@article{BohnertGeorgiadesMonoranuetal.2021, author = {Bohnert, Simone and Georgiades, Kosmas and Monoranu, Camelia-Maria and Bohnert, Michael and B{\"u}ttner, Andreas and Ondruschka, Benjamin}, title = {Quantitative evidence of suppressed TMEM119 microglial immunohistochemistry in fatal morphine intoxications}, series = {International Journal of Legal Medicine}, volume = {135}, journal = {International Journal of Legal Medicine}, number = {6}, issn = {1437-1596}, doi = {10.1007/s00414-021-02699-5}, url = {http://nbn-resolving.de/urn:nbn:de:bvb:20-opus-266934}, pages = {2315-2322}, year = {2021}, abstract = {The aim of this pilot study was to investigate the diagnostic potential of TMEM119 as a useful microglia-specific marker in combination with immunostainings for phagocytic function and infiltrating capacity of monocytes in cases of lethal monosubstance intoxications by morphine (MOR), methamphetamine (METH), and of ethanol-associated death (ETH) respectively. Human brain tissue samples were obtained from forensic autopsies of cases with single substance abuse (MOR, n = 8; ETH, n = 10; METH, n = 9) and then compared to a cohort of cardiovascular fatalities as controls (n = 9). Brain tissue samples of cortex, white matter, and hippocampus were collected and stained immunohistochemically with antibodies against TMEM119, CD68KiM1P, and CCR2. We could document the lowest density of TMEM119-positive cells in MOR deaths with highly significant differences to the control densities in all three regions investigated. In ETH and METH deaths, the expression of TMEM119 was comparable to cell densities in controls. The results indicate that the immunoreaction in brain tissue is different in these groups depending on the drug type used for abuse.}, language = {en} } @article{BohnertSeiffertTrellaetal.2020, author = {Bohnert, Simone and Seiffert, Anja and Trella, Stefanie and Bohnert, Michael and Distel, Luitpold and Ondruschka, Benjamin and Monoranu, Camelia-Marie}, title = {TMEM119 as a specific marker of microglia reaction in traumatic brain injury in postmortem examination}, series = {International Journal of Legal Medicine}, volume = {134}, journal = {International Journal of Legal Medicine}, issn = {0937-9827}, doi = {10.1007/s00414-020-02384-z}, url = {http://nbn-resolving.de/urn:nbn:de:bvb:20-opus-235346}, pages = {2167-2176}, year = {2020}, abstract = {The aim of the present study was a refined analysis of neuroinflammation including TMEM119 as a useful microglia-specific marker in forensic assessments of traumatic causes of death, e.g., traumatic brain injury (TBI). Human brain tissue samples were obtained from autopsies and divided into cases with lethal TBI (n = 25) and subdivided into three groups according to their trauma survival time and compared with an age-, gender-, and postmortem interval-matched cohort of sudden cardiovascular fatalities as controls (n = 23). Brain tissue samples next to cortex contusions and surrounding white matter as well as samples of the ipsilateral uninjured brain stem and cerebellum were collected and stained immunohistochemically with antibodies against TMEM119, CD206, and CCR2. We could document the highest number of TMEM119-positive cells in acute TBI death with highly significant differences to the control numbers. CCR2-positive monocytes showed a significantly higher cell count in the cortex samples of TBI cases than in the controls with an increasing number of immunopositive cells over time. The number of CD206-positive M2 microglial cells increased survival time-dependent. After 3 days of survival, the cell number increased significantly in all four regions investigated compared with controls. In sum, we validate a specific and robustly expressed as well as fast reacting microglia marker, TMEM119, which distinguishes microglia from resident and infiltrating macrophages and thus offers a great potential for the estimation of the minimum survival time after TBI.}, language = {en} } @article{BohnertReinertTrellaetal.2021, author = {Bohnert, Simone and Reinert, Christoph and Trella, Stefanie and Schmitz, Werner and Ondruschka, Benjamin and Bohnert, Michael}, title = {Metabolomics in postmortem cerebrospinal fluid diagnostics: a state-of-the-art method to interpret central nervous system-related pathological processes}, series = {International Journal of Legal Medicine}, volume = {135}, journal = {International Journal of Legal Medicine}, issn = {0937-9827}, doi = {10.1007/s00414-020-02462-2}, url = {http://nbn-resolving.de/urn:nbn:de:bvb:20-opus-235724}, pages = {183-191}, year = {2021}, abstract = {In the last few years, quantitative analysis of metabolites in body fluids using LC/MS has become an established method in laboratory medicine and toxicology. By preparing metabolite profiles in biological specimens, we are able to understand pathophysiological mechanisms at the biochemical and thus the functional level. An innovative investigative method, which has not yet been used widely in the forensic context, is to use the clinical application of metabolomics. In a metabolomic analysis of 41 samples of postmortem cerebrospinal fluid (CSF) samples divided into cohorts of four different causes of death, namely, cardiovascular fatalities, isoIated torso trauma, traumatic brain injury, and multi-organ failure, we were able to identify relevant differences in the metabolite profile between these individual groups. According to this preliminary assessment, we assume that information on biochemical processes is not gained by differences in the concentration of individual metabolites in CSF, but by a combination of differently distributed metabolites forming the perspective of a new generation of biomarkers for diagnosing (fatal) TBI and associated neuropathological changes in the CNS using CSF samples.}, language = {en} } @article{BohnertWirthSchmitzetal.2021, author = {Bohnert, Simone and Wirth, Christoph and Schmitz, Werner and Trella, Stefanie and Monoranu, Camelia-Maria and Ondruschka, Benjamin and Bohnert, Michael}, title = {Myelin basic protein and neurofilament H in postmortem cerebrospinal fluid as surrogate markers of fatal traumatic brain injury}, series = {International Journal of Legal Medicine}, volume = {135}, journal = {International Journal of Legal Medicine}, number = {4}, issn = {1437-1596}, doi = {10.1007/s00414-021-02606-y}, url = {http://nbn-resolving.de/urn:nbn:de:bvb:20-opus-266929}, pages = {1525-1535}, year = {2021}, abstract = {The aim of this study was to investigate if the biomarkers myelin basic protein (MBP) and neurofilament-H (NF-H) yielded informative value in forensic diagnostics when examining cadaveric cerebrospinal fluid (CSF) biochemically via an enzyme-linked immunosorbent assay (ELISA) and comparing the corresponding brain tissue in fatal traumatic brain injury (TBI) autopsy cases by immunocytochemistry versus immunohistochemistry. In 21 trauma and 19 control cases, CSF was collected semi-sterile after suboccipital puncture and brain specimens after preparation. The CSF MBP (p = 0.006) and NF-H (p = 0.0002) levels after TBI were significantly higher than those in cardiovascular controls. Immunohistochemical staining against MBP and against NF-H was performed on cortical and subcortical samples from also biochemically investigated cases (5 TBI cases/5 controls). Compared to the controls, the TBI cases showed a visually reduced staining reaction against MBP or repeatedly ruptured neurofilaments against NF-H. Immunocytochemical tests showed MBP-positive phagocytizing macrophages in CSF with a survival time of > 24 h. In addition, numerous TMEM119-positive microglia could be detected with different degrees of staining intensity in the CSF of trauma cases. As a result, we were able to document that elevated levels of MBP and NF-H in the CSF should be considered as useful neuroinjury biomarkers of traumatic brain injury.}, language = {en} } @article{StockMoeckelZanderetal.2023, author = {Stock, Benjamin and M{\"o}ckel, Sigrid and Zander, Christine and Heinsen, Helmut and Bohnert, Simone and Bohnert, Michael}, title = {„Black esophagus" - zwei Obduktionsf{\"a}lle mit infekti{\"o}ser Beteiligung}, series = {Rechtsmedizin}, volume = {33}, journal = {Rechtsmedizin}, number = {3}, issn = {0937-9819}, doi = {10.1007/s00194-022-00593-x}, url = {http://nbn-resolving.de/urn:nbn:de:bvb:20-opus-325022}, pages = {206-210}, year = {2023}, abstract = {„Black esophagus" oder „akute {\"O}sophagusnekrose" (A{\"O}N) ist eine seltene Erkrankung, die sich makroskopisch durch eine zirkumferente Schwarzverf{\"a}rbung der {\"O}sophagusmukosa mit abruptem Ende am gastro{\"o}sophagealen {\"U}bergang auszeichnet. Die genaue Pathogenese ist unbekannt; es werden multifaktorielle Einfl{\"u}sse wie z. B. S{\"a}urereflux, Isch{\"a}mie und verringerte Schutzmechanismen der Mukosa als m{\"o}gliche Ursachen diskutiert. Vorgestellt werden 2 Obduktionsf{\"a}lle, die typische Befunde einer A{\"O}N aufwiesen. Zus{\"a}tzlich hatten Fall 1 eine Candida-Infektion und Fall 2 eine Appendizitis, sodass eine infekti{\"o}se Genese in beiden F{\"a}llen eine Rolle gespielt haben k{\"o}nnte.}, subject = {Histopathologie}, language = {de} } @article{BohnertTrellaPreissetal.2022, author = {Bohnert, Simone and Trella, Stefanie and Preiß, Ulrich and Heinsen, Helmut and Bohnert, Michael and Zwirner, Johann and Tremblay, Marie-{\`E}ve and Monoranu, Camelia-Maria and Ondruschka, Benjamin}, title = {Density of TMEM119-positive microglial cells in postmortem cerebrospinal fluid as a surrogate marker for assessing complex neuropathological processes in the CNS}, series = {International Journal of Legal Medicine}, volume = {136}, journal = {International Journal of Legal Medicine}, number = {6}, doi = {10.1007/s00414-022-02863-5}, url = {http://nbn-resolving.de/urn:nbn:de:bvb:20-opus-325009}, pages = {1841-1850}, year = {2022}, abstract = {Routine coronal paraffin-sections through the dorsal frontal and parieto-occipital cortex of a total of sixty cases with divergent causes of death were immunohistochemically (IHC) stained with an antibody against TMEM119. Samples of cerebrospinal fluid (CSF) of the same cases were collected by suboccipital needle-puncture, subjected to centrifugation and processed as cytospin preparations stained with TMEM119. Both, cytospin preparations and sections were subjected to computer-assisted density measurements. The density of microglial TMEM119-positive cortical profiles correlated with that of cytospin results and with the density of TMEM119-positive microglial profiles in the medullary layer. There was no statistically significant correlation between the density of medullary TMEM119-positive profiles and the cytospin data. Cortical microglial cells were primarily encountered in supragranular layers I, II, and IIIa and in infragranular layers V and VI, the region of U-fibers and in circumscribed foci or spread in a diffuse manner and high density over the white matter. We have evidence that cortical microglia directly migrate into CSF without using the glympathic pathway. Microglia in the medullary layer shows a strong affinity to the adventitia of deep vessels in the myelin layer. Selected rapidly fatal cases including myocardial infarcts and drowning let us conclude that microglia in cortex and myelin layer can react rapidly and its reaction and migration is subject to pre-existing external and internal factors. Cytospin preparations proved to be a simple tool to analyze and assess complex changes in the CNS after rapid fatal damage. There is no statistically significant correlation between cytospin and postmortem interval. Therefore, the quantitative analyses of postmortem cytospins obviously reflect the neuropathology of the complete central nervous system. Cytospins provide forensic pathologists a rather simple and easy to perform method for the global assessment of CNS affliction.}, language = {en} } @article{JellinghausSchererStaufferetal.2020, author = {Jellinghaus, Katharina and Scherer, Charlotte and Stauffer, Edouard and Urban, Petra and Bohnert, Michael and Kneubuehl, Beat P.}, title = {Deadly injuries through recoilless anti-tank weapons while military shooting practice — two case studies from Germany and Switzerland}, series = {International Journal of Legal Medicine}, volume = {134}, journal = {International Journal of Legal Medicine}, issn = {0937-9827}, doi = {10.1007/s00414-020-02301-4}, url = {http://nbn-resolving.de/urn:nbn:de:bvb:20-opus-232727}, pages = {2199-2204}, year = {2020}, abstract = {In this casuistry, two accidents from Germany and Switzerland are presented that happened during the shot of recoilless anti-tankweapons. In both cases, the injuries led to the death of two soldiers: A 22-year-old soldier in Germany was struck by the countermass of a so-called Davis gun which had been fired by a comrade during a firing exercise; he died from his severe injuries,especially in the abdominal part of the body. As a peculiarity of the wound morphology, it was found to be a thick-layered,metallic, gray material in the wound cavity, which corresponded to the material of the counter mass that was ejected opposite tothe shooting direction. The other case took place in Switzerland, where a 24-year-old soldier was seriously injured during anexercise with portable anti-tank rockets. At the time the shot was fired, he stood behind the launcher and was hit by the propulsionjet of the rocket motor. He died as well from his severe injuries, which were located at the chest done by the gas jet and by the veryhigh pressure. In both cases, two different causes of death were present: massive blunt violence in the first case versus a jet of hotgases of very high speed and temperature in the second case.}, language = {en} } @article{MittalBohnert2023, author = {Mittal, Pawan and Bohnert, Michael}, title = {Intramuscular hemorrhages in the pathway of an electric current through the body - two case reports}, series = {Forensic Science, Medicine and Pathology}, volume = {19}, journal = {Forensic Science, Medicine and Pathology}, number = {1}, doi = {10.1007/s12024-022-00558-2}, url = {http://nbn-resolving.de/urn:nbn:de:bvb:20-opus-325019}, pages = {72-77}, year = {2023}, abstract = {Intramuscular hemorrhages at autopsy can have a variety of traumatic as well as non-traumatic causes, but their recognition in electrical deaths is almost a rarity. We report on two autopsy cases of electrical fatalities, the first relating to a portion of the right upper human extremity, consisting (only) of the forearm and hand, while the other case relates to a female child who died after a high voltage electrical shock. In both cases, layered dissection of the upper limb revealed fresh intramuscular hemorrhages in the skeletal muscles that could be topographically related to the path taken by the current through the body. Externally visible electric marks were present in both cases. The hemorrhages were most likely caused by current-induced tetanic muscle contractions, producing an internal muscle trauma with rupture of fibers and bleedings. In complex situations, such as inconspicuous marks or a complete lack of visible signs on the body, the finding may be helpful in solving the case in consideration of the case history and circumstances. The vitality, topography, and pattern of the hemorrhages are discussed in the light of the available literature.}, language = {en} }