Fibro osseous lesions of jaws/oral surgery courses by indian dental academyIndian dental academy
Indian Dental Academy: will be one of the most relevant and exciting training center with best faculty and flexible training programs for dental professionals who wish to advance in their dental practice,Offers certified courses in Dental implants,Orthodontics,Endodontics,Cosmetic Dentistry, Prosthetic Dentistry, Periodontics and General Dentistry.
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Chondroblastic osteosarcoma of the left zygomatic bone rare case report and ...Prashant Munde
Chondroblastic osteosarcoma (COS), a subgroup of intramedullary
osteosarcoma (OS), is the most common osteosarcoma that occurs in
adolescents and early adulthood. The COS has similar clinical and radiological
features to those of conventional OS. We present a case of 20‑year‑old male
patient with the chief complaint of pain and swelling in the left zygomatic region.
The computed tomography (CT) and three‑dimensional (3D) CT face showed
erosion, calcific foci, sunray type of spicules suggestive of OS. On fine‑needle
aspiration cytology (FNAC) examination, initial diagnosis was malignant
chondroid lesion, with differential diagnosis of mesenchymal chrondrosarcoma,
COS on incisional biopsy and finally COS on excisional biopsy. The patient
underwent radical resection of left zygomatic arch, followed by chemotherapy.
Although clinically unsuspected in this unusual site, histopathology along with
immunohistochemistry (IHC) results confirmed the COS. Because zygomatic
location of COS is very rare, this report aimed to discuss clinical, radiographic,
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literature.
Fibro osseous lesions of jaws/oral surgery courses by indian dental academyIndian dental academy
Indian Dental Academy: will be one of the most relevant and exciting training center with best faculty and flexible training programs for dental professionals who wish to advance in their dental practice,Offers certified courses in Dental implants,Orthodontics,Endodontics,Cosmetic Dentistry, Prosthetic Dentistry, Periodontics and General Dentistry.
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The Indian Dental Academy is the Leader in continuing dental education , training dentists in all aspects of dentistry and offering a wide range of dental certified courses in different formats.
Chondroblastic osteosarcoma of the left zygomatic bone rare case report and ...Prashant Munde
Chondroblastic osteosarcoma (COS), a subgroup of intramedullary
osteosarcoma (OS), is the most common osteosarcoma that occurs in
adolescents and early adulthood. The COS has similar clinical and radiological
features to those of conventional OS. We present a case of 20‑year‑old male
patient with the chief complaint of pain and swelling in the left zygomatic region.
The computed tomography (CT) and three‑dimensional (3D) CT face showed
erosion, calcific foci, sunray type of spicules suggestive of OS. On fine‑needle
aspiration cytology (FNAC) examination, initial diagnosis was malignant
chondroid lesion, with differential diagnosis of mesenchymal chrondrosarcoma,
COS on incisional biopsy and finally COS on excisional biopsy. The patient
underwent radical resection of left zygomatic arch, followed by chemotherapy.
Although clinically unsuspected in this unusual site, histopathology along with
immunohistochemistry (IHC) results confirmed the COS. Because zygomatic
location of COS is very rare, this report aimed to discuss clinical, radiographic,
histopathologic, IHC findings and diagnostic pitfalls of COS in light of the
literature.
The exact cause of primary bone cancer is not fully understood but the researchers believe that it is caused by over-activity of the bone cells. Studies have shown that there is a much higher risk of bone cancer in those persons, who had taken radiotherapy or chemotherapy with alkylating anticancer drugs during their childhood. Pain and swelling are the most common symptoms of bone cancer.
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WHO has defined it as an intraosseous lesion consisting of cellular and fibrous tissue that contains multiple foci of hemorrhage, aggregation of multinucleated giant cells and occasionally trabeculae of woven bone.
JAFFE (1953): considered this lesion to be a local reparative reaction of bone, possibly to intramedullary hemorrhage or trauma, hence the term reparative giant cell granuloma was accepted.
Charles A Waldron & W G Shafer (1966) suggested trauma to be an important etiological factor in the initiation of the CGCG of the jaws.
Thoma K H (1986) suggested that, the lesion may be due to capillary injury caused by defective wall due to some type of trauma
J V Soames and J C southam (1997) suggested that it could be a reaction to some form of hemodynamic disturbance in bone marrow, perhaps associated with trauma and hemorrhage REGEZI AND SCIUBBA(1999) :
Suggested that
Response to previous traumatic or inflammatory episodes.
This lesion is characterised by proliferation of fibroblasts and multinucleated giant cells, in a densely packed stroma
Gaint cell lesions of bone/oral surgery courses by indian dental academyIndian dental academy
Indian Dental Academy: will be one of the most relevant and exciting training center with best faculty and flexible training programs for dental professionals who wish to advance in their dental practice,Offers certified courses in Dental implants,Orthodontics,Endodontics,Cosmetic Dentistry, Prosthetic Dentistry, Periodontics and General Dentistry.
benign and malignant tumors of cartilage radiology and general.
helpful for radiology and general medicine and orthopedician.
consie yet sufficient for basic approach to cartilage tumors.
The exact cause of primary bone cancer is not fully understood but the researchers believe that it is caused by over-activity of the bone cells. Studies have shown that there is a much higher risk of bone cancer in those persons, who had taken radiotherapy or chemotherapy with alkylating anticancer drugs during their childhood. Pain and swelling are the most common symptoms of bone cancer.
For more information: www.cancertame.com
WHO has defined it as an intraosseous lesion consisting of cellular and fibrous tissue that contains multiple foci of hemorrhage, aggregation of multinucleated giant cells and occasionally trabeculae of woven bone.
JAFFE (1953): considered this lesion to be a local reparative reaction of bone, possibly to intramedullary hemorrhage or trauma, hence the term reparative giant cell granuloma was accepted.
Charles A Waldron & W G Shafer (1966) suggested trauma to be an important etiological factor in the initiation of the CGCG of the jaws.
Thoma K H (1986) suggested that, the lesion may be due to capillary injury caused by defective wall due to some type of trauma
J V Soames and J C southam (1997) suggested that it could be a reaction to some form of hemodynamic disturbance in bone marrow, perhaps associated with trauma and hemorrhage REGEZI AND SCIUBBA(1999) :
Suggested that
Response to previous traumatic or inflammatory episodes.
This lesion is characterised by proliferation of fibroblasts and multinucleated giant cells, in a densely packed stroma
Gaint cell lesions of bone/oral surgery courses by indian dental academyIndian dental academy
Indian Dental Academy: will be one of the most relevant and exciting training center with best faculty and flexible training programs for dental professionals who wish to advance in their dental practice,Offers certified courses in Dental implants,Orthodontics,Endodontics,Cosmetic Dentistry, Prosthetic Dentistry, Periodontics and General Dentistry.
benign and malignant tumors of cartilage radiology and general.
helpful for radiology and general medicine and orthopedician.
consie yet sufficient for basic approach to cartilage tumors.
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This is a powerpoint(case presentation) for radiology and imaging resident.There are many animations used inside this presentation so to see all the pictures which are placed layer by layer with the help of animations you simple need to download this presentation first.... Thanx.
A Large Intra-Articular Ossicle in the Knee Joint-A Rare Occurrence_Crimson P...CrimsonPublishersAICS
A Large Intra-Articular Ossicle in the Knee Joint-A Rare Occurrence by Lokesh Rana, Dinesh Sood, Raman Chauhan, Roshni Shukla, Pooja Gurnal SR and Himanshu Nautiyal in Advancements in Case Studies
CLINICOPATHOLOGICAL FEATURES OF PERIPHERAL OSSIFYING FIBROMA IN A SERIES OF 4...ishita1994
Peripheral ossifying fibromas are benign mesenchymal lesions that usually arise in the anterior maxilla of young female patients. Histologically they consist of spindle cell proliferation with focal mineralization. We reviewed 48 specimens from 41 patients and recorded the clinical data, sex, and age of the patients, site, and size of the lesions, treatment, and postoperative outcome. Histologically the presence of mature, woven bone, cementum, and calcifications was evaluated and evaluated immunohistochemically. Lesions were more frequent in female patients in the third and fourth decade and were usually in the lower maxilla and smaller than 2 cm. All lesions were conservatively excised, and they relapsed in eight patients. Histopathologically, the lesions were poorly circumscribed, with moderately cellular proliferation, and with no discernible architectural pattern. All tumors showed some degree of mineralization, the presence of immature bone being the most common. Immunohistochemical examination showed staining of tumoral cells for smooth muscle actin and CD68. Lesions tended to occur more commonly in female patients, but one decade later than usually reported. We found a higher recurrence rate in lesions that contained cementum-like material but without bone formation, suggesting a lack of maturation in this group. Immunohistochemical results were consistent with myofibroblastic differentiation but they added no information about the behavior of the lesions.
Disciplina os procedimentos para a elaboração, aprovação, publicação, implementação, monitoria, avaliação e revisão de planos de ação nacionais para conservação de espécies ameaçadas de extinção ou do patrimônio espeleológico.
Encryption in Microsoft 365 - ExpertsLive Netherlands 2024Albert Hoitingh
In this session I delve into the encryption technology used in Microsoft 365 and Microsoft Purview. Including the concepts of Customer Key and Double Key Encryption.
Kubernetes & AI - Beauty and the Beast !?! @KCD Istanbul 2024Tobias Schneck
As AI technology is pushing into IT I was wondering myself, as an “infrastructure container kubernetes guy”, how get this fancy AI technology get managed from an infrastructure operational view? Is it possible to apply our lovely cloud native principals as well? What benefit’s both technologies could bring to each other?
Let me take this questions and provide you a short journey through existing deployment models and use cases for AI software. On practical examples, we discuss what cloud/on-premise strategy we may need for applying it to our own infrastructure to get it to work from an enterprise perspective. I want to give an overview about infrastructure requirements and technologies, what could be beneficial or limiting your AI use cases in an enterprise environment. An interactive Demo will give you some insides, what approaches I got already working for real.
JMeter webinar - integration with InfluxDB and GrafanaRTTS
Watch this recorded webinar about real-time monitoring of application performance. See how to integrate Apache JMeter, the open-source leader in performance testing, with InfluxDB, the open-source time-series database, and Grafana, the open-source analytics and visualization application.
In this webinar, we will review the benefits of leveraging InfluxDB and Grafana when executing load tests and demonstrate how these tools are used to visualize performance metrics.
Length: 30 minutes
Session Overview
-------------------------------------------
During this webinar, we will cover the following topics while demonstrating the integrations of JMeter, InfluxDB and Grafana:
- What out-of-the-box solutions are available for real-time monitoring JMeter tests?
- What are the benefits of integrating InfluxDB and Grafana into the load testing stack?
- Which features are provided by Grafana?
- Demonstration of InfluxDB and Grafana using a practice web application
To view the webinar recording, go to:
https://www.rttsweb.com/jmeter-integration-webinar
UiPath Test Automation using UiPath Test Suite series, part 3DianaGray10
Welcome to UiPath Test Automation using UiPath Test Suite series part 3. In this session, we will cover desktop automation along with UI automation.
Topics covered:
UI automation Introduction,
UI automation Sample
Desktop automation flow
Pradeep Chinnala, Senior Consultant Automation Developer @WonderBotz and UiPath MVP
Deepak Rai, Automation Practice Lead, Boundaryless Group and UiPath MVP
LF Energy Webinar: Electrical Grid Modelling and Simulation Through PowSyBl -...DanBrown980551
Do you want to learn how to model and simulate an electrical network from scratch in under an hour?
Then welcome to this PowSyBl workshop, hosted by Rte, the French Transmission System Operator (TSO)!
During the webinar, you will discover the PowSyBl ecosystem as well as handle and study an electrical network through an interactive Python notebook.
PowSyBl is an open source project hosted by LF Energy, which offers a comprehensive set of features for electrical grid modelling and simulation. Among other advanced features, PowSyBl provides:
- A fully editable and extendable library for grid component modelling;
- Visualization tools to display your network;
- Grid simulation tools, such as power flows, security analyses (with or without remedial actions) and sensitivity analyses;
The framework is mostly written in Java, with a Python binding so that Python developers can access PowSyBl functionalities as well.
What you will learn during the webinar:
- For beginners: discover PowSyBl's functionalities through a quick general presentation and the notebook, without needing any expert coding skills;
- For advanced developers: master the skills to efficiently apply PowSyBl functionalities to your real-world scenarios.
Connector Corner: Automate dynamic content and events by pushing a buttonDianaGray10
Here is something new! In our next Connector Corner webinar, we will demonstrate how you can use a single workflow to:
Create a campaign using Mailchimp with merge tags/fields
Send an interactive Slack channel message (using buttons)
Have the message received by managers and peers along with a test email for review
But there’s more:
In a second workflow supporting the same use case, you’ll see:
Your campaign sent to target colleagues for approval
If the “Approve” button is clicked, a Jira/Zendesk ticket is created for the marketing design team
But—if the “Reject” button is pushed, colleagues will be alerted via Slack message
Join us to learn more about this new, human-in-the-loop capability, brought to you by Integration Service connectors.
And...
Speakers:
Akshay Agnihotri, Product Manager
Charlie Greenberg, Host
State of ICS and IoT Cyber Threat Landscape Report 2024 previewPrayukth K V
The IoT and OT threat landscape report has been prepared by the Threat Research Team at Sectrio using data from Sectrio, cyber threat intelligence farming facilities spread across over 85 cities around the world. In addition, Sectrio also runs AI-based advanced threat and payload engagement facilities that serve as sinks to attract and engage sophisticated threat actors, and newer malware including new variants and latent threats that are at an earlier stage of development.
The latest edition of the OT/ICS and IoT security Threat Landscape Report 2024 also covers:
State of global ICS asset and network exposure
Sectoral targets and attacks as well as the cost of ransom
Global APT activity, AI usage, actor and tactic profiles, and implications
Rise in volumes of AI-powered cyberattacks
Major cyber events in 2024
Malware and malicious payload trends
Cyberattack types and targets
Vulnerability exploit attempts on CVEs
Attacks on counties – USA
Expansion of bot farms – how, where, and why
In-depth analysis of the cyber threat landscape across North America, South America, Europe, APAC, and the Middle East
Why are attacks on smart factories rising?
Cyber risk predictions
Axis of attacks – Europe
Systemic attacks in the Middle East
Download the full report from here:
https://sectrio.com/resources/ot-threat-landscape-reports/sectrio-releases-ot-ics-and-iot-security-threat-landscape-report-2024/
Essentials of Automations: Optimizing FME Workflows with ParametersSafe Software
Are you looking to streamline your workflows and boost your projects’ efficiency? Do you find yourself searching for ways to add flexibility and control over your FME workflows? If so, you’re in the right place.
Join us for an insightful dive into the world of FME parameters, a critical element in optimizing workflow efficiency. This webinar marks the beginning of our three-part “Essentials of Automation” series. This first webinar is designed to equip you with the knowledge and skills to utilize parameters effectively: enhancing the flexibility, maintainability, and user control of your FME projects.
Here’s what you’ll gain:
- Essentials of FME Parameters: Understand the pivotal role of parameters, including Reader/Writer, Transformer, User, and FME Flow categories. Discover how they are the key to unlocking automation and optimization within your workflows.
- Practical Applications in FME Form: Delve into key user parameter types including choice, connections, and file URLs. Allow users to control how a workflow runs, making your workflows more reusable. Learn to import values and deliver the best user experience for your workflows while enhancing accuracy.
- Optimization Strategies in FME Flow: Explore the creation and strategic deployment of parameters in FME Flow, including the use of deployment and geometry parameters, to maximize workflow efficiency.
- Pro Tips for Success: Gain insights on parameterizing connections and leveraging new features like Conditional Visibility for clarity and simplicity.
We’ll wrap up with a glimpse into future webinars, followed by a Q&A session to address your specific questions surrounding this topic.
Don’t miss this opportunity to elevate your FME expertise and drive your projects to new heights of efficiency.
Dev Dives: Train smarter, not harder – active learning and UiPath LLMs for do...UiPathCommunity
💥 Speed, accuracy, and scaling – discover the superpowers of GenAI in action with UiPath Document Understanding and Communications Mining™:
See how to accelerate model training and optimize model performance with active learning
Learn about the latest enhancements to out-of-the-box document processing – with little to no training required
Get an exclusive demo of the new family of UiPath LLMs – GenAI models specialized for processing different types of documents and messages
This is a hands-on session specifically designed for automation developers and AI enthusiasts seeking to enhance their knowledge in leveraging the latest intelligent document processing capabilities offered by UiPath.
Speakers:
👨🏫 Andras Palfi, Senior Product Manager, UiPath
👩🏫 Lenka Dulovicova, Product Program Manager, UiPath
Epistemic Interaction - tuning interfaces to provide information for AI supportAlan Dix
Paper presented at SYNERGY workshop at AVI 2024, Genoa, Italy. 3rd June 2024
https://alandix.com/academic/papers/synergy2024-epistemic/
As machine learning integrates deeper into human-computer interactions, the concept of epistemic interaction emerges, aiming to refine these interactions to enhance system adaptability. This approach encourages minor, intentional adjustments in user behaviour to enrich the data available for system learning. This paper introduces epistemic interaction within the context of human-system communication, illustrating how deliberate interaction design can improve system understanding and adaptation. Through concrete examples, we demonstrate the potential of epistemic interaction to significantly advance human-computer interaction by leveraging intuitive human communication strategies to inform system design and functionality, offering a novel pathway for enriching user-system engagements.
GraphRAG is All You need? LLM & Knowledge GraphGuy Korland
Guy Korland, CEO and Co-founder of FalkorDB, will review two articles on the integration of language models with knowledge graphs.
1. Unifying Large Language Models and Knowledge Graphs: A Roadmap.
https://arxiv.org/abs/2306.08302
2. Microsoft Research's GraphRAG paper and a review paper on various uses of knowledge graphs:
https://www.microsoft.com/en-us/research/blog/graphrag-unlocking-llm-discovery-on-narrative-private-data/
FIDO Alliance Osaka Seminar: Passkeys at Amazon.pdf
Fibrous Dysplasia in a 120.000+ year old Neandertal from Krapina
1. Fibrous Dysplasia in a 120,000+ Year Old Neandertal
from Krapina, Croatia
Janet Monge1
, Morrie Kricun2
, Jakov Radovcˇic´3
, Davorka Radovcˇic´3
, Alan Mann4
, David W. Frayer5
*
1 University of Pennsylvania Museum, University of Pennsylvania, Philadelphia, Pennsylvania, United States of America, 2 Department of Radiology, University of
Pennsylvania Museum, University of Pennsylvania, Philadelphia, Pennsylvania, United States of America, 3 Croatian Natural History Museum, Zagreb, Croatia,
4 Department of Anthropology, Princeton University, Princeton, New Jersey, United States of America, 5 Department of Anthropology, University of Kansas, Lawrence,
Kansas, United States of America
Abstract
We describe the first definitive case of a fibrous dysplastic neoplasm in a Neandertal rib (120.71) from the site of Krapina in
present-day Croatia. The tumor predates other evidence for these kinds of tumor by well over 100,000 years. Tumors of any
sort are a rare occurrence in recent archaeological periods or in living primates, but especially in the human fossil record.
Several studies have surveyed bone diseases in past human populations and living primates and fibrous dysplasias occur in
a low incidence. Within the class of bone tumors of the rib, fibrous dysplasia is present in living humans at a higher
frequency than other bone tumors. The bony features leading to our diagnosis are described in detail. In living humans
effects of the neoplasm present a broad spectrum of symptoms, from asymptomatic to debilitating. Given the incomplete
nature of this rib and the lack of associated skeletal elements, we resist commenting on the health effects the tumor had on
the individual. Yet, the occurrence of this neoplasm shows that at least one Neandertal suffered a common bone tumor
found in modern humans.
Citation: Monge J, Kricun M, Radovcˇic´ J, Radovcˇic´ D, Mann A, et al. (2013) Fibrous Dysplasia in a 120,000+ Year Old Neandertal from Krapina, Croatia. PLoS
ONE 8(6): e64539. doi:10.1371/journal.pone.0064539
Editor: Janet Kelso, Max Planck Institute for Evolutionary Anthropology, Germany
Received January 2, 2013; Accepted April 15, 2013; Published June 5, 2013
Copyright: ß 2013 Monge et al. This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits
unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.
Funding: The authors have no support or funding to report.
Competing Interests: The authors state that Monge and Frayer are Academic Editors. This does not alter the authors’ adherence to all the PLOS ONE policies on
sharing data and materials.
* E-mail: frayer@ku.edu
Introduction
Tumors are seldom documented in the human skeletal record in
part because of their overall rarity. They are even more infrequent
in the human fossil record, an effect of much younger age-at-death
profiles and the fragmentary nature of most fossil remains. Here,
we describe a Krapina Neandertal rib, which preserves bony
indications of a fibrous dysplastic tumor.
The Krapina rock shelter is located on Husˇnjakovo Hill, in the
city of Krapina, some 55 km north of Zagreb, Croatia. Under the
direction of Gorjanovic´-Kramberger, excavations at the site began
in 1899 and continued until 1905, when almost 900 human bones
were recovered, along with stone tools and thousands of faunal
remains [1–4]. ESR and U-Series dating suggest a date between
120–130 kyr for the site with the entire stratigraphic sequence
accumulating over a short 20 kyr time period or less [5]. The lithic
collection has been characterized as Mousterian with side scrapers
as the most common tool [6]. Krapina has yielded one of the
largest samples of human skeletal remains accumulated from any
Upper Pleistocene site. These human bones were recovered in a
fragmentary condition, intermixed with the faunal and arche-
ological sample. Only a few articulated bones have been found
and there is no evidence of deliberate burial. Rather, cut marks
and other evidence of bone processing suggest postmortem
manipulation of the bones by other humans [7]. Among this
sample of fragmentary cranial and postcranial elements, a number
of pathologies have been identified, with most involving degen-
erative disease, blunt force trauma and dental hypoplasia [8–16].
Discussion
Krapina 120.71 is a 30mm long, left rib fragment containing
about 2/3rds of the neck, most of the tubercular facet and a small
section of the shaft. It appears to be a rib 3–6 [12] and matches up
well with adult rib K120.1, a left 4–6 rib. It shares identical areas
of preservation with 120.1 and both show deep muscular
impressions on the neck. (See Table S1 for comparable ribs.) On
K120.71 just lateral from the tubercular facet, the inferior surface
shows a fresh break, exposing cortical bone and a large chamber
(Fig. 1). External dimensions of the cavity are 18 mm in medial-
lateral length and 7.6 mm at the maximum anterior-posterior
breadth across the inferior, broken surface. The cavity’s internal
aspect forms a smooth surface at the ceiling and on the anterior
and posterior walls of the lesion. On the lateral-most portion of the
bone where the rib narrows, two tiny bone spicules run across the
medullary cavity in an anterior-posterior orientation. There are
also some tiny spicules deep on the dorsal-most portion of the
cavity, but for the most part the internal cavity is smooth and the
cortical bone around it dense. Compared to Krapina 120.6, a left
rib 3–5, where the cavity is packed with cancellous bone above the
facet and continuing into the medullary fossa, the empty Krapina
120.71 medullary chamber is striking.
A conventional radiograph of the rib shows an osteolytic lesion
with a geographic pattern of bone destruction arising in the
posterior-medial aspect of the shaft of the rib and showing a sharp
non-sclerotic margin. The lesion is eccentrically expansive with a
shell of periosteal bone (Fig. 2). From the m-CT scans we
PLOS ONE | www.plosone.org 1 June 2013 | Volume 8 | Issue 6 | e64539
2. calculated an internal maximum length of 24 mm, maximum
breadth of 16 mm and a maximum depth of 10 mm. Using
Analyze [R], contour outline measures of the internal void, taken
every.5 mm from individual slice m-CT scan projections, give a
volume for the tumor of 78 mm3
. Since the inferior most portion
of the rib is broken away, the tumor must have been larger than
this. The opposing cortex shows mild erosion, but no adjacent
periosteal reaction. The original matrix forming the tumor
disintegrated over time, and a m-CT examination shows soil
infiltration within the lesion. The m-CT also shows a portion of the
lesion that appears loculated with vertical septations. There has
been erosion beneath the facet of the tubercle (Fig. 3).
The radiographic appearance of the lesion, the location of the
lesion within the shaft of the rib and the estimated adult age of the
individual suggest the most likely diagnosis is fibrous dysplasia.
Fibrous dysplasia is a developmental disorder of bone in which
lesions develop fibrous tissue and spicules of woven bone [17]. The
medullary cancellous bone is replaced by fibrous tissue [18]. There
may be one lesion (monostotic), several lesions, or multiple bone
lesions (polyostotic). The monostotic form is the most common.
The polyostotic form is often associated with skin pigmentation,
may be associated with endocrine abnormalities and precocious
puberty in females and rarely can have sarcomatous transforma-
tions. Rib lesions are often unilateral in the polyostotic form [19].
Figure 2. Radiograph of 120.71. Two views of Krapina 120.71 rib
fragment: a: Superior/inferior radiograph view of Krapina 120.71 in
position matching illustration in Figure 1; b: Lateral view in position
matching the m-CT scan series in Figure 3. The radiograph shows the full
extent of the bony cavern excavated by the growth of the dysplastic
mass. The lesion occupies most of the length of the fragment, but does
not extend beyond the medial and distal borders. The full extent of the
lesion is visible within this small rib fragment.
doi:10.1371/journal.pone.0064539.g002
Figure 3. Krapina 120.71 was m-CT scanned at 20 micron
intervals (voxel size, 20 microns) across the long axis of the
curved bone producing 495 individual images. Four slices are
illustrated here showing the changing architectural detail of the internal
tumor compartment. Loculations and vertical septations are clearly
visible on each slice. Radiodense particles represent areas of adhering
soil matrix that were part of the sedimentary environment.
doi:10.1371/journal.pone.0064539.g003
Figure 1. Krapina 120.71 in a caudal view (a). The large lesion is
located above the tubercular facet and extends laterally. The trabeculae
have been destroyed and the cortex appears expansive. The thin
cortical bone forming the superior surface of the cavern was broken
away postmortem. (b) Krapina 120.6 shows the normal pattern of bony
trabeculae in the medullary space. The surface irregularities are post-
mortem.
doi:10.1371/journal.pone.0064539.g001
Krapina Neandertal Tumor
PLOS ONE | www.plosone.org 2 June 2013 | Volume 8 | Issue 6 | e64539
3. Results
Fibrous dysplasia is the most common benign tumor/tumor–
like lesion of ribs [20–21], accounting for 17% [22] to 33% [20] of
primary rib lesions other than myeloma. In the monostotic form of
fibrous dysplasia, 5.4% to 25% [17] of lesions occur in the ribs
[17–18,23–24]. In the polyostotic form of fibrous dysplasia, 55%
of individuals have rib lesions [25] and the rib lesions are often
unilateral [19]. Fibrous dysplasia occurs anywhere along the rib
except at the ends [24].
The radiographic appearance of fibrous dysplasia of a rib is that
of a slow-growing lesion with a geographic pattern of bone
destruction that may appear round, elongated, or lobulated. It is
centrally located in the marrow space, although it may appear
eccentric as well [19,24]. Bone ‘‘expansion’’ is common as the rib
is a thin flat bone and the distortion may be symmetric or
asymmetric. The margin of fibrous dysplasia is sharp and may be
sclerotic or non-sclerotic. The matrix may appear radiolucent,
may show peripheral trabeculae and appear loculated [22–23],
may show mineralization with amorphous, faint, homogeneous
increase in density (‘‘ground glass’’) appearance and on occasion
may appear sclerotic [23]. The degree of radiographic density of
the matrix depends upon the degree of spicules of woven bone
within the fibrous matrix [17].
An enchondroma (chondroma) may have a similar radiographic
appearance as the lesion presented, however, enchondromas
develop at the sternal ends of ribs with 81.6% of rib enchondromas
developing in the anterior aspect of the rib [22]. The matrix may
show punctate, ring or arc-like calcifications indicative of cartilage
matrix [24]. Enchondroma is the second most common benign rib
lesion [22].
A post-traumatic lesion is unlikely as there is no evidence of a
fracture and the expansive aspect of the lesion protrudes
anteriorly. Any trauma to the rib would have occurred posterior.
Chronic osteomyelitis is highly unlikely due to the lack of a
sclerotic margin and the lack of periosteal reaction along the
cortex opposing the expansive aspect of the lesion.
Chronic osteomyelitis is highly unlikely due to the lack of a
sclerotic margin and the lack of periosteal reaction along the
cortex opposing the expansive aspect of the lesion. Metastasis and
myeloma are not likely since the relatively thick base of the
periosteal shell suggests an underlying benign process [26]. In
addition, it is unlikely that metastasis or myeloma existing in the
medullary space, as seen in solitary hot spots (27) would have
‘‘expanded’’ the anterior cortex to such a degree without
destroying or ‘‘expanding’’ the opposing cortex in this thin bone.
Conclusions
Neoplastic bone disease, of both primary and secondary origin,
is an exceptionally rare occurrence in the evolutionary fossil and
archaeological record of human prehistory [28], until now
extending back in time only 1,000–4,000 years [29]. Additionally,
not only are primary bone neoplasms relatively rare in comparison
to other neoplasms (accounting for a mere 7% of all soft and hard
tissue forms of the disease [30–31]), but several other factors
confound the study of bone disease in past populations. Osteolytic
lesions on bone are difficult to classify without the accompanying
soft tissue analysis (primarily, but not exclusively histologic) that is
part of the medical process of the study of disease etiology.
Compounding this are the processes associated with decomposi-
tion of the body after burial or deposition that serves to fragment,
erode, distort, or completely destroy parts of the remaining bony
tissues.
The frequency of neoplastic disease is strongly correlated with
the relatively recent expansion of the human life span. This
increases the frequency of neoplastic diseases, many of which are
age-dependent [32]. Neandertals had average life spans that were
at best half those modern populations, especially of people in
developed countries [33–34]. Finally, it is recognized that
environmental changes wrought by humans, compounded by
population expansion, have resulted in an increase the types and
the intensification of the pollutants within the environment, many
of which are directly associated with neoplastic disease and were
not part of environments in the past [35].
Given these factors, most argue that cases of neoplastic bone
disease are rare in prehistoric human populations [27–28]. It is
against this background that the identification of a 120,000+ year
old Neandertal with a primary osteolytic lesion is surprising and
one that provides insights into the nature and history of the
association of humans to neoplastic disease.
Supporting Information
Table S1 A table of adult rib measurements for
comparative Neandertal ribs from Krapina.
(DOCX)
Acknowledgments
The rib was discovered in the faunal collection by TD White (University of
California, Berkeley) and N Toth (Indiana University, Bloomington) and
preliminarily identified as a pathological specimen in 1986 [11]. L Mjeda
(Zagreb) produced Figure 1. We thank V Butkovic´ (University of Zagreb,
Croatia) for the radiographs presented in Figure 2. We are grateful to GW
Weber (University of Vienna, Austria) for the high resolution m-CT images
on the Viscom X8060 scanner (http://www.micro-ct.at/).
Author Contributions
Conceived and designed the experiments: JM MK JR AM DWF.
Performed the experiments: JM MK DR AM. Analyzed the data: MK
DR AM. Contributed reagents/materials/analysis tools: JM MK DR.
Wrote the paper: JM MK AM DWF.
References
1. Gorjanovic´-Kramberger G (1906) Der diluviale Mensch von Krapina in
Kroatien. Ein Beitrag zur Pala¨oanthropologie. In: Walkhoff, O, editor. Studien
u¨ber die Entwicklungsmechanik des Primatenskelletes, Volume II. Wiesbaden: Kreidel, 59–
277.
2. Radovcˇic´ J, Smith FH, Trinkaus E, Wolpoff MH (2008) The Krapina hominids:
An illustrated catalog of the skeletal collection. Zagreb: Mladost and the
Croatian Natural History Museum. 118p.
3. Radovcˇic´ J (1988) Dragutin Gorjanovic´-Kramberger and Krapina early man.
Zagreb: Mladost and the Croatian Natural History Museum. 176 p.
4. Miracle PT (2007) The Krapina Paleolithic site. Zooarchaeology, taphonomy
and catalog of the faunal remains. Zagreb: Croatian Natural History Museum.
345p.
5. Rink WJ, Schwarcz HP, Smith FH, Radovcˇic´ J (1995) ESR dates for Krapina
hominids. Nature 378: 24.
6. Simek J, Smith FH (1997) Chronological changes in stone tool assemblages from
Krapina (Croatia). J Hum Evol 32: 561–575.
7. Russell MD (1987) Bone breakage in the Krapina Neandertal site. Am J Phys
Anthropol 72: 381–398.
8. Gorjanovic´-Kramberger D (1908) Anomalien und pathologische Erscheinungen
am Skelett des Urmenschen von Krapina. Korres Deutsch Gesell Anthropol,
Ethnol Urgesch 38: 108–112.
9. Gorjanovic´-Kramberger D (1908) Anomalien und Krankhafte Erscheinungen
am Skelett des Urmenschen von Krapina. Die Umschau 12: 623–662.
10. Molnar S, Molnar IM (1985) The incidence of enamel hypoplasia among the
Krapina Neandertals. Am Anthropol 87: 536–549.
11. Gardner JC, Smith FH (2008) The paleopathology of the Krapina Neandertals.
In: Monge J, Mann A, Frayer DW, Radovcˇic´ J, editors. New insights on the
Krapina Neandertals. Zagreb: Croatian Natural History Museum. 237–251.
Krapina Neandertal Tumor
PLOS ONE | www.plosone.org 3 June 2013 | Volume 8 | Issue 6 | e64539
4. 12. Kricun M, Monge J, Mann A, Finkel G, Lampl M, et al. (1999) The Krapina
hominids. A radiographic atlas of the skeletal collection. Zagreb: Croatian
Natural History Museum. 137p.
13. Hutchinson DL, Larsen CS, Choi I (1994) Stressed to the max?: Physiological
perturbation in the Krapina Neandertals. Curr Anthropol 38: 904–914.
14. Guatelli-Steinberg D, Larsen CS, Hutchinson DL (2004) Prevalence and
duration of linear hypoplasia: A comparative study of Neandertals and Inuit
foragers. J Hum Evol 47: 65–84.
15. Mann A, Monge J (2008) A Neandertal parietal fragment from Krapina
(Croatia) with a serious cranial trauma. In: Monge J, Mann A, Frayer DW,
Radovcˇic´ J, editors. New insights on the Krapina Neandertals. Zagreb: Croatian
Natural History Museum. 261–268.
16. Hutton Estabrook V, Frayer DW (2013) Trauma in the Krapina Neandertals:
Violence in the Middle Paleolithic? In: Knu¨sel C, Smith M, editors. The
bioarchaeology of human conflict: Traumatized bodies from early prehistory to
the present. London: Routledge. in press.
17. Mirra JM (1980) Bone Tumors: Diagnosis and treatment. Philadelphia: J.B.
Lippincott. 125–126.
18. Rodenberg J, Jensen OM, Keller J, Nielsen OS, Bu¨nger C, et al (1996) Fibrous
dysplasia of the spine, costae and hemipelvis with sarcomatous transformation.
Skel Radiol 25: 682–684.
19. Schajowicz F (1994) Tumors and tumorlike lesions of bone. Pathology,
radiology, and treatment. 2nd ed. Berlin: Springer-Verlag. 567–569.
20. The Netherlands Committee on Bone Tumors (1973) Radiological atlas of bone
tumors. Vol. 2. The Hague: Mouton and Co. pp. X, XII–XIII.
21. Pascuzzi CA, Dahlin DC, Clagett OT (1957) Primary tumors of the ribs and
sternum. Surg Gynecol Obstet 104: 390–400.
22. Hochberg LA (1953) Primary tumors of the rib. Review of the literature and
presentation of eleven cases not reported previously. Arch Surg 67: 566–594.
23. Gibson MJ, Middlemiss JH (1971) Fibrous dysplasia of bone. Br J Radiol 44: 1–
13.
24. Kricun ME (1993) Tumors of the ribs. In: Kricun ME, editor. Imaging of bone
tumors. Philadelphia: W.B. Saunders Company. 311–312.
25. Harris WH, Dudley HR Jr, Barry RJ (1962) The natural history of fibrous
dysplasia. An orthopaedic, pathological, and roentgenographic study. J Bone
Joint Surg 44A: 207–233.
26. Kricun ME (1993) Parameters of diagnosis. In: Kricun ME, editor. Imaging of
bone tumors. Philadelphia: W.B. Saunders Company. 6–7.
27. Baxter AD, Coakley FV, Finlay DB, West C (1995) The aetiology of solitary hot
spots in the ribs on planar bone scans. Nucl Med Commun 16: 834–837.
28. Ortner DJ, Putschar WGJ (1981) Identification of pathological conditions in
human skeletal remains. Washington DC: Smithsonian Contributions to
Anthropology, #28. p.365.
29. Capasso LL (2005) Antiquity of cancer. Int J Cancer 113: 2–13.
30. American Cancer Society (2012) Bone cancer overview. Available: http://www.
cancer.org/acs/groups/cid/documents/webcontent/003034-pdf.pdf.
31. Hauber EJ, Hogendoorn PCW (2009) Epidemiology of primary bone tumors
and economical aspects of bone metastases. In: Heymann D, editor. Bone
cancer: Progression and therapeutic approaches. New York: Academic Press. 3–
8.
32. Aufderheide AC, Rodriguez-Martin C (1998) The Cambridge encyclopedia of
human paleopathology. Cambridge: Cambridge University Press. 478p.
33. Caspari R, Lee SH (2004) Older age becomes more common late in human
evolution. PNAS USA 101: 10895–10900.
34. Monge JM, Mann AE (2007) Paleodeography of extinct hominin populations.
In: Henke W, Tattersall I, editors. Handbook of paleoanthropology. Berlin:
Springer-Verlag. 673–700.
35. Halperin EC (2004) Paleo-oncology: The role of ancient remains in the study of
cancer. Pers Biol Med 47: 1–14.
Krapina Neandertal Tumor
PLOS ONE | www.plosone.org 4 June 2013 | Volume 8 | Issue 6 | e64539