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Meckel-Gruber syndrome (MGS) is a rare disorder characterized by occipital encephalocele, polydactyly and polycystic kidney. Early diagnosis is very important because MGS has a high risk of recurrence and infants with MGS are frequently stillborn or die soon after birth. An autopsy case of MGS is presented and the focus is specifically on the myofibroblastic cells of the liver and polycystic kidney. Although routine histological examination did not reveal hepatic fibrosis, a specific distribution of alpha smooth muscle actin (alpha-SMA)-positive and h-caldesmon (h-CD)-negative stromal cells (myofibroblastic cells) was observed along the limiting plate of the portal area. Furthermore, myofibroblastic cells were focally distributed along the sinusoidal wall and around the bile ducts in the portal area. In the polycystic kidney, the presence of myofibroblastic cells in the stroma between the cystic lesions was also confirmed by electron microscopy. In conclusion, myofibroblastic cells were distributed in the liver and kidney of a patient with MGS and their specific distribution in the liver may be indicative of prestage hepatic fibrosis.

Objective: The aim of the present study was to investigate the differences between therapeutic granulocyte-colony stimulating factor (G-CSF) cycles and prophylactic G-CSF cycles in patients receiving paclitaxel and carboplatin combination chemotherapy for ovarian cancer.Material and Method: Medical records of 15 women who received paclitaxel and carboplatin combination chemotherapy for ovarian cancer between January 2003 and December 2012 were analyzed retrospectively. All 15 patients completed 6 cycles of paclitaxel and carboplatin as the first-line chemotherapy. The complications were compared between therapeutic G-CSF cycles and prophylactic G-CSF cycles.Results: The number of chemotherapy cycles correlated with the ratio of prophylactic G-CSF cycles. It was considered that earlier prophylactic G-CSF injections were chosen due to a gradual decrease in WBC and neutrophil counts. The WBC and neutrophil counts were significantly higher in prophylactic G-CSF cycles than in therapeutic G-CSF cycles. However, there were no significant differences in the intervals of chemotherapy, delay of chemotherapy, and incidence of febrile neutropenia between the therapeutic G-CSF and prophylactic G-CSF cycles.Conclusion: Prophylactic G-CSF injections were not effective in preventing the incidence of febrile neutropenia in patients receiving paclitaxel and carboplatin combination chemotherapy for ovarian cancer.

Objective: To evaluate the characteristics and risk factors of puerperal hematoma. Materials and Methods: Data from the medical records of 2,776 women, who delivered vaginally between January 2008 and December 2017 in the authors’ hospital, were analyzed retrospectively. Results: Primigravida status was considered to be a significant risk factor. Among women with multigravida status, maternal age, instrumental delivery, and episiotomy were considered to be statistically significant risk factors. Regarding characteristics, hematoma occurred on the right side in 61.5% of cases, 53.8% were ≥50 mm in size, 61.5% were detected within 2 h of delivery, 46.2% were associated with severe pain, and 61.5% required surgical treatment. Conclusion: Primigravida status a risk factor for puerperal hematoma, and maternal age, instrumental delivery, and episiotomy were risk factors for puerperal hematoma in women with multigravida status. Puerperal hematomas occurred more frequently on the right side than the left reflected by the number of episiotomies performed on the right side. Approximately one-half of the hematomas were associated with severe pain, and many were detected within 2 h after delivery. Many hematomas, especially those associated with severe pain, required surgical removal.

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