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The North Shore-Long Island Jewish Health System has adopted a total laboratory automation (TLA) system called the Roche/Hitachi Clinical Laboratory Automation System (CLAS) to decrease labor costs and space requirements and to achieve operation efficiency. CLAS is a turnkey system that is integrated into North Shore's online chemistry analyzers, online hematology systems, stand-alone coagulation systems and stand-alone immunochemistry systems. Its implementation initially involves the establishment of goals or vision for the laboratory followed by selection of systems to be implemented., Lab automation and consolidation can be a daunting, risky, major reengineering project. Done right, it can mean decreased labor costs and space requirements, increased test volume, and more efficient use [...]

Surgical Management of Traumatic Disruption of the Descending Aorta Traumatic disruption of the descending thoracic aorta due to blunt chest trauma continues to be a challenging surgical problem. It has [...]

Thoracic surgeons will be called upon increasingly in the future to assist orthopedic surgeons in the anterior approach to the spine for the treatment of spinal diseases. In this report, we attempt to illustrate some of the methods used by orthopedic surgeons in treating spinal problems from the anterior approach. We also point out some of the principles and pitfalls of anterior spinal surgery so that the thoracic surgeon may be better equipped to assist the orthopedic surgeon with these problems.

In debates over the virtues of delayed and early treatment for acute cholecystitis and the pros and cons of operating on the quiescent gallstone, the management of the elderly patient with acute symptoms has been given minimal attention. However, it is this patient who is being seen with increasing frequency in large municipal hospitals.Because of the high proportion of elderly patients and the relatively high incidence of acute biliary tract problems seen in this hospital, we have reviewed our surgical experience with acute cholecystitis over the past ten years. We were particularly interested in the role of cholecystostomy, and this group was reviewed in detail. A second group of patients undergoing definitive surgical procedures was also reviewed for comparison. The results are discussed in the light of previous reports from this hospital and other institutions. CASE MATERIALS The records of the San Francisco General Hospital from January 1958 to

Accidental or suicidal ingestion of corrosives usually injures the oropharynx and esophagus. Strong alkalies affect the esophageal mucosa most severely, and in only 20% of the cases is the stomach involved.1,2 Concentrated acids, however, tend to spare the esophagus and produce their major corrosive effects within the stomach because of the transit time and the resistance of the esophageal squamous epithelium.3-5The severity of corrosive injuries to the stomach is directly related to the agent ingested and its concentration and duration of contact with the viscus.6 Corrosive substances have been classified by Bosch del Marco7 into four major categories: (1) fixatives, such as phenolic acid and formaldehyde solution; (2) destructive substances, such as sulfuric acid, nitric acid, and hydrochloric acid; (3) softeners, such as alkalies, disinfectants (Lysol), and lye; and (4) weak substances, such as oxalic acid and arsenic.Robert,8 in 1828, was the first