Gaining Perspective into the Materiality of Manuscripts: The Contribution of Archaeometry to the Study of the Inks of the White Monastery Codices

An interdisciplinary approach to the study of manuscript traditions is here applied to the analysis of the leaves from the White Monastery, one of the greatest centres of literary production in Late Antique Egypt. In the framework of the ‘PAThs’ project, ar-chaeometric analyses complement the information pieced together by a range of disciplines in the field of humanities. The use of different complementary analytical techniques provides information on the type of ink used and its elemental composition, unveiling interesting details regarding the materials and methodology of manufacturing of writing media. Moreover, this contri-bution takes a step forward and discusses the possible existence of a regional arrangement in the elemental composition revealed in the inks studied

XRF Ink Analysis of Selected Fragments from the Herculaneum Collection of the Biblioteca Nazionale di Napoli

The most commonly used ink in antiquity was carbon-based, and the main element of carbonized papyrus is carbon, making conventional computed tomography (CT-scanning) of Herculaneum scrolls difficult. However, Roman and Greek inks containing metals have recently been identified in some papyri from Egypt, changing our understanding of ink technology in antiquity. This raises hope that some rolls can be virtually unrolled by CT-scanning. Here we present the results of a preliminary analysis, aimed at identifying scrolls whose ink contains metals

942-41 Dysplasia of the Atrioventricular Nodal Artery in Patients with Mitral Valve Prolapse and Sudden Cardiac Death

Patients with isolated mitral valve prolapse (MVP) without significant mitral regurgitation are at a slightly increased risk of sudden cardiac death compared to the normal population. The mechanism(s) of sudden cardiac death in isolated MVP are uncertain. We studied gross hearts and histologic sections of the atrioventricular (AV) node in 21 patients with isolated MVP dying suddenly without apparent cause other than MVP (Group 1, mean age 36±8 years, mean heart weight 420±89 grams). No patient in Group 1 had a history of or treatment for mitral regurgitation, and no left atrial dilatation was present at autopsy. Sudden cardiac death MVP cases were compared to 15 control hearts from trauma victims without cardiac disease (Group 2, mean age 30±7 years, mean heart weight 350±96 grams). Sections of the artery to the AV node within the atrial septum (mean 7 levels in each group) were stained for elastic tissue and proteoglycans. Dysplasia was defined as focal deposition of proteoglycans within the media and partial disruption of the internal elastic lamina. The ratio of lumen area to arterial area was determined by computerized planimetry at the level of greatest luminal narrowing and measured (mean±SEM) 0.33±0.04 for Group 1 and 0.52±0.04 for Group 2 (p=0.001) this ratio was independent of heart weight, age, or sex of patient by stepwise regression. Dysplasia of the AV nodal artery was present in 9/21 (43%) hearts in Group 1 versus 1/15 (7%) hearts in group 2 (p<0.02) We conclude that narrowing of the AV nodal artery and arterial dysplasia are more prevalent in patients with MVP and sudden cardiac death than controls and may represent a more generalized disorder of proteoglycan deposition. The relationship between these findings and sudden cardiac death needs to be further studied

Successful Endoscopic Clipping of Appendiceal Orifice Bleeding: A Technical Maneuver to Convert an Emergency to an Elective Procedure

Objective: We report a rare case of an elderly man with appendiceal bleeding successfully treated with endoscopic placement of hemoclips. Methods: We describe the patient’s clinical presentation, laboratory test results, imaging, and treatment. Results: An 89-year-old man presented with two episodes of bloody diarrhea that occurred two hours apart. Colonoscopy revealed active bleeding from the appen- diceal orifice. Hemostasis was achieved with epinephrine injections followed by placement of five hemoclips to effectively close the appendiceal orifice. An abdominal computed tomography (CT) showed an irregular thick- ening of the appendix wall, raising the possibility of an appendiceal mass. On hospital day 4, the patient underwent appendectomy and partial cecectomy. Pathology revealed focal ulceration of the mucosa without malig- nancy. The remainder of the patient’s hospital course was uneventful.Conclusion: The endoscopic methods used in our case proved effective in achieving hemostasis and allowed the patient to be stabilized prior to surgery. It is unclear whether longer monitoring would reveal any possible long-term complications after endoscopic closure of the appendix. It would be of interest to further investigate this approach to assess the long-term safety and efficacy of this procedure.

Acute Obstructive Suppuration of the Pancreatic Duct Causing Sepsis

Objective: We report a rare case of acute obstructive suppuration of the pancreatic duct causing sepsis, which was successfully treated with emergent endoscopic retrograde cholangiopancreatography (ERCP). Methods: We describe the patient’s clinical presentation, laboratory test results, and imaging used for diagnosis and treatment. Results: A 33-year-old female with a history of recurrent acute pancreatitis was admitted during an episode of acute pancreatitis. Computed tomography (CT) scan of the abdomen revealed acute pancreatitis, diffuse pancreatic atrophy and pancreatic ductal dilatation with obstruction due to a soft tissue lesion within the distal duct. Shortly after admission she developed symptoms and signs of sepsis. Urgent ERCP was performed to further assess the suspected cholangitis. “Clean” bile emanated from the common bile duct, while copious purulent fluid was detected at the dilated pancreatic duct orifice, confirming suppuration of the pancreatic duct. A plastic single pigtail stent was placed traversing the ampulla and pancreatic duct stones that were causing the obstruction, which were later removed. After endoscopic decompression, the patient rapidly improved over the following 24 hours and had no subsequent admissions for pancreatitis.Conclusion: Acute suppuration of the pancreatic duct (ASPD) is a rare and potentially fatal infectious complication of pancreatic ductal obstruction with few cases reported in the English literature. It would be of interest to further investigate the exact pathophysiology leading to development of ASPD. The endoscopic methods of urgent ERCP and pancreatic duct decompression utilized in our case proved effective in successfully treating ASPD. This unusual condition should be considered in patients with acute pancreatitis who develop early clinical decompensation.

X-Ray Fluorescence and Reflectography Data from Hamburg, Staats- und Universitätsbibliothek manuscripts Cod Heb 205, Cod Levy 102 and Cod Levy 148

XRF (ARTAX: 50kV, 600 µA, linescans of 10 to 26 points of 20s each) and reflectography (DinoLite: x50 magnification under vis, NIR and UV light) analysis of manuscripts Cod Heb 205 (14th-15th century CE, on parchment), Cod Levy 102 (Yemen, 17th century CE, on paper) and Cod Levy 148 (Kurdistan, 17th century CE, on paper) from the Staats- und Universitätsbibliothek Hamburg. CodHeb205_Reflectography.zip - reflectography data for Cod Heb205 CodHeb205_XRF.zip - XRF data for Cod Heb205 CodLevy102_Reflectography.zip - reflectography data for Cod Levy102 CodLevy102_XRF.zip - XRF data for Cod Levy102 CodLevy148_Reflectography.zip - reflectography data for Cod Levy148 CodLevy148_XRF.zip - XRF data for Cod Levy14