Determining regions of altered brain physiology after diffuse brain injury is challenging. Microglia, brain immune cells with ramified and dynamically moving processes, constantly surveil the parenchyma for dysfunction which, when present, results in a changed morphology. Our purpose was to define the spatiotemporal changes in microglia morphology over 28 days following rat midline fluid percussion injury (mFPI) as a first step in exploiting microglia morphology to reflect altered brain physiology. Microglia morphology was quantified from histological sections using Image J skeleton and fractal analysis procedures at three time points and in three regions post-mFPI: impact site, primary somatosensory cortex barrel field (S1BF), and a remote region. Microglia ramification (process length/cell and endpoints/cell) decreased in the impact and S1BF but not the remote region (p < 0.05). Microglia complexity was decreased in the S1BF (p = 0.003) and increased in the remote region (p < 0.02). Rod-shaped microglia were present in the S1BF and had a 1.8:1.0 length:width ratio. An in-depth quantitative morphologic analysis revealed diverse and widespread changes to microglia morphology in the cortex post-mFPI. Due to their close link to neuronal function, changes in microglia morphology, summarized in this study, likely reflect altered physiology with diverse and widespread impact on neuronal and circuit function.

Introduction: Chondroblastomas are benign, locally aggressive bone tumors that occur in the epiphysis of young patients, requiring surgical excision. The anatomic locations of these lesions pose technical challenges to the surgeon; their proximity to the articular surface and the physis make surgical approach and visualization difficult. This case series describes the use of intramedullary arthroscopic assistance during excisional curettage of three distal femoral chondroblastomas. Case Report: Three patients with distal femoral chondroblastomas underwent excisional curettage with intraosseous “dry” arthroscopic assistance. We describe a two-tunnel technique, using medial and lateral windows so the arthroscope and working instruments could be within the lesion simultaneously; as well as a one-tunnel technique, where the arthroscope was inserted into the working tunnel once curettage was complete, to assess the excision. Conclusion: Achieving adequate exposure and visualization, while protecting the articular surface and physis, during excision of chondroblastomas, is essential for avoiding local recurrence and complications. “Dry” arthroscopic assistance provides the surgeon with an enhanced view of the tumor and tumor cavity, minimizes invasiveness, and has the potential to reduce complications without compromising the completeness of the excision. Keywords: Chondroblastoma, orthopedic oncology, arthroscopy, dry arthroscopy, bone tumor.

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Hemophagocytic lymphohistiocytosis (HLH) is an aggressive hematologic disorder involving hyperstimulation of immune responses and severe inflammation. HLH has been well documented in lymphoid cancers and leukemias, but more rarely in solid tumors. The non-specific clinical characteristics of HLH can cause a diagnostic dilemma and delay in proper treatment, resulting in poor outcomes. We present a case of a patient with metastatic renal cell carcinoma who developed unexplained acute liver failure and was later found to have HLH. This case highlights the importance of including this syndrome on the differential diagnosis for acute liver failure of indeterminate cause and cytopenia in the setting of malignancy to facilitate proper timely treatment to improve outcomes and increase odds of survival.

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