical interventions. Both individuals were analysed by current morphologic-anthropological methods and radiological examinations were performed with a multislice CT-scanner. Additionally, this work surveys trepanations reported in Switzerland and calculates survival rates. In Switzerland, 34 individuals with trepanations have been published. As a tendency, the survival rate appears to be relatively high from the Neolithic to Late Antiquity but then decreases until Pre-Modern times. The 78% survival rate in Late Iron Age Switzerland indicates that the surgery was often performed successfully. Skull injuries sustained in conflicts could have been a reason for trepanation during the Iron Age.

Treatment of Retained Fetal Membranes: Comparison of the Postpartum Period after Routine Treatment or Routine Treatment Including an Additional Phytotherapeutic Substance in Dairy Cattle in Switzerland

Background: The therapy of retained fetal membranes (RFM) is a controversial subject. In Switzerland, intrauterine antibiotics are routinely administered although their effect on fertility parameters is questionable. The objective of this study was to compare the post-partal period after a routine treatment of RFM in 2 groups: one group received a placebo additionally (A), whereas the other group received a phytotherapeutic substance (lime bark) (B) additionally. The routine treatment of RFM included an attempt to manually remove the fetal membranes (for a maximum of 5 min), intramuscular administration of oxytetracycline and intrauterine treatment with tetracycline. In case of an elevated rectal temperature (>39.0°C), an additional non-steroidal inflam-matory drug was allowed. Methods: Cows undergoing caesarean section, suffering from prolapse of the uterus, deep cervical or vaginal injuries, hypocalcaemia, and illnesses during the last 14 days before calving were excluded. Cows had to be more than 265 days pregnant. Only cows that were artificially inseminated after RFM were included. Group stratification was done according to the last number on the ear tag (even/uneven) with (n = 50) cows in group A and (n = 55) cows in group B. Results: The number of treatments after the initial treatment of RFM was not significantly different between groups. The median interval from calving to the first insemination was 77 days in group A compared to 82 days in group B (p = 0.72). The number of AI’s until conception was not significantly different between groups. The median number of days open was 89 days in group A compared to 96 days in group B (p = 0.57). The culling rate was not significantly different between groups. Conclusion: There was neither a difference between the groups concerning therapies within the first 50 days after RFM nor concerning the subsequent fertility variables.

Monitoreo de parásitos patógenos en afluentes agroindustriales

Las aguas residuales son potenciales portadoras de enteroparásitos patógenos para el hombre cuya dosis infectiva puede ser mínima y prolongado el tiempo de sobrevivencia de huevos y quistes en el ambiente. La reglamentación limita la presencia de huevos de helmintos y, hasta el año 2000, no proponía una técnica para su detección. Este trabajo se realizó para caracterizar parasitológicamente los efluentes procedentes de agroindustrias. La capacitación en la identificación microscópica demandó la confección de fichas que describen las características de huevos de helmintos. Se efectuaron ensayos con muestras de bodegas y aceiteras en los puntos detectados de contaminación. Los métodos fueron adaptados a las particularidades de los efluentes. Los resultados no señalaron presencia de helmintos; no obstante, se hallaron Cyclospora e Isospora, protozoarios que, por su alto poder infectivo, también constituyen un riesgo para el hombre. Sin embargo, no están contemplados por la legislación. Respecto a helmintos, es necesario un estudio comparativo de las técnicas de detección para efluentes agroindustriales, con el fin de establecer las que optimicen su recuperación. En cuanto a otras especies es preciso continuar investigando su presencia para evaluar la conveniencia de incorporarlas a la reglamentación.

Similarities and Differences in Barrel Vaults of Traditional and Stately Houses in the Historic Centre of Arequipa, Perú

The traditional architecture of the centre of the city of Arequipa has been analyzed by comparing floor-plans of houses from the eighteenth and nineteenth centuries in order to explain the reasons behind the arrangement of their constructional elements and the evolution of said elements and floor-plans. The historic centre of Arequipa, a city located in the South of Perú, South America (Latitude 16°23' South, Longitude 71 °31' West), is based on a ground plan from 1540 that was set during the city's Spanish foundation. It was declared Patrimony of the Humanity by UNESCO. The manorial architecture is widely known for its decorated fronts and one-of-a-kind designs, but its differences with respect to the popular architecture are not based exclusively on decorative aspects. Peru's colonial period finished around 1825, but the barrel-vault, construction style continued in Arequipa through 1868, when an earthquake destroyed the city. Thereafter, the vaults were replaced by roofs made of rails, with cinders made out of the lava stone. The stately houses belonged to the founding families who settled around the main square on forty nine blocks that formed a square-grid, street layout. Also belonging to this category are the houses of landlords and traders from post-colonial times.

Functionalism and Caprice in Stonecutting. The Case of the Nativity Chapel in Burgos Cathedral

Starting from the inaugural text of Philibert de L'Orme, stereotomic treatises and manuscripts are subject to the opposing forces of reason and fancy. The Nativity Chapel in Burgos Cathedral provides an outstanding case study on this subject. It was built in 1571-1582 by Martín de Bérriz and Martín de la Haya, using an oval vault resting on trumpet squinches to span a rectangular bay. Bed joints and rib axes are not planar curves, as usual in oval vaults. This warping is not capricious; we shall argue that it is the outcome of a systematic tracing method. As a result of this process, the slope of the bed joints increases slightly in the first courses, but stays fairly constant after the third course; this solution prevents the upper courses from slipping. Thus, in the Nativity Chapel of Burgos Cathedral, the constraints of masonry construction fostered a singular solution verging on capriccio. It is also worthwhile to remark that the warping of the joints is not easily appreciable to the eye and that the tracing process does not seem to start from a previous conception of the resulting form. All this suggests that we should be quite careful when talking about the whimsical character of Late Gothic and Early Renaissance; in some occasions, apparent caprice is the offspring of practical thinking.

Technical Challenges in the Construction of Gothic Vaults: The Gothic Theory of Structural Design

The construction of a Gothic vault implied the solution of several technical challenges. The literature on Gothic vault construction is quite large and its growth continues steadily. The main challenge of any structure is that, during and after construction, it must be "safe", that is, it must not collapse. Indeed, it must be amply safe, able to support different loads for long periods of time. Masonry architecture has shown its structural safety for centuries or millennia. The Pantheon of Rome stands today after almost 2,000 years without having needed any structural reinforcement (of course, the survival of any building implies continuous maintenance) . Hagia Sophia in Istanbul, finished in the 6th century AD, has withstood not only the dead loads but also many severe earthquakes . Finally, the Gothic cathedrals, with their appearance of weakness, are• more than a half millennium old. The question arises of what the source of this amazing strength is and how the illiterate master masons were able to design such daring and safe structures . This question is usually evaded in manuals of Gothic architecture. This is quite surprising, the structure being a fundamental part of Gothic buildings. The present article aims to give such an explanation, which has been studied in detail elsewhere. In the first part, the Gothic design methods "V ill be discussed. In the second part, the validity of these methods wi11 be verified within the frame of the modern theory of masonry structures . References have been reduced to a minimum to make the text simpler and more direct.

The Islamic Crossed-Arch Domes in Cordoba: Geometry and Structural Analysis of the “Capilla de Villaviciosa”

Crossed-arch domes are a singular type of ribbed vaults. Their characteristic feature is that the ribs that form the vault are intertwined, forming polygons or stars, leaving an empty space in the centre. The earliest known vaults of this type are found in the Great Mosque of Córdoba, built ca. 960 a.C. The type spread through Spain, and the north of Africa in the 10th to the 16th Centuries, and was used by Guarini and Vittone in the 17th and 18th Centuries in Italy. However, it was used only in a few buildings. Though the literature about the structural behaviour of ribbed Gothic vaults is extensive, so far no structural analysis of crossed arch domes has been made. The purpose of this work is, first to show the way to attack such an analysis within the frame of Modern Limit Analysis of Masonry Structures (Heyman 1995), and then to apply the approach to study the stability of the dome of the Capilla de Villaviciosa. The work may give some clues to art and architectural historians to understand better the origin and development of Islamic dome architecture.

Wedges and plate-bandes: mechanical theories after De la Hire

Plate-bandes are straight masonry arches (they are called, also, flat arches or lintel arches). Ideally they have the surfaces of extrados and intrados plane and horizontal. The stones or bricks have radial joints converging usually in one centre. The voussoirs have the form of wedges and in French they are called "claveaux". A plate-bande is, in fact, a lintel made of several stones and the proportions of lintels and plate-bandes are similar. Proportions of plate-bandes, that is the relationship between the thickness t and the span s (t/s)varies, typically between 1/4–1/3 in thick plate-bandes, and is less than 1/20 in the most slender ones. A ratio of circa 1/8 was usual in the 18th Century and follows a simple geometrical rule: the centre form with the intrados an equilateral triangle and the plate-bande should contain an arc of circle. The joints are usually plane, but in some cases present a «rebated» or «stepped» form. Plate-bandes exert an inclined thrust as any masonry arch. This thrust is usually very high and it requires either massive buttresses, or to be built in the middle of thick walls. Master builders and architects have tried since antiquity to calculate the abutment necessary for any arch. A modern architect or engineer will measure the arch thrust in units of force, kN or tons. Traditionally, the thrust has been measured as the size of the buttresses to resist it safely. Old structural rules, then, addressed the design problem establishing a relationship between the span and the depth of the buttress. These were empirical rules, particular for every type of arch or structure in every epoch. Thus, the typical gothic buttress is 1/4 of the vault span, but a Renaissance or baroque barrel vault will need more than 1/3 of the span. A plate-bande would require more than one half of the span; this is precisely the rule cited by the French engineer Gautier, who tried unsuccessfully to justify it by static reasons. They were used, typically, to form the lintels of windows or doors (1-2 m, typically); in Antiquity they were used, also, though rarely, at the gates of city walls or in niches (ca. 2 m, reaching 5.2 m). Plate-bandes may show particular problems: it is not unusual that some sliding of the voussoirs can be observed, particularly in thick plate-bandes. The stepped joints on Fig. 1, left, were used to avoid this problem. There are other «hidden» methods, like iron cramps or the use of stone wedges, etc. In seismic zones these devices were usual. Another problem relates to the deformation; a slight yielding of the abutments, or even the compression of the mortar joints, may lead to some cracking and the descent of the central keystone. Even a tiny descent will convert the original straight line of the intrados in a broken line with a visible «kink» or angle in the middle. Of course, both problems should be avoided. Finally, the wedge form of the voussoirs lead to acute angles in the stones and this can produce partial fractures; this occurs usually at the inferior border of the springers at the abutments. It follows, that to build a successful plate-bande is not an easy matter. Also, the structural study of plate-bandes is far from simple, and mechanics and geometry are related in a particular way. In the present paper we will concentrate on the structural aspects and their constructive consequences, with a historical approach. We will outline the development of structural analysis of plate-bandes from ca. 1700 until today. This brief history has a more than purely academic interest. Different approaches and theories pointed to particular problem, and though the solution given may have been incorrect, the question posed was often pertinent. The paper ends with the application of modern Limit Analysis of Masonry Structures, developed mainly by professor Heyman in the last fifty years. The work aims, also, to give some clues for the actual architect and engineer involved in the analysis or restoration of masonry buildings.

Bóvedas y contrarresto del Colegio de Nuestra Señora de la Antigua de Monforte de Lemos : geometría, construcción y mecánica

El Colegio de Nuestra Señora de la Antigua de Monforte de Lemos (1593-1619) constituye el principal ejemplo del clasicismo herreriano de Galicia. Esta tesis analiza los aspectos técnicos de la construcción de sus bóvedas de cantería, en el marco disciplinar de la Historia de la Construcción. El Colegio contiene varios tipos de bóvedas entre las que destacan su cúpula trasdosada y su escalera monumental. Además, se conservan los documentos notariales históricos que describen las obras y una de las monteas más importantes de Galicia. Las bóvedas han sufrido movimientos y algunas presentan importantes deformaciones, que han suscitado preocupación sobre su estabilidad. El estudio se organiza en tres epígrafes: geometría, construcción y mecánica, tres aspectos estrechamente interrelacionados en este tipo de estructuras. La parte de estudio geométrico parte de un levantamiento en el que se emplea una estación total sin reflectante, una técnica que permite una medición muy precisa de la forma real de las bóvedas. Como complemento se ha recurrido a técnicas de escáner fotográfico. Con los datos de las mediciones se han elaborado los dibujos de las bóvedas, y analizado sus medidas e irregularidades. Se ha incluido un análisis metrológico por métodos inductivos, que ha puesto de manifiesto la unidad utilizada en la construcción. El estudio se completa con la recopilación de las reglas de dimensionamiento que figuran en los tratados, que se comparan con las dimensiones de las bóvedas analizadas. En el estudio constructivo se registran los despieces y la configuración constructiva y se contrastan, por un lado, con las soluciones que aparecen en los principales tratados de los siglos XVI, XVII y XVIII, y por otro, con las descripciones que se encuentran en los documentos históricos del Colegio. Se ha prestado especial atención al estudio de estos documentos, que han permitido conocer algunos aspectos originales del proceso de construcción de estas bóvedas. En una de las paredes del claustro se ha identificado una montea inédita cuyo levantamiento y análisis se incorpora en esta parte. En el estudio mecánico se analiza la estabilidad dentro del marco teórico del Moderno Análisis Límite de Estructuras de Fábricas. La comprensión del comportamiento estructural, unida a la precisión de los levantamientos, ha permitido explicar los movimientos de las fábricas e inferir la geometría original de algunas de las bóvedas, no siempre evidente en los casos de fuertes deformaciones. Los estudios realizados hasta ahora en bóvedas de los siglos XVI y XVII permiten vislumbrar un panorama de soluciones constructivas más rico que el que recogen los tratados históricos. Las nuevas técnicas de medición sin contacto abren nuevas posibilidades para analizar estas estructuras. Los casos estudiados todavía son escasos y se necesita un conjunto más amplio para poder realizar un análisis general. Esta tesis aporta el estudio de uno de esos casos con el fin de contribuir al mejor conocimiento de la construcción en España en los siglos XVI y XVII. ABSTRACT The Colegio de Nuestra Señora de la Antigua (1593-1619), in Monforte de Lemos, Spain, is the best example in Galicia of the classicism influenced by the Monastery of El Escorial and his architect, Juan de Herrera. This thesis analyzes the technical aspects of the construction of its masonry vaults within the discipline of Construction History. The Colegio exhibits various types of vaults, among which the extradosed ashlar dome and the grand staircase are particularly worth mentioning. In addition, the legal documents containing thorough specifications of the work, as well as one of the construction drawings at actual size —one of the best examples in Galicia—, have both been preserved to this date. Some of the vaults have undergone important deformations that have raised concerns about their stability. The study is organized in three sections: geometry, construction, and mechanics, the three clearly interrelated in this type of structures. The geometrical study starts out with a metric survey using a reflectorless total station, a technique that allows a very precise measurement of the actual shape of the vault. This technique was complemented with the use of a photo-based 3D scanner. The resulting measurements were used to draw the vaults, and analyze their dimensions and irregularities. An inductive metrological analysis, which was able to reveal the exact metric unit utilized during the construction, is included in this section. The section is completed with the gathering of the dimensional rules appearing in the various historical treatises, which are compared with the dimensions of the actual vaults. The construction study deals with the quartering of the structure, whose results are compared, on the one hand, with the approaches appearing in the main treatises of the 16th- 18th centuries, and on the other, with the descriptions in the historical documents of the Colegio itself. Special attention has been paid to the study of these documents, which have revealed some original aspects in the construction process of the vaults. In one of the cloister’s walls, a hitherto unheard-of construction drawing at actual size was found. Its survey and analysis is included in this section. The mechanical study analyzes the Colegio's vaults stability within the theoretical frame of the Modern Limit Analysis of Masonry Structures. The interpretation of the structural behavior, coupled with the precision of the surveys, has allowed a deep understanding of the masonry’s movements and the original geometry of some of the vaults —not always evident in the case of strong deformations— has been inferred. The studies dealing with XVI and XVII century vaults conducted up to this date show a landscape of constructive solutions far richer than the one suggested in the historical treatises. The new contactless measuring techniques offer exciting possibilities for the analysis of these structures. The cases studied are still few and more would be needed before a general analysis can be attempted. This thesis constitutes one such additional case and its goal is to improve our understanding of Spanish construction in the 16th-17th centuries.