Annual Report on External Quality Assessment in Hematology in Korea (2008) / 임상검사와정도관리

Four trials of external quality assessment in diagnostic hematology were performed in 2008 with average 822 participating laboratories in Korea. We performed quality assessment for white blood cell count, hemoglobin, hematocrit, red blood cell count, platelet count, blood cell morphology, prothrombin time and activated partial thromboplastin time. The response rate was more than 96.5%. The coefficients of variation in hemoglobin, hematocrit and RBC was stable but variable in platelet count and WBC count according to measuring cell count. Test results of blood cell morphology showed variation among various cell morphologies.

Annual Report on External Quality Assessment in Hematology in Korea (2007) / 임상검사와정도관리

Four trials of external quality assessment in diagnostic hematology were performed in 2007 with average 722 participating laboratories in Korea. We performed quality assessment for white blood cell count, hemoglobin, hematocrit, red blood cell count, platelet count, blood cell morphology, prothrombin time and activated partial thromboplastin time. The response rate was more than 95.2%. The coefficients of variation in hemoglobin, hematocrit and RBC were stable but variable in platelet count and WBC count according to measuring cell counters. Test results of blood cell morphology showed variation among various cell morphologies.

Annual Report on External Quality Assessment in Hematology in Korea (2007) / 임상검사와정도관리

Four trials of external quality assessment in diagnostic hematology were performed in 2007 with average 722 participating laboratories in Korea. We performed quality assessment for white blood cell count, hemoglobin, hematocrit, red blood cell count, platelet count, blood cell morphology, prothrombin time and activated partial thromboplastin time. The response rate was more than 95.2%. The coefficients of variation in hemoglobin, hematocrit and RBC were stable but variable in platelet count and WBC count according to measuring cell counters. Test results of blood cell morphology showed variation among various cell morphologies.

Annual Report on External Quality Assessment in Hematology in Korea (2005) / 임상검사와정도관리

Four trials of external quality assessment in diagnostic hematology were performed in 2005 with about 500 participating laboratories in Korea. We performed quality assessment for white blood cell count, hemoglobin, red blood cell count, platelet count, white cell differential count, red blood cell morphology. The response rate was more than 97%. The coefficients of variation in hemoglobin and RBC number was stable but variable in platelet number and WBC number according to measuring cell counts. Test results showed wide variation according to measuring machine and reagents.

Reconstruction of the Anterior Cruciate Ligament in over 40-year-old Patients / 대한정형외과학회잡지

PURPOSE: The purpose of the current study was to examine outcome after ACL reconstruction in patients over 40 years old, and to evaluate factors affecting outcome, such as, associated injuries and the preoperative period after injury. MATERIALS AND METHODS: Clinical results were obtained from 36 cases over 40 years old at the time of surgery. The average age was 45 years (40 to 67 years), and the average follow-up period was 27.6 months (12 to 85 months). Group 1 was composed of 13 cases with a less than 3 months preoperative period, and group 2 23 cases of more than 3 months. 31 cases had associated injuries and 5 cases did not. The parameters used were the Lachman test, KT-2000 arthrometry, Lysholm score, IKDC score, and return to sports activity before injury. RESULTS: The Lachman test was positive in 9 cases (25%) and mean side-to-side difference as determined by KT-2000 arthrometry was 3.9mm, however, there was no statistical difference between group 1 and group 2, regardless of associated injuries (p>.05). Lysholm score averaged 89.8 in total, and was 92.2 in group 1 and 88.5 in group 2, and 93.6 in those without associated injury and 89.2 in those with associated injury (p>.05). The IKDC score was normal (A) in 7 cases, nearly normal (B) in 25, abnormal (C) in 4. Twelve cases (92.3%) were graded A or B in group 1, and 20 cases (87%) were graded A or B in group 2 (p>.05). There were 5 cases (100%) of grade A or B in the group without associated injury and there were 27 cases (87.1%) of A or B in group with associated injury (p>.05). Return to sports activity before injury was possible in 19 cases (53%); 7 cases (53.8%) in group 1 and 12 cases (52.2%) in group 2 (p>.05), and 3 cases (60%) in the group without associated injury and 16 cases (51.6%) in the group with associated injury (p>.05). CONCLUSION: In patients over 40 years old with ACL injury, results can be successful after ACL reconstruction.

Primary Total Hip Arthroplasties Using Harris-Galante Porous Coated Cementless Prosthesis: Mean 10-Year Follow-Up Results / 대한정형외과학회잡지

PURPOSE: The purpose of this study was to analyze the intermediate to long-term results of primary total hip arthroplasties with a Harris-Galante prosthesis. MATERIALS AND METHODS: Among 97 consecutive total hip replacements with Harris-Galante prosthesis in 85 patients, 76 hips in 67 patients were evaluated clinically and roentgenographically. The mean follow-up was for 10.1 years (range 6.2-13 years). Clinical and radiographic evaluations including osteolysis, stability of prosthesis, and wear of polyethylene were performed. Statistical analysis was conducted to find the relevant factors influencing osteolysis. The survivorship of overall and each acetabular and femoral component was analyzed by Kaplan-Meier method. RESULTS: The Harris hip score averaged 44 points at preoperatively and improved to 89 points at the most recent follow-up. Pelvic osteol-ysis was found in 3 hips (4%) and femoral osteolysis was found in 32 (42%). The linear polyethylene wear rate was averaged 0.13 mm/year. Nine femoral components and two acetabular components were revised. There were 2 recurrent dislocations, 3 periprosthetic fractures and 4 infections. The probability of survival of the femoral and acetabular component at a mean 10 years was 81% (range 71- 93%) and 96% (range 91-100%) by the Kaplan-Meier method. CONCLUSION: The intermediate to long-term follow up of primary total hip arthroplasty with Harris-Galante prosthesis revealed a low failure rate of acetabular component and a relatively high failure rate of the femoral component which was usually related with loosening and osteolysis.

Evaluation of Parasite Lactate Dehydrogenase-based Immunochromatographic Antigen Assay (DiaMed OptiMAL(epsilon)) for Rapid Diagnosis of Malaria / 대한임상병리학회지

BACKGROUND: Microscopic examination of peripheral blood smears has been a standard diagnostic test for malarial infection for a long time, but it is labor-intensive and time-consuming. Recently, a rapid diagnostic test for malarial infection containing a dipstick bearing monoclonal antibodies against the intracellular metabolic enzyme, parasite lactate dehydrogenase (pLDH), was introduced (DiaMed OptiMAL(epsilon)). We evaluated the usefulness of the OptiMAL test in malaria diagnosis by comparing with a microscopic examination of peripheral blood smears. METHODS: Fifty-eight (initial 44 and follow-up 14) whole blood samples were obtained from 44 patients who were suspected of having malarial infection. After 1 drop of whole blood reacted with the dipstick, band numbers and positions on the dipsticks determined the results. All results were compared to those of microscopic examination findings. RESULTS: The OptiMAL test revealed 100% sensitivity and specificity by comparing with the microscopic examination. The intensity of stained bands showed positively correlated with the severity of parasitemia. The OptiMAL test revealed a more rapid negative conversion than the microscopic examination after treatment. CONCLUSIONS: The OptiMAL test is a simple, rapid and accurate test for diagnosis of malarial infection; moreover, it is good tool for monitoring after treatment.

The Expression of p53, c-erbB-2 and nm23 Proteins in Breast Cancer

Recently, p53, c-erbB-2 and nm23 proteins have been studied in breast cancer. The expression of p53 protein indicates the mutation of p53 gene known as a tumor supressor gene, and c-erbB-2 gene amplification has been considered an indicator of poor prognosis and nm23 a metastsis suppressor gene. In order to elucidate the roles and relations of these proteins in the develpoment, progression and metastasis in breast cancer, we studied 89 cases of invasive breast cancer and 32 cases of lymph node metastasis for the expression of p53, c-erbB-2 and nm23 proteins using an immunohistochemical method. The results were as follows: 1) The expression rates of p53, c-erbB-2, and nm23 proteins in breast cancer were 40.4%, 34.8% and 55.1%, respectively. Co-expression of p53 protein and c-erbB-2 protein was found in 20.2% of cases, showing the highest incidence in poorly differentiated type (40%). 2) p53 protein expression was increased in poorly differentiated type but was not statistically significant. On the other hand, the expression of nm23 protein was decreased in poorly differentiated type, which was statistically significant (p<0.05). 3) The correlation of p53 protein expression with c-erbB-2 protein expression was statistically significant (p<0.05) but that with nm23 protein was not. 4) In the cases with lymph node metastasis, discordant expression of p53, c-erbB-2 and nm23 proteins between primary tumor and the lymph node metastatic tumor was found in 9.4%, 3.1% and 18.8% of cases, respectively. The above results suggest that overexpression of p53 and c-erbB-2 proteins and downregulation of nm23 protein are associated with the tumor progression in the breast cancer.

Comparison of Leukocyte Depletion between COBE Spectra LRS/TM and COBE Specta followed by PALL PXL/TM 8 on Single Donor Platelet

BACKGROUND: Use of single donor apheresis platelets and concerning for the quality of apheresis platelets has been rapidly increased. Apheresis platelets depleted white blood cell(WBC) are used to prevent or to reduce febrile non-hemolytic transfusion reactions, alloimmunization and cytomegalovirus infection. We compared COBE Spectra LRS (leukoreduction system) and COBE Spectra with PALL PXL 8 in terms of the yield predictors, processing times, and WBC contamination. METHOD: Seventy-two single donors who visited Apheresis Unit(APU) in St. Mary s hospital were prospectively randomized into COBE Spectra LRS and COBE Spectra followed by PALL PXL 8 between September 1997 and October 1998. We used Coulter counting for platelet and Nageotte hemocytometer for WBC count. Data were analyzed by independent t-test. RESULTS: The mean platelet yield per unit was 3.6+ 1.0 x 10 ' with COBE spectra LRS compared to 2.9+ 1.1 X 10 with COBE Spectra(p=0.002), and the mean WBC content per unit with COBE spectra LRS was 4.1 x 104(0.4-23.5) compared to 3.7 x 104(0.43-17.9) with PALL PXL""8(p=0.0728). CONCLUSIONS: This study shows that COBE Spectra LRS has higher platelet yields than that of COBE Spectra, and similar WBC contamination compared to PALL PXL 8. Therefore, this data suggests that COBE Spectra LRS is conveient than COBE Spectra with PALL PXL 8 in clinical practice. (Korean J Blood Transfusion 10(1): 43-51, 1999)

Analysis of Danger Zone of the Posterior Column of Acetabulum and Morphological Data of the Isehial Tuberosity / 대한정형외과학회잡지

Ten emhalmed cadaveric adult bony hemipelvis specimens were ohtained to evaluate the configuration of the posterior column of acetabulum and to find a safe path for screw placement into it as well as to report on the morphological data of the ischial tuherosity and to determine the most optimaI technique for ischial tuberosity screw placement for open reduction and internal fixation of posterior acetabular fracture. Cadaveric studies were performed analyzing icm cross-sections through the acetabulum for the purpose of studying the anatomical configuration of the danger zone. The plane of the cross-section was perpendicular to the posterior column. Each cross-section had the medial boundary ot the acetabulum projected onto the posterior column. By analysing the projections on the posterior column, the exact configuration of the danger zone was determined. In this study, the average width of the posterior column at the mid-acetabular Ievel was 3.9cm. Computed tomography scan of the acetabulum yielded valuable int'ormation regarding screw placement in the posterior column. The average width, height and depth of the ischial tuberosity were 25.7 mm, 33. 1 mm and 31.7mm, respectively. The average angles hetween the posterior and medial aspects and hetween the posterior and lateral aspects of the ischial tuherosities were 79.5degreesand 111.5degrees, respectively. The entry point of the screw should be Smm or 10mm medial to the lateral margin of the ischial tuherosity and the screws should be directed 35-40degrees, 45-50degrees and 50-55degrees caudally at the level of the inferior acetahular margin and lcm and 2cm below it, respectively. to obtain the most favorable bony purchase.

Osteonecrosis of the Femoral Head and Acetabulum Following Radiation Therapy: Difficult Case in Diagnosis and Treatment: A Case Report / 대한정형외과학회잡지

Radiation therapy is used for the palliative treatment of malignant tumors and the radiation induced osteonecrosis is one of the well documented complications. Especially, in pelvic region, there are a few reports for osteonecrosis of the femoral head and acetabulum after the radiation therapy for the the malignant tumors such as cervical carcinoma or prostatic cancer. Roentgenographic changes that are caused by radiation include the rarefaction of bone and coarsening of the trabeculae. The radiolucencies tend to coalesce and patchy sclerosis appears. In acetabular region, this Pagetoid appearance mimics the findings of other malignant bone tumors, the recurrence of preexisting malignant peivic tumors and other infectious condition. After the diagnosis is confirmed, the treatment for the femoral head and acetabulum is also difficult. The authors report one case of osteonecrosis of the femoral head and acetabulum following radiation therapy which had many difficulties in its diagnosis and treatment.

Normoblasts and Lymphocytes Carry the Fused Bcr-Abl Gene in Chronic Myelogenous Leukemia: Two Color Fluorescence in Situ Hybridization(FISH) Analysis on the Blood Smears

We performed dual color fluorescence in situ hybridization (FISH) for the bcr/abl fusion in CML using the peripheral blood smears without destruction of cell morphology to determine the bcr/abl fusion. Two patients of CML, one patient in accelerated phase and one patient in chronic phase, were selected. The blood smears were fixed in absolute methanol. FISH was performed with the Mbcr/abl translocation DNA probe mixture and the slides were stained with Wright's stain after FISH. The blood smears of both cases revealed distinct signals without destruction of cellular morphology. The normoblasts and lymphocytes revealed beautiful fused bcr/abl signals as well as granulocytes in both cases. The results provide a novel finding that the normoblasts and lymphocytes in CML are also neoplastic clonal cells which has not been demonstrated with a single-cell approach before.

A Retrospective Study of Funguria / 병원감염관리

BACKGROUND: The incidence of fungal urinary tract infections has increased in the immunocompromized patients. We analyzed urine culture results of St. Mary's Hospital during 28 month period between October 1993 and January 1996 to evaluate the frequency of yeast isolates and to survey the distribution of departments from where yeasts isolated. METHODS: We performed a retrospective analysis of urine culture results. Yeasts were identified by the examination of germ tube production in human serum at 37degrees C and API2OC (BioMerieux, France) yeast strip. RESULT: A total of 1,387 urine cultures were reviewed, of which 164 (11.8%) were isolated as fungi. Candida albicans occurred in 36.5% of the total yeast isolates, C. tropicalis in 35.3%, C. glabrata in 10.9% and Trichosporon beigelii in 0.6%. The incidence of urinary fungal infection increased in 1995 (13.0%) than 1994 (9.1%) (P=0.047). Fifty two percents (85/164) of urinary fungi were isolated from patients in Neurosurgery (NS), where isolation of C. tropicalis was significantly more increased than other departments. In four patients, candiduria progressed to candidemia, which were caused by C. albicans (three patients) and C. glabrata (1 patient). CONCLUSIONS: The isolation rate of yeast species was different in NS and non-NS department. The frequency of isolation of C. albicans increased in non-NS department than NS department, while the frequency of isolation of C. tropicalis increased in NS department than non-NS department. The most common organism was C. albicans and department was Neurosurgery.

Detection of Minimal Lesion and Identification of Clonality in Malignant Lymphoma

The bone marrow biopsy is an integral part of the staging process in patients with malignant lymphomas. Bone marrow(BM) involvement indicates stage IV disease, but there are always a lot of cases in which clear separation is not possible when based on morphology alone. Additional difficulties are caused by morphologic discordance between the BM and the primary lymphoma. Immunohistochemical stain, mRNA in situ hybridization (ISH) for light chain restriction and polymerase chain reaction (PCR) for IgH CDR3 and TCRgamma were performed to find a minimal lesion and the clonality in formalin fixed paraffin embedded tissues of 39 primary lymphomas and corresponding BM biopsy specimens. As a result, nine morphologically negative bone marrows of 18 lymphomas were positive by PCR (Group I). Among the 6 lymphoma cases with morphologically suspicious BM involvement (Group II), one was confirmed to be positive for marrow involvement by both mRNA ISH and PCR and the other four by PCR alone. The positive bone marrows of Group I and II revealed gene rearrangement at the same site as the primary lesion, suggesting the same clonality. Thirteen of 15 lymphomas with morphologically positive BM (Group III) had the same clonality in the primary lymphomas and the BM lesion. Three cases among the Group III with morphologic discordance also revealed the same clonality by PCR. This study shows that a combination of mRNA ISH and PCR in addition to an immunohistochemical stain improves the diagnostic sensitivity in the detection of BM involvement and identification of clonality. Among the three different methods used, PCR is the most sensitive in detecting a minimal lesion.

Immunophenotyping of Normal Human Bone Marrow by Flow Cytometric Analysis / 대한혈액학회지

BACKGROUND: By development of monoclonal antibodies (MoABs) directed against hematopoietic cells, flow cytometric analysis of bone marrow has become commonplace in clinical hematology laboratories and has a major role in evaluation of lymphohematopoietic malignancies. However, little information about antigen expressions and distribution of normal human bone marrow cells has been published. Therefore, we analysed the immunophenotype of the normal human bone marrow cells to get a normal baseline data for flow cytometric analysis. METHODS: The bone marrow aspirates of 20 healthy donors of allogeneic bone marrow transplantation were analysed using flow cytometry (Becton-Dickinson Co, USA). Seven gated region (R) were set using the forward vs. right angle light scatter (FSC/SSC) cytogram and the percentages of positive cells against 17 monoclonal antibodies were identified in these gated regions by dual parameter flow cytometry. RESULTS: The proportion of total CD45+ cells was 87.57+/-12.82% (mean+/-1SD, n=20) and CD45- (nucleated erythrocytes) cells was 12.43+/-12.82% of all nucleated bone marrow cells. T cells were more numerous than B cells in total gates (P=.0001). T helper/inducer cells (Th) to T suppressor/cytotoxic cells (Ts) ratio was 1.38+/-0.53 and CD4+ cells were distributed in larger size and higher SSC fractions in FSC/SSC cytogram than CD8+ cells (P=.0001). While CD4+, 8+ cells were rarely existed, CD10+ cells were 17.63+/-11.43% of all nucleated bone marrow cells and they mainly distributed in granulocytic fractions. Lymphocytes represent 60% of all lymphogate cells and T cells were mostly mature cells. CD10+ cells and CD34+ cells in the R1 (lymphogate) were 4.37+/-3.07% and 1.78+/-1.25%, respectively. The total CD34+ cells represent 0.88+/-0.5% of all nucleated bone marrow cells and 65% of them were CD34+CD33+ cells. CONCLUSION: These results indicate each subpopulation of normal bone marrow reveals different regional expression from morphological estimation and these normal expressions should be considered in flow cytometric analysis of hematologic disorders.

Clinical Significance of Platelet Indices in Hematologic Disorders / 대한임상병리학회지

BACKGROUND: The clinical significance of mean platelet volume (MPV), platelet distribution width (PDW) and megathrombocyte index (MTI) is not clear. METHODS: We examined platelet indices in 900 cases of patients with hematologic disorders and compared them with those of the control to predict thrombopoiesis in the bone marrow. MPV and PDW were measured by Coulter Counter STKS (U.S.A). We calculated megathrombocyte index (MTI, the percentage of megathrombocytes) in the peripheral blood film using ocular micrometer, and examined megakaryocyte number in the bone marrow aspirates. RESULTS: In patients with acute leukemia, and aplastic anemia, MPV and MTI were lower than the control but PDW was higher. In myeloproliferative disorders, all platelet indices were higher, and in ITP (idiopathic thrombocytopenic purpura), MPV and MTI were higher but PDW was not significantly different. MTI was higher in complete remission than initial acute leukemia. All platelet indices were not significantly different between pre- and post-BMT in AML. But in aplastic anemia, MPV and MTI were higher in post-BMT than pre-BMT. MTI was a better index to screen than MPV in the decreased megakaryocyte group, but in increased megakaryocyte group, there was no difference in screening ability between MPV and MTI. CONCLUSIONS: The platelet indices in peripheral blood may be good markers for predicting thrombopoiesis in hematologic disorders and in post chemotherapy of acute leukemia. In addition, after BMT of aplastic anemia, these indices could be used as valuable markers of engraftment.

Design of a Teleradiology System / 대한의료정보학회지

In clinical surgery, there are frequent needs for communication between the house staff and the attending physician in an emergency situation. It's often insufficient for the house staff to make a decision through the information which is delivered in the form of only voice through the telephone line. To overcome the limitation of voice communication, we have designed an emergency teleradiology system which can be used for emergency surgical and medical decision making. The system can transmit the high quality images of CT, MRI, and other X-ray data using a PC attached to a modem through the conventional telephone line. Progressive transmission adopted in the system enables us to efficiently utilize the band-width of telephone line which is typically very low. The iterative residual coding/decoding algorithm compresses various medical images effectively, and thus fast-transmission of images date helps the house staff to perceive the status of emergent patient and make a fast and correct decision about the patient. The system also satisfies design requirements such as low-cost, ease of operation and interactive image communication including voice. 'Teleradiology system' proposed in this paper has been installed and operated in the emergency care unit of Severance Hospital, and as a result, it is effective in the emergency situations.

Design of an emergency teleradiology system based on progressive transmission

In clinical surgery, there are frequent needs for communication between the house staff and the attending physician in an emergency situation. To overcome the limitation of voice communication through the telephone line, we have designed an 'emergency teleradiology system' which can be used for emergency surgical and medical decision making. This system can transmit the high quality images of CT, MRI, and other X-ray data using a PC attached to a modem through the conventional telephone line. It is based on the progressive transmission system which enables the successive update of a received image. The iterative residual coding/decoding algorithm efficiently compresses the image to maximally utilize the low bandwidth PSTN channels. This system also satisfies design requirements such as low-cost, ease of operation, fast transmission, and interactive image communication including voice. Test results using several CT, MR, and X-ray images evaluate the compression performance, image quality, transmission time and computational time of the coding and decoding processes, thus demonstrate the usefulness of this system in an emergency situation.

Clinical Study of Acetabular Fractures / 대한정형외과학회잡지

Acetabular fractures are relatively uncommon, but when they occur they often result in permanent disability due to management difficulties. Undisplaced acetabular fractures have a good prognosis but major displaced acetabular fractures have always given rise to difficulty and concern during treatment and have a variable prognosis in different reports. In order to restore excellant function to a displaced acetabular fracture, anatomic open reduction and secure internal fixation followed by early mobilization are neccessary. And in order to approach fracture of acetabulm safely and with maximum ease, it is neccessary to understand the pathologic anatomy. The authors studied the sex and age distribution, clssification according to roentgenographic findings, associated injuries and methods of treatment of 49 patients who were admitted to the department of orthopedic surgery of our hospital from January, 1976 to June, 1981 under the diagnosis of acetabular fracture. The results of treatment of 31 patients who were followedup over a 6month period were as follows: 1. The mean age was 37 years, the range being from 17 to 71. 2. The most common cause of injury was traffic accidents (38 cases: 77.6%) which was followed by falls from heights (5 cases;10.2%). 3. Thirty cases were treated by conservative mea ures and 19 by surgery. The results were as follows: Excllent-10(32.3%), Good-14 (45.2%), Fair-6(19.3%), Poor-1 (3.2%), 4. The one case that had a poor result was a “T” shaped fracture with a central dislocation, which was impossible to reduce surgically due to severe comminution. 5. If the grossly displaced fragments are present they should be reduced and fixed surgically. But only if anatomical reduction and secure internal fixation is possible, surgery should be done. With a severely comminuted fracture, medial wall fracture, or central fracture-dislocation, surgical treatment is difficult therefore conservative treatment is better. 6. It is of great help to have various methods of roentgenography, conventional tomography, and computed axial tomographic scan in order to understand the pathologic anatomy of complicated acetabular fractures. 7. If surgery is attempted, it is essential to achieve an anatomic reduction and firm fixation by fully understanding the pathologic anatomy and by choosing an appropriate approach and fixative device.

The Clinical Consideration for Intracranial Epidural Abscess

The intracranial epidural abscess is a not indenpendent disease which is practically always secondary to osteitis or osteomyelitis of overlying bone. Also it was developed from complication of frontal sinusitis, middle ear or mastoiditis, incomplete debridement of compound comminuted depressed fracture and post-operative complications. Occasionally it was derived from dural sinus thrombophlebitis especially cavernous sinus. It was frequently developed frontal and temporal region. We have experienced 5 cases of intracranial epidural abscesses for this one year. Followings are the results ; 1. The causes were complication of compound depressed fracture, chronic osteomyelitis and post-operative complications. 2. The usual symptom was headache, fever and increased lethargy. 3. The laboratory findings of CBC were the increased WBC count and ESR. The CSF findings revealed occasionally increased the cell count and sugar. 4. The pus culture revealed proteus, coliform bacilli and paracolon bacili. 5. Treatment was surgical removal of overlying diseased bone, drainage of the purulent materials and instillation of antibotics irrigation. 6. The prognosis of the 5 cases of the intracranial epidural abscess was good. There was not appeared any complication or sequelae.