Biomedical subjects
S Cropper
Publications and source records attributed to S Cropper.
Analysing the medicine-management interface in acute trusts.
The impact of the NHS reforms, and the resulting purchaser-provider split, has refocused attention on the relationship between management and medicine in acute hospitals. It is timely to assess the explanatory power of various theoretical models regarding the management-medicine interface. Argues that this interface is currently rather fluid and that a dynamic and adaptive model is best suited to understanding the way in which doctors and managers develop their relationship within the changing policy context. Two examples illustrate these shifting boundaries.
Hepatic clearance of rat plasma intestinal alkaline phosphatase.
The mechanism and route of clearance of intestinal alkaline phosphatase from plasma have been studied in rats to define the magnitude of hepatic extraction and biliary excretion of the enzyme. Plasma clearance, tissue distribution, and biliary excretion of enzyme were followed after intravenous administration of physiological amounts of 125I-labeled rat intestinal alkaline phosphatase. The plasma disappearance curve was biphasic; the initial phase was rapid, during which 50% of injected enzyme was selectively extracted by the liver over 5 min. Less than 4% of total hepatic radioactivity was excreted into bile over 80 min; this was shown by chromatographic analysis to be degraded enzyme only. Rapid clearance of enzyme could be significantly slowed by injection of large amounts of mannan or N-acetylglucosamine-bovine serum albumin, but not by desialylated fetuin, demonstrating that clearance was probably mediated by mannose/N-acetylglucosamine-specific receptors. It is concluded that, under physiological conditions, rat plasma intestinal alkaline phosphatase is rapidly cleared from the circulation by the liver. However, biliary excretion of undergraded enzyme is negligible, and a physiologically significant enterohepatic circulation seems most unlikely.