No abstract

A 24-year-old woman presented with painful swelling of the left ankle lasting for several months. She denied any history of prior trauma or surgery. Her level of C-reactive protein was 2.4 mg/L (normal reference <6 mg/L). Plain radiographs showed an area of soft tissue density in the anteromedial aspect of the left ankle joint. Magnetic resonance imaging (MRI) revealed a 3.4×2.3×3.7-cm soft tissue lesion in the anterior aspect of the ankle with compression and displacement of the extensor digitorum longus and the extensor hallucis longus. The lesion exhibited dark T1 and T2 signals (Pictures 1, 2), intermediate to low signals on fat-saturated proton density-weighted images and heterogeneous enhancement following gadolinium administration. Under suspicion of a diagnosis of pigmented villonodular synovitis (PVNS) of the intertarsal joint, the patient underwent extensive excision of the tumor. Pathologic examinations confirmed the diagnosis of PVNS. The histopathology (Picture 3) demonstrated a diffuse-type giant cell tumor with a nodular appearance and an infiltrative border into the adipose tissue (red

The brain is protected from the entry of foreign substances by blood-brain barrier (BBB), but becomes a barrier while chemotherapy is needed for the brain diseases. Ultrasound with microbubbles (MBs) has been shown to noninvasively increase the permeability of the BBB in the normal tissue and brain tumor. The real mechanism for disruption is still unknown. Hemorrhage was usually found in the sonicated region of the brain. Thus, treatment safety is the primary concern when considering clinical application of BBB disruption induced by ultrasound in the presence of MBs. Here we investigate the effects of ultrasound on the permeability of BBB whether the MBs were administered. The data reveals that Evans blue (EB) accumulation was highest in the brain after sonication with MBs. However, the permeability of BBB also can be significantly increased by ultrasound alone. These results demonstrated that noninvasive disruption of BBB by ultrasound alone with no damage is possible.