Postoperative Ultrasound Findings of the Rotator Cuff Tendon after Arthroscopic Repair of a Rotator Cuff Tear

Ultrasound (US) imaging is an efficient, easy to use, rapid, dynamic, noninvasive, with rare side-effects and inexpensive tool allowing for facilitated diagnosis and management of the painful shoulder. It also has advantages over other imaging modalities in the evaluation of the postoperative shoulder for rotator cuff integrity and correct anchor and suture placement, as well as rotator cuff analysis following repair surgery. Early postoperative tendons frequently had a hypo- echoic echo texture and the absence of a fibrillar pattern, which might be misinterpreted as recurrent tears. however, these features often normalized into tendons with an increased echo texture and the reappearance of a fibrillar pattern at 6 months. Based on these sequential findings, the US findings within 3 months after surgery should be interpreted with caution to accurately understand and monitor the repaired tendon status.

Comparison of Regeneration Effects of Direct and Alternating Microcurrent Therapy on Atrophied Calf Muscle in a Rabbit

Objective@#We compared the regenerative effects of microcurrent therapy (MT) according to the type of electric current, which were direct current microcurrent therapy (DCMT) and alternating current microcurrent therapy (ACMT) on atrophied calf muscle in cast-immobilized rabbit. @*Methods@#Rabbits were allocated into control group (sham MT), ACMT group, and DCMT group.Before starting treatment, right gastrocnemius (GCM) muscle was immobilized by cast for 2 weeks. Compound muscle action potential of tibial nerve in nerve conduction study, circumference of calf muscle using a ruler, and thickness of medial and lateral GCM muscle measured by ultrasound, cross sectional area (CSA), and proliferating cell nuclear antigen (PCNA) ratios (%) of muscle fibers were measured on the immunohistochemical analysis. @*Results@#The mean atrophic changes (%) in right medial and lateral GCM muscle thickness, right calf circumference, and amplitude of CMAP of the right tibial nerve in ACMT group and DCMT group were significantly lower than those in control group, respectively (p＜0.05). The mean CSA (μm 2 ) of type I and type II and PCNA ratios (%) of medial and lateral GCM muscle fibers in ACMT group and DCMT group were significantly greater than those in control group, respectively (p＜0.05). There were no significant differences between the ACMT group and DCMT group at all parameters. @*Conclusion@#This study demonstrated that ACMT and DCMT showed better regeneration effect than sham MT. Microcurrent may be effective in regeneration of atrophied muscle regardless of the type of current.

Postoperative Ultrasound Findings of the Rotator Cuff Tendon after Arthroscopic Repair of a Rotator Cuff Tear

Ultrasound (US) imaging is an efficient, easy to use, rapid, dynamic, noninvasive, with rare side-effects and inexpensive tool allowing for facilitated diagnosis and management of the painful shoulder. It also has advantages over other imaging modalities in the evaluation of the postoperative shoulder for rotator cuff integrity and correct anchor and suture placement, as well as rotator cuff analysis following repair surgery. Early postoperative tendons frequently had a hypo- echoic echo texture and the absence of a fibrillar pattern, which might be misinterpreted as recurrent tears. however, these features often normalized into tendons with an increased echo texture and the reappearance of a fibrillar pattern at 6 months. Based on these sequential findings, the US findings within 3 months after surgery should be interpreted with caution to accurately understand and monitor the repaired tendon status.

Comparison of Regeneration Effects of Direct and Alternating Microcurrent Therapy on Atrophied Calf Muscle in a Rabbit

Objective@#We compared the regenerative effects of microcurrent therapy (MT) according to the type of electric current, which were direct current microcurrent therapy (DCMT) and alternating current microcurrent therapy (ACMT) on atrophied calf muscle in cast-immobilized rabbit. @*Methods@#Rabbits were allocated into control group (sham MT), ACMT group, and DCMT group.Before starting treatment, right gastrocnemius (GCM) muscle was immobilized by cast for 2 weeks. Compound muscle action potential of tibial nerve in nerve conduction study, circumference of calf muscle using a ruler, and thickness of medial and lateral GCM muscle measured by ultrasound, cross sectional area (CSA), and proliferating cell nuclear antigen (PCNA) ratios (%) of muscle fibers were measured on the immunohistochemical analysis. @*Results@#The mean atrophic changes (%) in right medial and lateral GCM muscle thickness, right calf circumference, and amplitude of CMAP of the right tibial nerve in ACMT group and DCMT group were significantly lower than those in control group, respectively (p＜0.05). The mean CSA (μm 2 ) of type I and type II and PCNA ratios (%) of medial and lateral GCM muscle fibers in ACMT group and DCMT group were significantly greater than those in control group, respectively (p＜0.05). There were no significant differences between the ACMT group and DCMT group at all parameters. @*Conclusion@#This study demonstrated that ACMT and DCMT showed better regeneration effect than sham MT. Microcurrent may be effective in regeneration of atrophied muscle regardless of the type of current.

Korean Pain Descriptors in Patients with Neuromusculoskeletal Pain

OBJECTIVE: To evaluate which Korean pain descriptors are frequently used in the patients with neuromusculoskeletal diseases and compare the frequency of Korean pain descriptor according to age, gender, pain pattern and intensity, and clinical diagnosis.METHOD: Two hundreds sixty nine patients with neuromusculoskeletal diseases were enrolled in this study. The patients were asked to fill out a pain questionnaire using Korean. The Korean pain descriptors were collected and classified according to neurophysiological mechanism. The frequency of Korean pain descriptor was analyzed by age, gender, pain pattern and intensity, and clinical diagnosis. They were divided into axial spine and peripheral joint pain group depending on the location of causal disease and shoulder pain descriptors were divided into intra-articular and bursa group.RESULTS: Among 24 Korean pain descriptors, ‘arida’ was the most common pain descriptor, followed by ‘ssusida’ and ‘jjireunda’. When the pain descriptors were classified according to neurophysiological mechanism, superficial somatic pain was the most common, followed by deep somatic pain. There was a significant difference in the frequency of the pain descriptor between axial spine and peripheral joint pain group (p=0.007). The pain descriptor ‘danggida’ was used significantly more in the patients with axial spine pain than peripheral joint pain (p=0.024). However, there was no significant difference in other factors.CONCLUSION: The patients with neuromusculoskeletal diseases expressed their pain using various Korean pain descriptors with stabbing nature and superficial somatic pain. Our results may be helpful to assess and develop a new Korean pain quality measure in the patients with neuromusculoskeletal diseases.

Synergic Effects of Cranial Electrotherapy Stimulation with Sleep Hygiene in Patients with Chronic Insomnia

OBJECTIVES: To investigate the therapeutic effect of cranial electrotherapy stimulation (CES) with sleep hygiene in patients with chronic insomnia. METHODS: This study was designed as a prospective, double-blinded, and randomized controlled trial. Twenty-seven patients with chronic insomnia were recruited and randomly allocated to two groups; cranial microcurrent therapy (MC) group and sham group. All patients received sleep hygiene education. Pittsburgh Sleep Quality Index (PSQI) and Insomnia Severity Index (ISI) were measured at baseline (pre-treatment), and 2 weeks and 4 weeks of treatment. RESULTS: In MC group, the PSQI and ISI showed a tendency to decrease consistently until 4 weeks of treatment. In sham group, PSQI and ISI initially decreased during the first 2 weeks, but it increased after 2 weeks of treatment. CONCLUSIONS: This study showed that combination treatment of CES and sleep hygiene is more effective in treating chronic insomnia than sleep hygiene only as demonstrated by improvement and maintenance of sleep score for 1 month.

Thrombosed Fusiform Dilatation of Persistent Median Artery with Normal Median Nerve

Carpal tunnel syndrome can be produced by abnormal mass effect due to trauma, ganglion cysts, various soft tissue tumors, musculotendinous variants, and aberrant vascular structures. Persistent median artery is one of the causes of the carpal tunnel syndrome. Thrombosed persistent median artery usually accompanies the anomaly of the median nerve and causes a sudden onset of severe pain and paresthesia. In contrast to previous literature, we report the rare case of gradual onset and mild symptom of a 53-year-old man with a thrombosed persistent median artery but without anomaly of the median nerve and abnormal finding of electrophysiologic study.

Augmentation of respiratory muscle activities in preterm infants with feeding desaturation / 소아과

PURPOSE: Frequent desaturation due to immature incoordination of suck-swallow-breathing in preterm infants can influence multiple organs such as the heart, lungs, and brain, which can then affect growth and development. Most notably in preterm infants, feeding desaturation may even affect pulmonary function during gavage feeding. Because respiratory muscle activities may reflect the work required during respiration, we evaluated the differences in these activities between full-term and preterm infants with feeding desaturation, and investigated the correlations with clinical variables. METHODS: Nineteen preterm infants with feeding desaturation (group 1) and 19 age-matched full-term infants (group 2) were evaluated. Oromotor function was evaluated using video recording. The root-mean-squre (RMS) envelope of the electromyography signal was calculated to quantify the activities of muscles involved in respiration. The differences in RMS between both groups and the correlation with clinical variables including gestational age (GA), birth weight (BW), and Apgar scores (AS) at 1 and 5 minutes after birth were evaluated. RESULTS: The RMS values of the diaphragm (RMS-D) and rectus abdominis (RMS-R) were significantly greater in group 1 compared to group 2, and the 1- and 5-min AS were significantly lower in group 1 compared to group 2. RMS-D and RMS-R were inversely correlated with GA, BW, 1- and 5-min AS in all infants. CONCLUSION: This study showed that respiratory muscle activities were augmented during feeding in preterm infants compared to full-term infants. Additionally, respiratory muscle activities were inversely correlated with all clinical variables.

Stimulatory and Inhibitory Effects of Alternating Current on the Growth of Trichophyton rubrum / 대한의진균학회지

BACKGROUND@#Electric stimulation has been investigated for potential medical uses. Numerous articles have been published that focused on antimicrobial effects of electric current, but few studies have reported regarding modifications of fungal growth following exposure to electric current.@*OBJECTIVE@#To evaluate effects of low alternating current on the growth of Trichophyton rubrum.@*METHODS@#In total, 35 plates inoculated with T. rubrum were allocated to one of the five treatment groups (groups A, B, C, D, or E). Fungal colonies in each group were treated with a different intensity of electric current (0.5 µA, 4 µA, 25 µA, 600 µA, or 900 µA) at a frequency of 8 Hz. The area of each fungal colony was measured every other day for 7 days to evaluate the effects on fungal growth.@*RESULTS@#No experimental groups treated with electric current showed any statistically significant differences against the control groups.@*CONCLUSION@#Microcurrent did not show any detectable changes in the viability of the fungus. Our findings indicate that microcurrent may affect fungal seeding to the media rather than the growth rate. Unfortunately, there are limited studies on this topic, and further research is warranted to clarify the precise effect of electric stimulation on the activity of microorganisms.

Effects of Low Alternating Current on Growth of the Trichophyton tonsurans and Microsporum canis / 대한의진균학회지

BACKGROUND@#A large number of studies have been focused on bacterial growth but limited number of literature has been reported regarding modification of fungal growth.@*OBJECTIVE@#This study aims to investigate effects of low alternating current on Microsporum (M.) canis and Trichophyton (T.) tonsurans growth.@*METHODS@#Inoculums of M. canis and T. tonsurans were applied to twenty-four PDACT (potato dextrose agar-corn meal-Tween 80) plates with a sterile spreader. Petri dishes were allocated into 8 groups according to the fungi species and the amperage delivered to these dishes. Group A, B, C and D were M. canis group and E, F, G, H were T. tonsurans group. The given amperage of electric current was 0.5 µA in group A and E, 2 µA in B and F, 4 µA in C and G. No electric current was given in group D and H.@*RESULTS@#In groups A, B, and C the average time elapsed for colony appearances were 42 hours, 43.17 hours, and 40.5 hours respectively. The average time elapsed in the control group D was 88.67 hours. In groups E, F, and G the average time elapsed for colony appearances were 63.67 hours, 61.83 hours, and 64.17 hours respectively. The average time elapsed in the control group H was 90.60 hours.@*CONCLUSION@#With electric current, faster fungal growth was observed in the amperage range used in this study. Based on these results, we hypothesized that microcurrent helps the fungal growth.

Therapeutic Effect of Microcurrent Therapy in Children With In-toeing Gait Caused by Increased Femoral Anteversion: A Pilot Study

OBJECTIVE: To investigate the efficacy of portable microcurrent therapy device (PMTD) of the hip internal rotators in the treatment of in-toeing gait caused by increased femoral anteversion in children over 8 years of age. METHODS: Eleven children (22 legs; 4 boys and 7 girls; mean age, 10.4±1.6 years) with in-toeing gait caused by increased femoral anteversion were included in the present study. All children received 60 minutes of PMTD (intensity, 25 µA; frequency, 8 Hz) applied to the hip internal rotators daily for 4 weeks. Hip internal rotation (IR) angle, external rotation (ER) angle, and midmalleolar-second toe angle (MSTA) measurement during stance phase at transverse plane and Family Satisfaction Questionnaire, frequency of tripping and fatigue like pains about the PMTD were performed before treatment and at 4 weeks after initial PMTD treatment. Paired t-test and Fisher exact test were used for statistical analysis. RESULTS: Hip IR/ER/MSTA was 70.3°±5.4°/20.1°±5.5°/–11.4°±2.7°, and 55.7°±7.8°/33.6°±8.2°/–2.6°±3.8° before treatment and at 4 weeks after initial PMTD treatment, respectively (p<0.01). Ten of 11 (91%) children's family stated that they were generally satisfied with the PMTD treatment. The frequency of tripping and fatigue like pains was significantly lower at 4 weeks after PMTD treatment (p<0.05). Excellent inter-rater and intra-rater reliability was observed for repeated MSTA measurements between the examiners (k=0.91–0.96 and k=0.93–0.99), respectively. CONCLUSION: PMTD of the hip internal rotators can be effective in improving the gait pattern of children with in-toeing gait caused by increased femoral anteversion.

Regenerative Medicine in the Treatment of Sports Injuries: Prolotherapy and Extracorporeal Shock Wave Therapy / 대한스포츠의학회지

The treatment of sports injuries traditionally has included the use of the PRICE principle (protection, rest, ice/cold, compression, and elevation), analgesics/nonsteroidal anti-inflammatory drugs (NSAIDs), and, commonly, corticosteroids. Although NSAIDs, modalities, and corticosteroids may be helpful for short-term pain reduction and early recovery of function, they do not typically reverse the structural changes associated with degenerative conditions and may contribute to even worse long-term outcomes by potentially interfering with tissue healing. Regenerative interventions, including prolotherapy and extracorporeal shock wave therapy, recently have been used to treat refractory painful conditions such as chronic tendinopathies because of the potential of these interventions to facilitate tissue healing. The true utility of prolotherapy and regenerative medicine for sports injuries will become clearer as more high-quality research is published.

Investigating Effects of Nano- to Micro-Ampere Alternating Current Stimulation on Trichophyton rubrum Growth

BACKGROUND: Fungi are eukaryotic microorganisms including yeast and molds. Many studies have focused on modifying bacterial growth, but few on fungal growth. Microcurrent electricity may stimulate fungal growth. OBJECTIVE: This study aims to investigate effects of microcurrent electric stimulation on Trichophyton rubrum growth. METHODS: Standard-sized inoculums of T. rubrum derived from a spore suspension were applied to potato dextrose cornmeal agar (PDACC) plates, gently withdrawn with a sterile pipette, and were applied to twelve PDACC plates with a sterile spreader. Twelve Petri dishes were divided into four groups. The given amperage of electric current was 500 nA, 2 µA, and 4 µA in groups A, B, and C, respectively. No electric current was given in group D. RESULTS: In the first 48 hours, colonies only appeared in groups A and B (500 nA and 2 µA exposure). Colonies in group A (500 nA) were denser. Group C (4 µA) plates showed a barely visible film of fungus after 96 hours of incubation. Fungal growth became visible after 144 hours in the control group. CONCLUSION: Lower intensities of electric current caused faster fungal growth within the amperage range used in this study. Based on these results, further studies with a larger sample size, various fungal species, and various intensities of electric stimulation should be conducted.

Therapeutic Effect of Extracorporeal Shock Wave Therapy According to Treatment Session on Gastrocnemius Muscle Spasticity in Children With Spastic Cerebral Palsy: A Pilot Study

OBJECTIVE: To investigate the therapeutic effect of extracorporeal shockwave therapy (ESWT) according to treatment session on gastrocnemius muscle spasticity in children with spastic cerebral palsy (CP). METHODS: Twelve children with spastic CP underwent 1 ESWT and 2 sham ESWT sessions for gastrocnemius (group 1) or 3 ESWT sessions (group 2) once per week for 3 weeks. Modified Ashworth Scale (MAS) score, passive range of motion (PROM) of the ankle plantar-flexor muscles with knee extension, and median red pixel intensity (RPI) of color histogram of medial gastrocnemius on real-time sonoelastography (RTS) were measured before ESWT, immediately after the first and third ESWT, and at 4 weeks after the third ESWT. RESULTS: Mean ankle PROM was significantly increased whereas as mean ankle MAS and median gastrocnemius RPI were significantly decreased in both groups after the first ESWT. Clinical and RTS parameters before ESWT were not significantly different from those immediately after the third ESWT or at 4 weeks after the third ESWT in group 1. However, they were significantly different from those immediately after the third ESWT or at 4 weeks after the third ESWT in group 2. Mean ankle PROM, mean ankle MAS, and median gastrocnemius RPI in group 2 were significantly different from that in group 1 at 4 weeks or immediately after the third ESWT. CONCLUSION: The therapeutic effect of ESWT on spastic medial gastrocnemius in children with spastic CP is dependent on the number of ESWT sessions.

A New Ultrasound Method for Assessment of Head Shape Change in Infants With Plagiocephaly

OBJECTIVE: To compare a new ultrasound measurement method with calliper cephalometry in infants with deformational plagiocephaly (DP) and to assess the differences of two methods according to the severity of DP. METHODS: Fifty-two infants with DP were divided into two groups according to the degree of cranial vault asymmetry (CVA); group 1 included 42 infants with CVA over 10 mm, and group 2 included 10 infants with CVA under 10 mm. Cranial vault asymmetry index (CVAI) and occipital angle ratio (OAR) were measured by using calliper and ultrasound measurements, respectively. The occipital angle was defined as the angle between the lines projected along the lambdoid sutures of the skull. RESULTS: The occipital angles of the affected sides were significantly greater than those of unaffected sides in both groups. The CVAI and OAR were significantly greater in group 1 than in group 2 (CVAI, 9.3%+/-2.3% vs. 4.6%+/-1.5%; OAR, 1.05+/-0.4 vs. 1.01+/-0.0; p<0.05). The OAR was positively correlated with the CVAI in all infants (r=0.789) and in group 1 (r=0.784; p<0.05). CONCLUSION: Our study revealed that OAR using the new ultrasound measurement was positively correlated with the CVAI in infants with DP. Therefore, the occipital angle measurement using ultrasound combined with cephalometry could provide better understanding about the characteristics of the overall cranial bone and lambdoid suture complex in infants with DP.

Comparison of Treatment Effects Between Children With Spastic Cerebral Palsy Under and Over Five Years After Botulinum Toxin Type A Injection

OBJECTIVE: To evaluate whether age influences a change in the spasticity of the ankle plantar flexor after botulinum toxin type A (BTA) injection in children with spastic cerebral palsy (CP). METHODS: Sixteen children with spastic CP were enrolled in the study. Seven children (group 1) were under 5 years of age, and nine (group 2) were over 5 years of age. They all received BTA injection in the gastrocnemius muscle (GCM) under ultrasound guidance. Passive range of motion (PROM) of ankle dorsiflexion, Modified Ashworth Scale (MAS) of the ankle plantar flexor, Gross Motor Function Measure (GMFM) and median red pixel intensity (RPI) of the medial GCM on real-time sonoelastography were measured at baseline (pre-injection) and 1-, 3-, and 6-month post-injection. RESULTS: In both groups, the mean PROM, MAS, and RPI were significantly improved after injection until 6-month post-injection. The change of PROM of ankle dorsiflexion in group 1 was significantly greater than that in group 2, until 6-month post-injection. The change in the MAS and GMFM between baseline and 6-month post-injection in group 1 was greater than that in group 2. The changes in the median RPI between baseline and 3- and 6-month post-injections were greater in group 1 than in group 2. CONCLUSION: Our pilot study demonstrated the different changes in spasticity of the ankle plantar flexor after BTA injection based on age. Therefore, age may be considered when establishing a treatment plan using BTA injection for children with spastic CP.

Comparison of Treatment Effects Between Children With Spastic Cerebral Palsy Under and Over Five Years After Botulinum Toxin Type A Injection

OBJECTIVE: To evaluate whether age influences a change in the spasticity of the ankle plantar flexor after botulinum toxin type A (BTA) injection in children with spastic cerebral palsy (CP). METHODS: Sixteen children with spastic CP were enrolled in the study. Seven children (group 1) were under 5 years of age, and nine (group 2) were over 5 years of age. They all received BTA injection in the gastrocnemius muscle (GCM) under ultrasound guidance. Passive range of motion (PROM) of ankle dorsiflexion, Modified Ashworth Scale (MAS) of the ankle plantar flexor, Gross Motor Function Measure (GMFM) and median red pixel intensity (RPI) of the medial GCM on real-time sonoelastography were measured at baseline (pre-injection) and 1-, 3-, and 6-month post-injection. RESULTS: In both groups, the mean PROM, MAS, and RPI were significantly improved after injection until 6-month post-injection. The change of PROM of ankle dorsiflexion in group 1 was significantly greater than that in group 2, until 6-month post-injection. The change in the MAS and GMFM between baseline and 6-month post-injection in group 1 was greater than that in group 2. The changes in the median RPI between baseline and 3- and 6-month post-injections were greater in group 1 than in group 2. CONCLUSION: Our pilot study demonstrated the different changes in spasticity of the ankle plantar flexor after BTA injection based on age. Therefore, age may be considered when establishing a treatment plan using BTA injection for children with spastic CP.

The Effects of Intra-Articular Platelet-Rich Plasma Injection According to the Severity of Collagenase-Induced Knee Osteoarthritis in a Rabbit Model

OBJECTIVE: To investigate whether the cartilage regenerative effects of intra-aricular platelet-rich plasma (PRP) are different, according to the severity of osteoarthritis (OA), in a collagenase-induced knee OA rabbit model. METHOD: New Zealand white rabbits (N=21) were randomly divided into three groups. Three different doses (0.25 mg, group 1; 0.5 mg, group 2; and 1.0 mg, group 3) of collagenase were injected twice into both knees of each group under an ultrasound guidance. The mean platelet concentration of the PRP fraction was 2,664+/-970x10(3)/microl and was enriched 8.2-times, compared with the whole blood. PRP (0.3 ml) was injected into the left knee and saline (0.3 ml) into the right knee at 4 weeks, and macroscopic and histological scores of both injected knees were evaluated at 9 weeks after the first collagenase injection. RESULTS: Macroscopic and histological scores of group 3 were significantly higher than those of group 1 and 2 (p<0.05). Macroscopic and histological scores of the PRP-injected knees were significantly lower than those of the saline-injected knees, in all groups (p<0.05). Differences of gross morphologic and histologic scores between saline- and PRP-injected knees in group 3 were significantly higher than those in group 1 and 2 (p<0.05). CONCLUSION: Intra-articular PRP injection influences cartilage regeneration in all severities of rabbit knee OA, and the cartilage regenerative power of PRP injection in moderate knee OA was greater than that in mild or very mild OA. A large preclinical trial is needed to establish the validity of our study.

The Change of Intrinsic Stiffness in Gastrocnemius after Intensive Rehabilitation with Botulinum Toxin A Injection in Spastic Diplegic Cerebral Palsy

A recent study claimed that botulinum toxin A (BTX-A) injection into the calf muscle of cerebral palsy (CP) children did not change the intrinsic stiffness. Contrary to this recent report, in our case, decreased muscle spasticity, which was measured using a modified Ashworth scale, and increased Gross Motor Function Measure score were demonstrated at 4 weeks after intensive rehabilitation treatment (IRT) with BTX-A injection to the medial gastrocnemius muscle in a child with spastic CP. Additionally, we indentified decreased muscle stiffness which was demonstrated by a decrease in the color-coded scale and shear velocity, and an increase in the strain ratio using dynamic sonoelastography.

Reference Value for the Cross Sectional Area of Fibular Nerve Ultrasonography through the Anatomic Investigation in Korean

OBJECTIVE: To investigate the reference value for cross sectional area (CSA) of the fibular nerve in Koreans. METHOD: One musculoskeletal radiologist and one physiatrist performed fibular nerve ultrasonography (US) on 60 lower extremities of 30 asymptomatic Korean volunteers (16 males, 14 females). The mean age was 46.6 years (range: 21-75 years). We measured CSA of the fibular nerve at three sites: proximal portion (PP) at the bifurcation, mid-portion (MP), and an area just above the fibular head (FH). In addition, the fibular nerves of 7 lower extremities from 4 cadavers were cut from the fibular head to the proximal portion and divided into three sections (PP, MP, FH). They were subsequently fixed with 10% neutral buffered formalin and perpendicularly excised to 2 mm thickness. They were photographed by an operating microscope and CSA was measured. Using the Kruskal-Wallis test, measurements obtained from US images were compared between asymptomatic volunteers with a significance level of 0.05. RESULTS: In asymptomatic volunteers, the CSA of the three portions were PP: 13.8+/-1.2 mm2, MP: 11.1+/-1.0 mm2, FH: 10.9+/-0.6 mm2. The fibular nerves were well visualized with clear borders by US. In cadavers, the CSA of three portions were PP: 20.3+/-10.3 mm2, MP: 16.7+/-8.6 mm2, FH: 14.4+/-8.9 mm2. There was no significant difference between the three portions in asymptomatic volunteers and cadavers (p>0.05). CONCLUSION: In normal Korean adults, the area of fibular nerve at the fibular head is 10.9+/-0.6 mm2. Ultrasonographic evaluation of the fibular nerve can be helpful in diagnosing fibular nerve lesions.