Our data show that M1 macrophage content of atherosclerotic plaques is associated with clinical incidence of ischemic stroke and increased inflammation or fibrinolysis. We also show the benefits of using ultrasound to evaluate vulnerability in the plaques.

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Although a number of operative procedures have been already reported to prevent cosmetic and functional complications following fronto-temporal craniotomy, little has been analyzed concerning the limitation of mouth opening due to the atrophy, fibrosis and contracture of the temporal muscle. Our focus was placed on the changes and degrees of maximum postoperative mouth opening day by day following fronto-temporal craniotomy. We evaluated the efficacy of newly modified craniotomy (n＝17) compared with the previous conventional one (n＝14).Our modified surgical strategy comprises: 1) tailored fascia and pericranium in Z-shaped fashion, 2) gentle manipulation of fascia, pericranium and muscle, and 3) ample humidification of fascia, pericranium and muscle wrapped with soaked saline gauze during operation. In this maneuver, the temporal muscle was firmly anchored to the fascia and pericranium in the original position. Postoperative limited mouth opening of the modified group was quickly (P＜0.05) and fully resolved with statistical significance.

Prolactinomas are rarely diagnosed in children under the age of 10. A 9-yr-old Japanese boy complained of severe headache and progressive visual disturbance. His growth had been retarded for approximately 3 yr, and his serum PRL level was 811.6 ng/ml. Brain magnetic resonance imaging (MRI) revealed an enlarged pituitary (2.8 × 2.6 × 2.1 cm) with heterogeneous enhancement. He was diagnosed as having a macroprolactinoma accompanied by pituitary apoplexy and growth hormone deficiency. A surgical approach was initially undertaken due to the progressive visual deficits, but a residual tumor was observed, and the level of serum PRL was still high after the surgery. Cabergoline was then started, and the dose was gradually increased to 1.5 mg/wk. The serum PRL level decreased from 138.8 ng/ml to 32.5 ng/ml and 17.7 ng/ml after 5 wk and 19 wk, respectively. At 33 wk of cabergoline treatment, brain MRI demonstrated no evidence of the residual tumor. Thereafter, the serum level of PRL decreased to less than 10 ng/ml, and remission was consistently confirmed on repeated MRI. No adverse events have been observed. The present case suggests that cabergoline can be an effective treatment for prolactinomas in prepubertal children as well as in adults.