The human brain contains magnetic iron oxide nanoparticles in the form of magnetite (Fe3O4); however, the origin and physiological implications of these crystals remain debated. Due to their low concentrations in brain tissue (∼1-20 ng g-1), the identification and characterization of individual magnetic particles require nanometer-scale spatial resolution over large scan volumes. In contrast to conventional electron microscopy techniques that have field of views typically on micron scales, the Quantum Diamond Microscope (QDM), based on wide-field nitrogen-vacancy center imaging, can generate magnetic field maps over areas of several square millimeters while detecting nanoscale particles. Moreover, the QDM can directly quantify the strength and direction of the particles' magnetic moments. Operating the QDM in a high-sensitivity mode, coupled with long acquisition times, enabled the detection of magnetic moments as small as 3 × 10-17 Am2, corresponding to a magnetite particle diameter of approximately 50 nm, in maps covering 1.40 × 2.25 mm2. This is the highest magnetic moment sensitivity of wide-field magnetic microscopy >1 mm2 to date. In addition, collecting repeat, but slightly offset magnetic field maps resulted in the unique ability to distinguish sources within a sample from contamination and artifacts. By applying this technique to tissue, we demonstrate the detection of magnetic dipole-generating sources in human and rodent brain samples with the QDM. Detected particles span a size range of 60-135 nm, consistent with the larger end of magnetite particle sizes found by electron microscopy. These are the first direct magnetic observations of magnetite nanoparticles in brain tissue using quantum sensing techniques.

Radiofrequency ablation (RFA) has become an important minimally invasive option for the treatment of painful spinal tumors and benign bone lesions. While its effectiveness within the vertebral body is well established, there is ongoing concern about unintended heat exposure of nearby neural structures. Experimental data describing how heat propagates beyond the vertebra during spinal RFA are still limited. This experimental in vitro study aims to assess the extravertebral temperature exposure during spinal radiofrequency ablation as a surrogate parameter for potential neural injury risk under controlled conditions. This experimental in vitro study was performed on four fresh-frozen human lumbar spines. Radiofrequency ablation was carried out using a commercially available system and standard clinical protocols. Two anatomical configurations were examined: ablation within the vertebral body and ablation within the pedicle. Temperatures were measured at predefined locations outside the vertebra, including the spinal canal and cortical boundaries, using multiple thermocouples. To aid interpretation of radiofrequency-related measurement artifacts, an additional control setup using an electrothermal heating system without radiofrequency energy was included. Temperature data were evaluated descriptively. In the control experiments, temperature profiles were consistent across all measurement sites, and no values exceeded 42 °C. During radiofrequency ablation, temperature recordings showed pronounced fluctuations related to electromagnetic interference. In the pedicle configuration, temperatures rose gradually during energy delivery and decreased after the procedure, with maximum values reaching up to 44 °C. Although temperatures above 42 °C occurred intermittently, no sustained exposure above 45 °C was observed at any extravertebral location. Under controlled in vitro conditions and with intact cortical bone, spinal radiofrequency ablation led to limited heat propagation beyond the vertebral body and pedicle. Temperature levels commonly associated with irreversible neural injury were not reached or were exceeded only briefly. These findings suggest a low risk of clinically relevant thermal injury to adjacent neural structures when spinal RFA is performed with appropriate probe placement and preserved osseous integrity. Caution is warranted when applying these results to clinical situations involving cortical destruction or altered vertebral anatomy.

Heavy metals can be incorporated into the human body in different ways; nutrition, environment, exposure at work, lifestyle, and endoprosthetic treatment are examples. Metal-containing parts of artificial hip and knee joints release degradation products particularly during malfunctions. Depending on the composition of the prosthetic materials, systemic exposure can occur, leading to increased metal concentrations in body fluids and tissues, which can be harmful to human’s health. Measuring the concentrations of these metals in body fluids and tissues can help predict the failure of artificial joints and prevent intoxications and metal accumulation. Existing publications providing values for metal concentrations in human organs and tissues are limited by the number of organs analyzed, or metals determined, or they are related to selected diseases. Furthermore, differences between the studies can be found in the sample preparation (ashed, dried, or fresh samples) and in the measurement techniques used. In this study, the heavy metal content was determined in autopsy tissues from 33 people. The samples were taken from nine human organs/tissues (brain, heart, lung, kidney, liver, joint capsule, lymph node, fatty tissue, and bone marrow), freeze-dried, treated by microwave-assisted acid digestion, and measured using inductively coupled plasma mass spectrometry (ICP-MS). The concentrations of metals contained in many implants (titanium, vanadium, chromium, cobalt, nickel, and molybdenum) were determined. As a result, this study shows a methodology for exploring the migration of different metals to different organs of interest. Organs, metals, and individuals are subjects for expansion and diversification. The main focus of this study is to contribute for both the reference value generation for the concentration ranges of heavy metals inside the human body as well as the determination of special heavy metal concentrations in the organs of the individuals investigated.

Lethal intoxications can only very rarely be recognized during an external examination of corpses, as poisoning does not leave any characteristic findings on the deceased. The present study is a retrospective review on 2,4-dinitrophenol (2,4-DNP) intoxications in human subjects from the beginning of the 20th century until today, as well as a case report on a fatal intoxication of a 50-year old obese man in Rostock (Germany) and an introduction for toxicological analysis in post-mortem specimens of the substance ingested in these rare cases. Via selective literature search, the information on occurrence and localization of abnormal pathomorphological external and/or internal findings in cases of 2,4-DNP ingestion/ intoxication was gathered. By 2021, a total of 13 case reports with information on morphological findings due to 2,4-DNP ingestion/intoxication were found. The external findings were dominated by yellowing of the skin, followed by exanthemas/rashes and yellowing of the sclera. The internal findings included yellowing of the internal organs, yellow color of the stomach contents, yellowing of the mucous membranes and an intense yellow color of the urine. Yellowish discoloration of the skin, sclera, mucous membranes, internal organs, sweat and/or an intensive yellow discoloration of the urine are not observed in every 2,4-DNP intoxication. However, when they do occur, they are a characteristic indication of 2,4-DNP ingestion and, if localized to the skin, indicate prolonged consumption. A fatal case from Rostock in 2016 due to prolonged intake of 2,4-DNP for weight loss is exemplified. A simple, fast and cost-effective workup combined with HPLC-DAD for post-mortem toxicology ultimately delivers reliable analysis results.

Retinal degeneration protein 3 (RD3) plays a crucial role in controlling guanylate cyclase activity in photoreceptor rod and cone cells, and mediates trafficking processes within photoreceptor cells. Loss of RD3 function correlates with severe forms of retinal dystrophy and the development of aggressive neuroblastoma cancer. In the present study, we analyzed RD3 expression in glioblastoma in comparison to non-tumor tissue using public databases and qRT-PCR. We found that RD3 is downregulated in glioblastoma compared to non-tumor tissues. To better understand the cellular function of RD3 in the context of tumor development, we performed first functional cell culture studies to clarify a possible involvement of RD3 in cell survival and the cell cycle. Interestingly, RD3 overexpression significantly decreased cell viability, which subsequently led to cell-cycle arrest at the G2/M phase and induced cell apoptosis. Conversely, single-point mutations in RD3 at the exposed protein surface involved in RD3-target interaction diminished the impact of RD3. Therefore, a controlled RD3 expression level seems to be important for a balance of cell death and cell survival rate. These new functional mechanisms of RD3 expression could help in understanding tumor development and growth

Ante- oder postmortale Dekapitationen sind in der Regel durch die Befundmorphologie an Kopf und Rumpf oder die Auffindesituation des Leichnams mühelos einem Entstehungsmechanismus zuzuordnen. Infrage kommen scharfe/halbscharfe Werkzeuge, Tierfraß, Fäulnis oder Strangulationsvorgänge. Von essenzieller Bedeutung ist die Abgrenzung zwischen Selbst- und Fremdbeibringung, da diese im Ergebnis einen großen Einfluss auf Ermittlungsumfang, Zeitdruck, Zuständigkeiten und kriminaltechnische Aufarbeitung hat. Im vorliegenden Fall war die Befunderhebung durch Fäulnis erschwert, der Kopf fehlte zunächst und die rechtsmedizinische Leichenschau erfolgte verspätet und fernab des Fundorts. Die Aufklärung des Sachverhalts und die Zuordnung zu einer strangulationsbedingten Enthauptung im Rahmen eines Suizids konnten dennoch mit klassischen Untersuchungsmethoden und effizienter Zusammenarbeit zwischen Polizei und Rechtsmedizin realisiert werden. Im Fokus standen dabei die knöcherne Morphologie der Abtrennungsebenen an Kopf und Rumpf sowie die interdisziplinäre Inspektion des Fundorts.

Magnetic iron-oxide nanoparticles in the form of magnetite (Fe3O4) are present in the human brain. They have been hypothesized to biomineralize in situ, as a result of dysfunctional iron homeostasis related to Alzheimer's disease, or to enter the brain as airborne pollution particles. Regardless of their origin, magnetic iron-oxides pose a potential hazard to human health due to their high redox activity and surface charge. Here we report measurements on four post-mortem human brainstems, with one brainstem showing approximately 100 times higher magnetite concentrations than the other cases. This brainstem came from a subject with alcohol-associated liver disease (ALD) that manifested in liver cirrhosis and massive hepatic iron overload. Laser ablation - inductively coupled plasma - mass spectrometry showed the highest levels of trace metals (iron, copper and manganese) in the ALD brainstem. It is well established that a dysfunctional liver can result in the accumulation of trace metals in the brain. Our data indicate a similar pathway for magnetite particles, yet liver pathology has not been linked to magnetite occurrence in the brain so far. It may prove to be a crucial factor in understanding the high variation of magnetite concentrations found in human brains.

Zusammenfassung Einleitung Die vorliegende Studie hatte das Ziel, Erkenntnisse über Veränderungen in der Knochendichte und der kortikalen Dicke bei Patienten mit diffuser idiopathischer skelettaler Hyperostose (DISH) und Osteoporose zu gewinnen, um das Verständnis für Risikobereiche für das Auftreten von Insuffizienzfrakturen am Achsenskelett zu verbessern. Fallbeschreibung und Ergebnisse Eine weibliche 83-Jährige Körperspenderin mit DISH und Osteoporose wurde mittels CT/QCT- sowie Mikro-CT-Bildgebung untersucht. Die kortikale Dicke wurde an den Endplatten und der kortikalen Schale von 15 Wirbelkörpern an 1800 Messpunkten ermittelt, um Unterschiede zwischen den Wirbelsäulen Abschnitten festzustellen. Alle erhobenen Daten wurden mit dem Softwarepaket SPSS, Version 24.0 (Armonk, New York: IBM Corp., USA) analysiert. Es zeigte sich eine signifikant höhere kortikale Dicke in der Brustwirbelsäule im Vergleich zur Hals- (p=0,001) und Lendenwirbelsäule (p<0,001). Die Kortikalisdicke ist an der Hinterkante in den verschiedenen Abschnitten am geringsten ausgeprägt. Der spongiöse Knochenmineralgehalt steigt in den von DISH betroffenen Wirbelkörpern an. Obwohl die Halswirbelsäule nicht von DISH betroffen war, fand sich dort die höchste Knochendichte der gesamten Wirbelsäule. Schlussfolgerungen Die signifikant höhere kortikale Dicke und der erhöhte spongiöse Knochenmineralgehalt in der Brustwirbelsäule bei DISH könnte auf eine erhöhte Stabilität und ein geringeres Frakturrisiko in diesem Bereich hinweisen. Die hohe Knochendichte im HWS-Bereich scheint auch bei vorliegender Osteoporose am Achsenskelett einen kritischen Frakturschwellenwert nicht zu unterschreiten.

Neuromyelitis optica is a paradigmatic autoimmune disease of the central nervous system, in which the water-channel protein AQP4 is the target antigen 1 . The immunopathology in neuromyelitis optica is largely driven by autoantibodies to AQP4 2 . However, the T cell response that is required for the generation of these anti-AQP4 antibodies is not well understood. Here we show that B cells endogenously express AQP4 in response to activation with anti-CD40 and IL-21 and are able to present their endogenous AQP4 to T cells with an AQP4-specific T cell receptor (TCR). A population of thymic B cells emulates a CD40-stimulated B cell transcriptome, including AQP4 (in mice and humans), and efficiently purges the thymic TCR repertoire of AQP4-reactive clones. Genetic ablation of Aqp4 in B cells rescues AQP4-specific TCRs despite sufficient expression of AQP4 in medullary thymic epithelial cells, and B-cell-conditional AQP4-deficient mice are fully competent to raise AQP4-specific antibodies in productive germinal-centre responses. Thus, the negative selection of AQP4-specific thymocytes is dependent on the expression and presentation of AQP4 by thymic B cells. As AQP4 is expressed in B cells in a CD40-dependent (but not AIRE-dependent) manner, we propose that thymic B cells might tolerize against a group of germinal-centre-associated antigens, including disease-relevant autoantigens such as AQP4.

Zusammenfassung Hintergrund Forensisch-medizinische Untersuchungen von Lebenden gehören seit jeher zu den Aufgaben in der rechtsmedizinischen Praxis. Während Studien über Gewaltopfer bereits umfassend veröffentlicht wurden, sind systematische Untersuchungen zu tatverdächtigen Personen, insbesondere zu Verdächtigen in Fällen von Tötungsdelikten, bislang nur vereinzelt publiziert worden. Fragestellung Es sollte untersucht werden, in wie vielen Fällen Tatverdächtige eines vorsätzlichen Tötungsdeliktes rechtsmedizinisch untersucht worden sind, und ob sich an den Personen charakteristische Befunde feststellen lassen, die eine Rekonstruktion des Tatgeschehens unterstützen können. Material und Methoden Zwischen 2002 und 2022 wurden durch Mitarbeiter des Instituts für Rechtsmedizin der Universitätsmedizin Rostock 67 Personen rechtsmedizinisch untersucht, die zum Untersuchungszeitpunkt tatverdächtig waren, ein Tötungsdelikt begangen zu haben. Die im Institut für Rechtsmedizin der Universitätsmedizin Rostock zur Verfügung stehenden Informationen zu den Untersuchungen als auch den Delikten selbst wurden anhand zahlreicher Kriterien analysiert. Besonderes Augenmerk wurde dabei auf die Korrelation der verschiedenen Gewaltformen mit bestimmten Verletzungsmustern gelegt. Ergebnisse Die Tatverdächtigen waren in 91 % der Fälle männlich und vorwiegend im jüngeren Erwachsenenalter. Führend bei der Tatbegehung war die Anwendung von scharfer Gewalt, gefolgt von der kombinierten Anwendung scharfer und stumpfer Gewalt. Von den 48 Personen, die verdächtig waren, eine andere Person u. a. mittels scharfer Gewalt getötet zu haben, wiesen 20 Personen (41 %) Verletzungen auf, die auf das Hantieren mit einem scharfen Werkzeug zurückzuführen waren. Von den 30 Personen, die verdächtig waren, eine andere Person u. a. mittels stumpfer Gewalteinwirkung getötet zu haben, wiesen 23 Befunde (78 %) auf, die im Rahmen einer körperlichen Auseinandersetzung mit der getöteten Person entstanden sein können, wobei die festgestellten Verletzungen wesentlich uncharakteristischer waren. In weiteren 9 Fällen (13 %) konnten Verletzungen festgestellt werden, die als eine körperliche Gegenwehr durch das Opfer interpretiert wurden. Schlussfolgerung Die rechtsmedizinische Untersuchung von Beschuldigten, denen ein vorsätzliches Tötungsdelikt vorgeworfen wird, kann erheblich zur Rekonstruktion des Tatgeschehens und zur Aufklärung der Tat beitragen. Insofern sollte den Ermittlungsbehörden eine solche Untersuchung für alle infrage kommenden Fälle mit Nachdruck angeboten werden.

Das ausgehende 19. Jh. war das Zeitalter der Kolonialmächte und der Industrialisierung, durch die die Erforschung der Welt und ihrer Bewohner erleichtert wurde. Mit der Kolonialisierung wurden Ressourcen in Überseegebieten erkundet und ausgebeutet. Reisende brachten neben Kulturgütern aller Art auch Schädel und Knochen der „Eingeborenen“ als Belegexemplare für ihre Sammlungen mit. Diese sollten kulturelle Praktiken der indigenen Bevölkerung illustrieren, aber auch zu Forschungszwecken dienen. In Messreihen, v. a. an Schädeln, wollte man vermeintliche Unterschiede der verschiedenen menschlichen „Rassen“ bestimmen. In diesem Zusammenhang legte der Anatom Friedrich Merkel in Rostock eine solche „Raçen-Schädelsammlung“ an. Auch Deutschland widmet sich der Erforschung seiner kolonialen Vergangenheit und bedient sich dabei der Provenienzforschung – der Aufarbeitung der Herkunft von Sammlungs-„Objekten“ und ihrer Erwerbsumstände. Dabei ist v. a. die Frage zu klären, ob „Unrechtskontexte“ vorliegen, koloniale Machtverhältnisse also gezielt zum Erwerb ausgenutzt wurden. In diesem Zusammenhang wurden auch die außereuropäischen Schädel des Instituts für Anatomie in Rostock in einem interdisziplinären, durch das Deutsche Zentrum Kulturgutverluste geförderten Forschungsprojekt vom Arbeitsbereich Geschichte der Medizin untersucht. Die historischen Informationen zu den Human Remains der Rostocker anatomischen Sammlung waren spärlich oder nicht vorhanden. Daher wurde eine historische Recherche durchgeführt, und die Schädel u. a. wurden anthropologisch untersucht. Nachdem sich einzelne Detailfragen ergaben, wurden diese Schädel rechtsmedizinisch mitbegutachtet. Es sollen 2 menschliche Schädel („Cd 35, Bergdamara“; „Ce 22, Alt-Peruaner“) vorgestellt werden, die hinsichtlich sichtbarer Knochendefekte rechtsmedizinisch beurteilt wurden. Es wurden abgeheilte Impressionsfrakturen an „Cd 35“, Schädelmodifikationen sowie postmortale Knochendefekte an „Ce 22“ festgestellt. In der Beurteilung der Auffälligkeiten konnten die anthropologischen Gutachten um die rechtsmedizinische Einschätzung ergänzt werden. Die Bedeutung der unterschiedlichen Blickwinkel der kooperierenden Fachdisziplinen wird am Beispiel der Provenienzforschung besonders deutlich. Die rechtsmedizinische Zuarbeit ist in Provenienzforschungsprojekten bislang unüblich, sie kann jedoch eine wertvolle Ergänzung darstellen. Grundsätzlich sollte historisches Unrecht neu bewertet und der Umgang mit Human Remains in medizinischen Sammlungen überdacht werden.

Lethal accidents caused by lightning are divided into observed and unobserved events. Pathognomonic or characteristic findings are often overlooked during external postmortem examination. Classical mistakes may be made which may often lead to an incorrect diagnosis. An analysis of 270 fatalities was performed on a historical collection of the Committee for Lightning Conductor Construction for the United Economic Area e. V. (ABBW) on lethal accidents due to lightning that occurred in Germany for the period 1951–1965. Furthermore, a selective literature research was carried out. The aim of the study was to analyze the death scene, the clothing, and the victim. The authors focused on chief findings which were relevant to the correct diagnosis of “death by lightning.” Both Lichtenberg figures and singed body hair were considered pathognomonic for a lightning strike. The question arose as to whether Lichtenberg figures, for example, represented the finding that most often led to the correct diagnosis. Of the 270 lightning-struck victims from the case collection, 129 (47.8%) had singed body hair and 25 (9.3%) had Lichtenberg figures. A comparison of the frequency of the two reported findings, singed body hair versus Lichtenberg figures, has only been performed in the literature for case numbers below 40. This study is the first evaluation of a relatively large number of lethal accidents due to lightning. Singed body hair was reported more frequently in lightning-struck victims than Lichtenberg figures. This study showed that singed body hair is probably more diagnostically important than Lichtenberg figures.

Traumatic brain injury (TBI) is a ubiquitous, common sequela of accidents with an annual prevalence of several million cases worldwide. In forensic pathology, structural proteins of the cellular compartments of the CNS in serum and cerebrospinal fluid (CSF) have been predominantly used so far as markers of an acute trauma reaction for the biochemical assessment of neuropathological changes after TBI. The analysis of endogenous metabolites offers an innovative approach that has not yet been considered widely in the assessment of causes and circumstances of death, for example after TBI. The present study, therefore, addresses the question whether the detection of metabolites by liquid-chromatography-mass spectrometry (LC/MS) analysis in post mortem CSF is suitable to identify TBI and to distinguish it from acute cardiovascular control fatalities (CVF). Metabolite analysis of 60 CSF samples collected during autopsies was performed using high resolution (HR)-LC/MS. Subsequent statistical and graphical evaluation as well as the calculation of a TBI/CVF quotient yielded promising results: numerous metabolites were identified that showed significant concentration differences in the post mortem CSF for lethal acute TBI (survival times up to 90 min) compared to CVF. For the first time, this forensic study provides an evaluation of a new generation of biomarkers for diagnosing TBI in the differentiation to other causes of death, here CVF, as surrogate markers for the post mortem assessment of complex neuropathological processes in the CNS (“neuroforensomics”).

The neuropathological features seen in two cases with giant intracerebral aneurysm (GIA) and their forensic implications are presented. A 60-year-old woman fell while riding her bicycle and broke her femur. After a month she died suddenly while having lunch in the rehabilitation center. A 42-year-old woman with recent behavioral disorders and depression died suddenly at home by unknown causes. Upon autopsy, both cases had a GIA with rupture and recent bleeding. GIAs in both cases progressed slowly and were only detected by post-mortem examination. GIAs have several forensic implications. They can mimic brain tumors, cause sudden unexpected death, and alter patients’ behavior. The fact that GIAs can mimic brain tumors should lead to clinical and radiological monitoring of symptomatic cases. In the forensic field, knowing the natural history of GIA is of fundamental importance for clarifying the cause and manner of death.

Extramedullary hematopoiesis (EMH) in subdural hematoma (SDH) is a rare condition, which only a few cases have been described. We present 9 cases of different ages (newborn to 92 years) of EMH within SDH in traumatic brain injury (TBI) deaths. These findings were found during the forensic examinations of SDH with the aim of estimating the post-traumatic interval (PTI). In three cases (74 to 92 years of age, PTI: 18 days to 2 months) EMH nests were found within the stromal support around granulation tissue. In four cases (40 to 69 years of age, PTI: 11 days to 18 days) EMH were found among the outer neomembrane and lakes of red blood cells. In two cases (age: newborn and 26 days old; PTI: 1 day to 3 days respectively) EMH was found within fresh SDH. Prevalent clusters of erythroid precursors compared to other cell lines were identified by H&E and immunohistochemical stains. EMH has been observed from approximately 10 days after trauma in the adult, so when it is found, it may be considered for the estimation of PTI. EMH foci were present in the first days after trauma in the newborn and infant suggesting different timing based on the age of the individual. EMH clusters could be a useful tool in the forensic field when evaluated together with other histological features of SDH.

Background: Knowledge of the histomorphometric structure of the vertebral body and factors influencing the structure is essential for a fundamental understanding of osteoporosis and osteoporotic fractures. The present study is focused on osteocyte density -a parameter seldom investigated so far - and trabecular width as well as bone area over tissue area in human vertebral bodies.Methods: Ninety-two vertebral body specimens (C5, C6, Th8, Th12, L1, L2) from 12 males and seven females were studied (Ethics Application Number A 2017-0072). The prepared vertebral specimens were extracted from the ventral aspect with a Jamshidi needle (R). The punches were decalcified and subsequently H&E stained. Using the Fiji/Image J program (version 1.53 f, Wayne Resband, National Institute of Mental Health, USA), osteocyte numbers were counted per calcified bone surface, and the trabecular width and bone area of trabecular bone were measured. The collected data were analyzed using the statistical software package SPSS, version 23.0 (SPSS Inc., Chicago, USA). Pearson's correlation coefficient was used for correlation analyses. Multiple linear regression analyses were also performed.Results: Osteocyte density did not differ significantly in comparisons based on gender and age (<= 65 years; >= 66 years). Men had wider trabeculae (p < 0.001) and a higher bone area over tissue area (BA/TA, %) (p = 0.025) than women. Individuals over 65 years of age had thinner trabeculae (p < 0.001) and a smaller BA/TA (%) (p < 0.001) than younger individuals. Multiple linear regression analyses were performed to determine the influence of 'gender' and 'age' on trabecular width and bone area over tissue area. The R2 was 0.388 for trabecular width and 0.227 for BA/TA (%). Per year of life, trabecular width decreases by 0.368 mu m (beta < 0.001) and BA/TA (%) by 0.001% (beta = 0.001). Men have on average 8.2 mu m wider trabeculae than women (beta = 0.035). A negative correlation (r = -0.275) was observed between trabecular width and osteocyte density. The wider the trabeculae, the fewer osteocytes per mm2 (p = 0.008). Conclusions: Surprisingly, we found no difference in osteocyte density with reference to age or gender. However, we did register significant age-and gender-related differences in bone area over tissue area and trabecular thickness. The age-related differences were more pronounced, implying that age-dependent loss of bone structure may be more important than differences between genders. (c) 2022 Elsevier GmbH. All rights reserved.

A fatal case of 1,4-butanediol (1,4-BD) oral ingestion is reported here, in which a 51-year-old man was found dead in his bed. According to the police report, the deceased was a known drug user. A glass bottle labeled (and later confirmed to be) "Butandiol 1,4" (1,4-BD) was found in the kitchen. Furthermore, the deceased's friend stated that he consumed 1,4-BD on a regular basis. The autopsy and histological examination of postmortem parenchymatous organ specimens did not revealed a clear cause of death. Chemical-toxicological investigations revealed gammahydroxybutyrat (GHB) in body fluids and tissues in the following quantities: femoral blood 390 mg/L, heart blood 420 mg/L, cerebrospinal fluid 420 mg/L, vitreous humor 640 mg/L, urine 1600 mg/L, and head hair 26.7 ng/mg. In addition, 1,4-BD was qualitatively detected in the head hair, urine, stomach contents, and the bottle. No other substances, including alcohol, were detected at pharmacologically relevant concentrations. 1,4-BD is known as precursor substance that is converted in vivo into GHB. In the synoptic assessment of toxicological findings, the police investigations and having excluded other causes of death, a lethal GHB-intoxication following ingestion of 1,4-BD, can be assumed in this case. Fatal intoxications with 1,4-BD have seldom been reported due to a very rapid conversion to GHB and, among other things, non-specific symptoms after ingestion. This case report aims to give an overview to the published of fatal 1,4-BD-intoxications and to discuss the problems associated with detection of 1,4-BD in (postmortem) specimens.

The neuropathological features seen in two cases with cerebral amyloid angiopathy (CAA) associated intracerebral hemorrhage (ICH) are presented. An 82-year-old man collided with a car while riding his electric bicycle and died in hospital after more than two weeks in the absence of external traumatic signs. The cause of death was an ICH in the right fronto-parietal lobe. An 80-year-old woman broke her femur after a fall in a nursing home and was operated on. After 6 days, she developed reduced vigilance. Computed tomography showed an intracerebral hemorrhage and she died one day later. The cause of death was an ICH in the left parieto-occipital lobe. In both cases autopsy was ordered by the prosecutor in order to differentiate between traumatic hemorrhages and hemorrhage due to a natural disease. Brain samples from both cases were studied on differently stained sections. Leptomeningeal and cortical vessels showed characteristic alterations seen in CAA. Within the leptomeninges and superficial cortical layers there were also areas of cortical superficial siderosis (cSS). The underlying cause of ICH in both cases was CAA and therefore a natural manner of death. In addition, cSS, a well-known radiological marker used to estimate future cerebral bleeding, has been used as a useful tool also in the forensic field, allowing the manner of death to be defined.

Zusammenfassung Hintergrund Insgesamt treten Suizide bei Kindern und Jugendlichen zwar selten auf, sie stellen jedoch die zweithäufigste Todesursache nach Unfällen bei unter 18-Jährigen dar. Während die Unfalltodeszahlen von Kindern und Jugendlichen seit Jahren sinken, bleibt die Suizidrate nahezu konstant. Methodik Im Rahmen dieser Untersuchung wurden Fälle von Suiziden bei Kindern und Jugendlichen, die jünger als 18 Jahre waren, im Zeitraum von Januar 2001 bis Dezember 2022 retrospektiv ausgewertet. Ergebnisse Während des betrachteten Zeitraumes konnten 13 Suizide von Kindern und Jugendlichen in die Erhebung eingeschlossen werden, wobei in 10 Fällen eine gerichtlich angeordnete Obduktion durchgeführt wurde. Das Alter der 8 betroffenen Mädchen und 5 betroffenen Jungen erstreckte sich vom 12. bis zum 17. Lebensjahr. Die Kinder und Jugendlichen verstarben am häufigsten durch Erhängen, das in einem Fall kurzzeitig überlebt wurde, sowie an den Folgen eines Polytraumas. Andere Todesursachen waren Intoxikationen mittels unterschiedlicher Substanzen sowie ein Kopfschuss. In 3 Fällen war eine Depression vorbekannt. Diskussion Zwar sind Suizide im Kindes- und Jugendalter selten, dennoch stellen sie für beteiligte Personen immer ein tragisches Ereignis dar. Vor allem die Unterscheidung zwischen einem Suizid und einem Unfalltod kann schwierig sein. Hierbei kann insbesondere eine rechtsmedizinische Leichenschau am Ereignisort mit anschließender Obduktion entscheidend zur Aufklärung des Falls beitragen.