The use of long-range planning techniques is essential if health care organizations are to survive. The regulatory and competitive forces that exist right now are likely to become even stronger in the future. It is important to remember that these forces represent opportunities as well as risks. Health care organizations can best resolve the conflicts that exist by using the strategic planning process to identify alternate voluntary means to achieve the same goals.
Much has been learned in the past 10 years about the mechanism of action of coumarin anticoagulants and the role of vitamin K in the production of functional clotting factors. This paper reviews the mechanism for post-ribosomal modification of precursor proteins into functional clotting factors, the therapeutic uses of vitamin K, pharmacologic and therapeutic uses of vitamin K antagonists, and the current means of testing for vitamin K antagonism. In addition, information concerning newly discovered vitamin K-dependent proteins in other tissues and pathologic processing is discussed.
Renal epithelial fragments, an infrequently reported entity, were observed by cytologists in urine sediment from a patient who underwent nephrostomy for the relief of a ureteral obstruction. This case report describes the occurrence and various cytomorphologic features of exfoliated renal fragments. Urine specimens obtained following the insertion of a nephrostomy tube can provide the cytologist a unique opportunity to study and distinguish renal epithelial fragments from those of urothelial origin.
A new method for satisfactorily removing the formalin pigment from microscopic tissue sections is reported. The method requires a relatively short period of time and will not alter the staining quality of the section.
