Two separate nodules of Merkel cell carcinoma occurring concomitantly on one cheek

Merkel cell carcinoma (MCC) is a rare and highly aggressive neuroectodermal carcinoma arising from mechanoreceptor Merkel cells. Multiple MCCs are even rarer. We report a case of two independent MCCs simultaneously present in the cheek of a patient, which were effectively and esthetically treated using a cheek flap. Punch biopsy performed in a 60-year-old woman admitted with a chief complaint of two skin-colored hard nodules in her left cheek, accompanied by an itching sensation, was suggestive of MCC. Accordingly, we performed sentinel lymph node biopsy through the modified Blair incision under general anesthesia, in cooperation with the head and neck surgery department. The defect was covered with a cheek flap by slightly extending the existing incision following wide excision with a safety margin of 1 cm. This paper is significant in that it introduces an effective reconstruction technique that maintains function using a cheek flap for the management of this rare case. In addition, this paper is the first to classify multiple MCCs according to the time of onset. We believe that this paper presents an effective alternative reconstruction technique with sentinel node biopsy through the modified Blair incision.

Successful Surgical Treatment of a Recurrent Esophageal Malignant Gastrointestinal Neuroectodermal Tumor

Malignant gastrointestinal neuroectodermal tumor (GNET) is a very rare disease entity, especially in the esophagus. The diagnosis of GNET is based on histologic, immunohistochemical, and genetic findings. The choice of treatment is complete resection, and further treatment options can be considered. Herein, we describe a case of successful surgical treatment of a 23-year-old man with recurrent malignant esophageal GNET.

Pediatric Ewing's Sarcoma/Primitive Neuroectodermal Tumor (ES/PNET) Developed in the Small Intestine: A Case Report / 임상소아혈액종양

Ewing sarcoma/primitive neuroectodermal tumors (ES/PNET) are a group of malignant tumors with varying degrees of neuroectodermal differentiation. Although it may develop in any organs, ES/PNET originating from small intestine is exceedingly rare. We experienced a 9-year-old girl presenting with abdominal pain, melena, and iron deficiency anemia. Imaging work-up showed multiple masses in the small bowel and omentum with disseminated peritoneal seeding nodules, indicating lymphoma as the most likely diagnosis. Pathological reports from explorative diagnostic laparoscopic biopsy showed tumors comprising small round cells with CD99 expression and EWS-FLI1 translocation leading to the diagnosis of ES/PNET. Tumor burden decreased gradually during five consecutive cycles of systemic chemotherapy. The patient received segmental resection of jejunum, followed by adjuvant chemotherapy. This is the first pediatric case of ES/PNET found in small intestine in Korea.

Pediatric Ewing's Sarcoma/Primitive Neuroectodermal Tumor (ES/PNET) Developed in the Small Intestine: A Case Report / 임상소아혈액종양

Ewing sarcoma/primitive neuroectodermal tumors (ES/PNET) are a group of malignant tumors with varying degrees of neuroectodermal differentiation. Although it may develop in any organs, ES/PNET originating from small intestine is exceedingly rare. We experienced a 9-year-old girl presenting with abdominal pain, melena, and iron deficiency anemia. Imaging work-up showed multiple masses in the small bowel and omentum with disseminated peritoneal seeding nodules, indicating lymphoma as the most likely diagnosis. Pathological reports from explorative diagnostic laparoscopic biopsy showed tumors comprising small round cells with CD99 expression and EWS-FLI1 translocation leading to the diagnosis of ES/PNET. Tumor burden decreased gradually during five consecutive cycles of systemic chemotherapy. The patient received segmental resection of jejunum, followed by adjuvant chemotherapy. This is the first pediatric case of ES/PNET found in small intestine in Korea.

Diagnostic Significance of Cellular Neuroglial Tissue in Ovarian Immature Teratoma

BACKGROUND: Immature teratoma (IT) is a tumor containing immature neuroectodermal tissue, primarily in the form of neuroepithelial tubules. However, the diagnosis of tumors containing only cellular neuroglial tissue (CNT) without distinct neuroepithelial tubules is often difficult, since the histological characteristics of immature neuroectodermal tissues remain unclear. Here, we examined the significance of CNT and tried to define immature neuroectodermal tissues by comparing the histological features of neuroglial tissues between mature teratoma (MT) and IT. METHODS: The histological features of neuroglial tissue, including the cellularity, border between the neuroglial and adjacent tissues, cellular composition, mitotic index, Ki-67 proliferation rate, presence or absence of tissue necrosis, vascularity, and endothelial hyperplasia, were compared between 91 MT and 35 IT cases. RESULTS: CNTs with a cellularity grade of ≥ 2 were observed in 96% of IT cases and 4% of MT cases (p < .001); however, CNT with a cellularity grade of 3 in MT cases was confined to the histologically distinct granular layer of mature cerebellar tissue. Moreover, CNT in IT exhibited significantly higher rates of Ki-67 proliferation, mitoses, and necrosis than those in MT (p < .001). Furthermore, an infiltrative border of neuroglial tissue and glomeruloid endothelial hyperplasia were significantly more frequent in IT cases than in MT cases (p < .001). CONCLUSIONS: Our results suggest that if CNT with a cellularity grade of ≥ 2 is not a component of cerebellar tissue, such cases should be diagnosed as IT containing immature neuroectodermal tissue, particularly if they exhibit an infiltrative border, mitoses, necrosis, and increased Ki-67 proliferation.

Células de la cresta neural: Evolución, bases embrionarias y desarrollo cráneo-facial. Revisión sistemática de la literatura / Neural crest cells: Evolution, embryonic bases and craniofacial development. Systematic literature review

Las células de la cresta neural constituyen una población de células embrionarias - pluripotenciales que se diferencian desde el neuro-ectodermo y cuya aparición se constituye en una innovación evolutiva que le permitió a los vertebrados desarrollar una serie de estructuras morfo-funcionales para adaptarse de un estilo de alimentación suspensívora-filtradora a una predadora activa mucho mas eficiente. Esta revisión sistemática de la literatura describe el papel fundamental de las células de la cresta neu - ral en el desarrollo evolutivo y embrionario de las estructuras cráneo-faciales. Con este propósito se realizó una búsqueda en PubMed a través del descriptor en salud (MeSh) "neural crest" combinado con las expresiones "neurulation, evolution, embryonic and fetal development, craniofa - cialdevelopment" a través de los conectores boleanos "AND" y "+". Palabras claves: Neurulación, placa neu- ral, cresta neural, células de la cresta neural, desarrollo embrionario y fetal, desarrollo cráneo-facial.

The neural crest cells are a population of embryonic stem cells that differentiate from the neuro-ectoderm and whose appearance constitutes an evolutionary innovation allowed vertebrates develop different morpho-functional structures to adapt from asuspensivorous eating style to a predatory style, much more efficient. This systematic literature review describes the essential role of neural crest cells in the evolutionary and embryonic development of the craniofa - cial structures of the vertebrates.For this purpose we searched PubMed through the Medical Subject Headings (MeSh) "neural crest" combined with the terms "neurula - tion, evolution, embryonic and fetal develo - pment, craniofacial development" through the Boolean connectors"AND" y "+".

Expression analysis of ciliary rootlet coiled coil protein mRNA during Xenopus development / 대한수의학회지

Ciliary rootlet coiled coil protein (CROCC), the structural component that originates from the basal body at the proximal end of the ciliary rootlet, plays a crucial role in maintaining the cellular integrity of ciliated cells. In the current study, we cloned Xenopus CROCC and performed the expression analysis. The amino acid sequence of Xenopus laevis was related to those of Drosophila, cow, goat, horse, chicken, mouse and human. Reverse transcription polymerase chain reaction analysis revealed that CROCC mRNA encoding a coiled coil protein was present maternally, as well as throughout early development. In situ hybridization indicated that CROCC mRNA occurred in the animal pole of embryo during gastrulation and subsequently in the presumptive neuroectoderm at the end of gastrulation. At tailbud stages, CROCC mRNA expression was localized in the anterior roof plate of the developing brain, pharyngeal epithelium connected to gills, esophagus, olfactory placode, intestine and nephrostomes of the pronephric kidney. Our study suggests that CROCC may be responsible for control of the development of various ciliated organs.

Sox9 regulates development of neural crest and otic placode in a time- and dose-dependent fashion / 동물의과학연구지

Neural crest and placodes share a number of important features, pointing to a possible common evolutionary origin. They both arise from the neural plate border, which is the boundary between the non-neural ectoderm and neural plate. The transcription factor Sox9 has been implicated in neural crest and otic placode induction in several species. To investigate the differential regulation of neural crest and otic placode induction by Sox9, a gain of function assay was performed using a hormone-inducible version of the Sox9 construct at different doses and time periods. Sox9 was expressed in both neural crest and otic placode cell populations in the same stage embryos by in situ hybridization. Using a gain of function approach, increased expression of neural crest marker (Snail2) and otic placode marker (Pax8) in Sox9-overexpressed embryos was observed. Higher dose of Sox9 reduced or eliminated both neural crest and placode cells in the embryos. Interestingly, otic placodes cells were more strongly affected as compared to neural crest cells. So, optimal dosage and timing of Sox9 expression are important for the development of the neural crest and otic placode. The development of the neural crest and otic placode are affected by Sox9 in a time- and dose-dependent manner.

Temporal and Spatial Expression Patterns of miR-302 and miR-367 During Early Embryonic Chick Development

The microRNAs (miRNAs) are small, non-coding RNAs that modulate protein expression by interfering with target mRNA translation or stability. miRNAs play crucial roles in various functions such as cellular, developmental, and physiological processes. The spatial expression patterns of miRNAs are very essential for identifying their functions. The expressions of miR-302 and miR-367 are critical in maintaining stemness of pluripotent stem cells, including embryonic stem cells (ESCs) and induced pluripotent stem cells (iPSCs) but their functions in early development are not fully elucidated. So, we used Locked Nucleic Acid (LNA) probes to perform in situ hybridization and confirmed the temporal and spatial distribution patterns during early chick development. As a result, we found that miR-302 and miR-367 were expressed in various tissues such as primitive steak, neural ectoderm, neural plate, neural fold, neural tube, notochord, and oral cavity. Specially, we confirmed that miR-302 and miR-367 were strongly expressed in neural folds in HH8 to HH10. miR-302 was expressed on dorsal part of the neural tube but miR-367 was expressed on lateral and ventral parts of the neural tube. And also we performed quantitative stem-loop real-time PCR to analyze global expression level of miR-302 and miR-367. miR-302 and miR-367 expression was sustained before Hamburger and Hamilton stage (HH) 14. Thus, the temporal and spatial expression patterns of miR-302 and miR-367 may provide us information of the role of these miRNAs on tissue formation during early chick development.

Congenital Melanocytic Nevus with Asymptomatic Neurocutaneous Melanosis / 대한피부과학회지

Congenital melanocytic nevi (CMN) are benign pigmented lesions that are defined as a tissue malformation of the neuroectoderm. Giant melanocytic nevi with multifocal involvement show significantly greater risk of developing malignant melanomas and neurocutaneous melanocytosis, particularly those in a posterior axial location. Neurocutaneous melanosis is a rare, congenital, non-inherited disorder characterized by the presence of large, multiple congenital melanocytic nevi with proliferation of melanocytes in the central nervous system. Asymptomatic neurocutaneous melanosis can be detectable only by MRI. The patients who have clinical manifestations have an extremely poor prognosis. We present a patient with giant congenital melanocytic nevi involving a major portion of the back with multiple satellite nevi scattered over the whole body associated with asymptomatic neurocutaneous melanosis. We emphasize the importance of imaging study for detection of early neurological symptoms or melanomas. To our knowledge, this is the first case of giant congenital melanocytic nevi associated with asymptomatic neurocutaneous melanosis in Korean dermatologic literatures.

A Case of Primitive Neuroectodermal Tumor in the Nasal Cavity

A primitive neuroectodermal tumor is a highly malignant, small, round-cell tumor characterized by a neuroectodermal origin and poor prognosis. These tumors are found in nervous tissue in children and adolescents. The thoracopulmonary region is known to be the most common site of this disease, and it is rare that a primitive neuroectodermal tumor would occur in the nasal cavity. We report a case of a primitive neuroectodermal tumor in the left nasal cavity with a review of relevant literature.

Gastrointestinal Stromal Tumors in a Patient with Neurofibromatosis Type 1 / 대한내과학회지

Neurofibromatosis type 1 (NF1) is a genetic disease characterized by neoplastic and non-neoplastic disorders involving tissues of neuroectodermal and mesenchymal origin. NF1 is caused by mutations in the NF1 gene, which is found on chromosome 17q11.2. Patients with NF1 are at increased risk of developing soft tissue sarcomas that arise within the stromal compartment of the gastrointestinal tract, termed gastrointestinal stromal tumors (GISTs). GISTs associated with neurofibromatosis differ from sporadic GISTs, particularly with respect to their lower response rate to imatinib. We recently experienced a case involving a 45-year-old man with NF1 who was admitted to the hospital with epigastric pain and vomiting. Abdominal computed tomography revealed a duodenal GIST with pancreatic invasion. He had a base substitution mutation involving replacement of 2041 cytosine with thymine. He was treated successfully with a surgical operation and adjuvant imatinib therapy.

Gastrointestinal Stromal Tumors in a Patient with Neurofibromatosis Type 1 / 대한내과학회지

Neurofibromatosis type 1 (NF1) is a genetic disease characterized by neoplastic and non-neoplastic disorders involving tissues of neuroectodermal and mesenchymal origin. NF1 is caused by mutations in the NF1 gene, which is found on chromosome 17q11.2. Patients with NF1 are at increased risk of developing soft tissue sarcomas that arise within the stromal compartment of the gastrointestinal tract, termed gastrointestinal stromal tumors (GISTs). GISTs associated with neurofibromatosis differ from sporadic GISTs, particularly with respect to their lower response rate to imatinib. We recently experienced a case involving a 45-year-old man with NF1 who was admitted to the hospital with epigastric pain and vomiting. Abdominal computed tomography revealed a duodenal GIST with pancreatic invasion. He had a base substitution mutation involving replacement of 2041 cytosine with thymine. He was treated successfully with a surgical operation and adjuvant imatinib therapy.

Surgical Correction of Disfiguring Plexiform Neurofibroma Using an Anterolateral Thigh Free Flap

PURPOSE: Neurofibromas of neuroectodermal origin are commonly found in Von Recklinghausens disease or neurofibormatosis type 1. It is an autosomal dominant disease caused by mutation of the long arm of chromosome 17. It can present from small nodules to disfiguring giant tumor. Plexiform neurofibroma is benign in most cases, but it could be transformed into malignant tumor, which requires surgical excision. To cover the defects after the excision, a number of surgical correction methods are available. This study is to report a surgical correction of disfiguring plexiform neurofibroma using anterolateral thigh free flap for extensive defects after surgical excision of neurofibrona. METHODS: Data of five neurofibroma patients with an average age of 39 including medical history, physical examination, computed tomography, and magnetic resonance imaging were checked. No disease other than neurofibroma were detected. Biopsy on the excised tissues was performed. The follow-up period was 7 to 27 months. RESULTS: The average size of defects after complete excision of neurofibroma was 13x10~25x15cm. Defects were covered by anterolateral thigh free flap, while donor sites were covered by local flap, split thickness skin graft and regional flap. Throughout follow-up, there were no complication, relapse, or any abnormalities. CONCLUSION: Despite various surgical correction methods are applicable to defects after excision on disfiguring plexiform neurofibroma, coverage of massive defects is still challenging in plastic and reconstructive surgeon. We have made five successful cases of surgical correction of disfiguring plexiform neurofibroma using anterolateral thigh free flap.

Inducción de placas ateromatosas en ratas Wistar crónicamente infectadas con Trypanosoma cruzi: alimentadas con dieta rica en grasas / Induction of atheromatous plaques in Wistar rats chronically infected with Trypanosoma cruzi: fed high fat diet

En el presente trabajo se investiga la inducción de placas ateromatosas en ratas albinas machos, cepa Wistar (Rattus norvegicus) crónicamente infectadas con Trypanosoma cruzi y alimentadas ad libitum con una dieta rica en grasas de origen vegetal, durante tres meses. La infección crónica evidenciada por pruebas sero-parasitológicas, reveló presenciade anticuerpos IgG anti- T. cruzi y ausencia de parasitemiaspatentes. La dieta rica en grasas produjo en las ratas infectadas (A) y sanas (C) un aumento significativo en el peso (P<0,05), en comparación con las ratas controles (B) y sanas (D) sometidas a la dieta normal. El estudio histopatológicode secciones de la arteria aorta de las ratas del grupo A (infectadas/dieta grasa), mostró abundantes depósitoslipídicos, procesos inflamatorios (vasculitis) y placas ateromatosas en formación. En las secciones de corazón y músculo esquelético se evidenció miocarditis y miositis con características de cronicidad sin parasitismo tisular. Las pruebas inmunohistoquímicas aplicadas a los cortes de arteria,corazón y músculo esquelético de las ratas infectadas A (infectadas/dieta-grasa) y B (infectadas/dieta-normal), mostraron abundantes depósitos antigénicos, lo que indica persistencia de antígenos parasitarios. En conclusión, las ratasinfectadas con T. cruzi alimentadas con la dieta rica en grasas, tienen una mayor propección a desarrollar placas ateromatosas.Los resultados demostraron que una dieta hiperlipídicaes un factor de riesgo para el desarrollo de enfermedadateromatosa en individuos con enfermedad de Chagas

This work is focused on the induction of atheromatous plaques in male albino rats (Rattus norvegicus), Wistar, chronically infected with Trypanosoma cruzi and fed ad libitum with diet rich in fats of vegetal origin, during three months. The chronic infection detected by serological and parasitological assays, revealed the presence of antibodies IgG anti- T. cruzi and the absence of patents parasitemias. The diet rich in fats produced in the group of infected rats (A) and the group of healthy rats (C) a significant increase in the weight (P<0,05), in comparison with the control group of infected rats (B) and the group of healthy rats (D), fed with a normal diet. The histopathological study of sections of the aorta arteryof the rats of the group (A) (infected/diet fat), showed abundants lipid deposits, inflammatory processes (vasculitis) and atheromatous plaques in development. The sections of the heart and skeletal muscle showed pictures of a myocarditis and myositis with features of chronic tissue without parasitism. The immunohistochemestry assays applied to the cuts of artery, heart and skeletal muscle of the infected rats A (diet/fat) and B (normal/diet), showed abundants antigen deposits. In conclusion, the rats chronically infected with T. cruzi and fed with a diet rich in fats, have a main propensity to develop atheromatous plaques. The results showed that a hyperlipidic diet is a risk factor for the development of atheromatous disease in individuals with Chagas`disease

Cervical Ganglioneuroma Associated with Neurofibromatosis Type 1

PURPOSE: Ganglioneuromas are well-differentiated tumors derived from neuroectodermal neural crest cells. Although these tumors can occur anywhere along the sympathetic chain from the base of the skull to the pelvic cavity, they usually develop in the posterior mediastinum and retroperitoneum these tumors are rarely found in the cervical region. METHODS: We report the case of a 16-year-old male patient with neurofibromatosis type 1 who was admitted because of a palpable mass centrally located on the left side of the neck. A preoperative contrast-enhanced neck computed tomography image showed a low-density homogeneous mass on the parapharyngeal space along with marked displacement of the trachea and carotid vessels. Round and soft masses were also detected on both axillae. RESULTS: The patient subsequently underwent complete excision of the neck mass via the transcervical approach. The mass was smooth and well encapsulated between the sternocleidomastoid muscle and the trachea. Further, the mass appeared to arise from the cervical sympathetic chain, which was preserved during surgery. Both the axillary masses were also excised. The histopathological findings were ganglioneuroma for the neck mass and neurofibroma for both the axillary masses. CONCLUSION: Cervical ganglioneuromas are rare tumors that present as enlarging parapharyngeal cervical masses in the oropharynx or neck. To our knowledge, a case of cervical ganglioneuroma associated with neurofibromatosis type 1 has never been reported. In patients with neurofibromatosis, multiple tumors may develop, and therefore periodic clinical and radiological follow-up is recommended. Further, repeated imaging analysis should be performed if the presence of another tumor is suspected.

A Case Report of Congenital Spinal Dermal Sinus Tract

PURPOSE: Congenital spinal dermal sinus tract is a rare lesion connecting skin to deeper structures including neural tissue. It results from the failure of the neuroectoderm to separate from the cutaneous ectoderm in the third to fifth week of gestation. The common locations are the lumbosacral and occipital regions. Sometimes it extends to spinal canal. In this paper we report a case of congenital spinal dermal sinus tract in the coccyx. METHODS: A 21-month-old male child born after an uncomplicated full-term pregnancy was admitted to our institute with a midline dermal sinus and a cartilaginous protrusion in the coccygeal region. There were no signs of infection. Neurologic examination showed no functional deficit in both lower limbs. He was treated with complete excision of the tract and an underlying accessory cartilage. RESULTS: The spinal dermal sinus tract was extended from the skin to the coccyx. The stalk was loosely attached to the accessory cartilage of coccyx. At that point, it was dissected from the accessory cartilage and resected. The accessory cartilage was also resected at the bone and cartilage junction. During the follow-up period of 6 months, the wound healed well without any complication nor recurrence. CONCLUSION: Congenital spinal dermal sinus tract is known as a form of spinal dysraphism. In order to prevent complications, timely surgical intervention including complete resection of sinus tract with correction of associated abnormalities is of utmost importance.

Isolation of Early Neurogenesis Genes with Xenopus cDNA Microarray / 한국실험동물학회지

Neurogenesis is the process that develops neuroectoderm from ectoderm. Bone morphogenetic protein (BMP) inhibition in ectodermal cells is necessary and sufficient for neurogenesis in Xenopus embryos. To isolate genes involved in early neurogenesis, Xenous Affymetrix gene chips representing 14,400 genes were analyzed in early stage of neuroectodermal cells that were produced by inhibition of BMP signaling with overexpression of a dominant-negative receptor. We identified 265 candidate genes including 107 ESTs which were newly expressed during the early neurogenesis by blocking BMP signaling. The candidates of 10 ESTs were selected and examined for upregulation in neuroectoderm. Five EST genes were confirmed to be upregulated in neuroectoderm and examined for time-dependent expression patterns in intact embryos. Two EST genes were cloned and identified as a homology of CYP26c (Xl.1946.1.A1_at) and Kielin containing VWC domain (Xl.15853.1.A1_at). One of them, CYP26c, was further characterized for its transcriptional regulation and role of anterior-posterior patterning during neurogenesis. Taken together, we analyzed and characterized genes expressed in early neurogenesis. The results suggest that neurogenesis by inhibition of BMP provides useful system to isolate genes involved in early events of neurogenesis during early vertebrate embryogenesis.

Two cases of immature teratoma / 대한산부인과학회지

About 20~30% of benign or malignant tumors of ovarian origin arise from embryonic cells, and only 3% represent malignancy. But under age of 20, 70% of ovarian tumors arise from embryonic cells, and over 1/3 of them are malignant tumors. Over all the ovarian tumors arising from embryonic cells, immature teratoma is germ cell tumor, components include immature tissues and cells derived from ectoderm, mesoderm, and endomermal origins. Most of the immature tissues are from neuroectodermal origins. The immature teratoma of the ovary is a rare tumor, representing less than 1% of all ovarian neoplasm. These tumors typically present in young age woman (mean age 10~20 years) with pelvic and abdominal pain. Nowadays newly developed combination chemotherapeutic agents such as bleomycin, etoposide, cisplatin give us great survival and disease free prognosis than before. We have experienced two cases of immature teratoma so we report them with a brief review of concerned literatures.

Effect of Recombinant Basic Fibroblast Growth Factor (Fiblast(R)) in Treatment with Chronic Soft Tissue Defect

PURPOSE: Chronic soft tissue defects resulting from pressure sore, trauma or comorbid disease such as diabetes, osteomyelitis are difficult to treat. Although many advances have been made, consensus on the best treatment to hasten healing of chronic soft tissue defects has not been reached. Recently, it has been found that the wound healing could be accelerated by the action of growth factors. Fibroblast growth factor (FGF) stimulate proliferation and differentiation of neuroectodermal and mesodermal tissues (endothelial cells and fibroblasts), playing a key role in regeneration of granulation tissues. We report the effect of recombinant basic fibroblast growth factor, Fiblast(R) (Kaken Pharmaceutical, Japan) to chronic soft tissue defect. METHODS: From October 2009 to December 2009, 10 patients (7 men and 3 women) with chronic soft tissue defect were treated using bFGF. Average age, sex, treatment period, cause of soft tissue defect, size (volume, cm3) of wound during treatment, investigator global assessment were assessed. The bFGF was sprayed then foam dressing was applied to soft tissue defects. RESULTS: The average treatment period is 18.6 days (6~45days) and the average age is 41.5 (4~73 years old). Among 10 patients, 7 patients were with pressure sore and other 3 were with trauma, postoperative wound, burn. The size of wound was measured by volume (cm3), and it was decreased 49.5% (0~100%) after treatment. The Average investigator global assessment for these subjects was 2.4 on a 0~3 scale. (3; excellent, 2; good, 1; minimal effective, 0; no effective). No complication was seen locally or systemically with bFGF. CONCLUSION: Using of bFGF for chronic soft tissue defect decreased the size of wound while short period. Clinically, wound treatment with bFGF lead to reduction of the surgery area and healing of wound. Additional researches on investigating the different type of wounds, biological effects and underlying mechanisms are needed.