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한국 신생아의 위액분비에 관한 연구

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[영문]There are numerous reports of the incidence of peptic ulcers in infancy, and even in utero(Guthrie, 1942: Muggia and Spiro, 1959: Lee and Wells, 1923). It has been shown that gastric acid secretion is directly related to peptic ulcers(Polacek and Ellison, 1966). Peptic ulcers in the newborn is caused by rapidly increasing gastric acidity during the first 24 hours after birth (Kelsey et al, 1968). Avery et al (1966) reported the changes of gastric contents in specific diseases in infancy. The normal values of gastric contents are important for the correction of electrolytes after losing a large amount of gastric juice. Since the first estimation of gastric acidity in infancy were made by Tangl (1906) and Hess (1913), there have been many reports in foreign literature on the fasting gastric acidity, electrolytes and pepsin, and on the gastric function test using test meal. In Korea, Ahn and Kim (1963) determined the pH and volume of gastric juice from birth to one week, and You (1966) reported the norma1 values of the gastric electrolytes in Korean adults. There has been no report yet on the gastric function teat using test meal in the pediatric age group in Korea. This investigation is aimed at studying: 1) The values of the fasting gastric contents at different ages in Korean newborn. 2) The normal gastric function curves of the above contents at different ages after test meal(skimed powdered milk and water). 3) The correlation among the gastric contents, age, gestation week and body weight. The subjects, grouped in 8 different ages, were newborn babies delivered at Wonju Union Christian Hospital from Oct. 1972 to April 1973. Age and case number in each group were as follows: at birth, 26 eases; 2 hours, 30 cases; 8 hours, 21 cases:24 hours, 56 cases: 48 hours, 25 cases: 72 hours, 23 cases; 1 week, 20 cases: 4 weeks. 12 cases. Every specimen was aspirated using syringe connected to a soft rubber or polyethylene tube inserted gently into the stomach about 23-25 cm through the nasal cavity. Aspiration was done at 6 hours after previous feeding for fasting values, and at thirty minutes, one hour, one and a half hours, and two hours after test meal for gastric function curves. The determinations of value of acidity by Toepfer-Michael's method, sodium and potassium by Emission flame photometry, and chloride by Schales and Schales method were made, and pepsin by Anson's method. Factor Analysis for the statistical correlation among the gastric contents, age, gestation week and body weight was made. There were no difference in gestation period and body weight of subjects at the same age by sex. The following results were obtained; 1. Fasting values were a) total acidity was 26.1±3.45 at birth: 62.5±4.65 at 2 hours: 87.3±5.05 at 48hours and then decreased to 15.3±6.88ml. 0.1N Na0H/100m1. at 4 weeks. b) free acidity was 5.2±2.34 at birth: 28±3.77 at 2 hours; 35.3±3.86 at 8 hours; and then gradual decrease to 15.3±6.88ml. 0.1N Na0H/100m1. at 4 weeks. c) sodium was 91.1±4.73 atarth, bnd then gradual decrease to 48.8±5.57mEq/L at 4 weeks. d) potassium was 8.5±0.61 at birth; 23.3±1.27 at 72 hours: and then gradual decrease to 16.9±0.94 mEq/L at 4 weeks. e) chloride was 101.1±4.54 at birth: 112.9±4.19 at 2 hours: and then gradual decrease to 82.8±5.98 mEq/L at 4 weeks. f) pepsin was 191.7±19.34 at birth and then gradual increase to 420.7±60.13 mg/100ml. at 4 weeks. g) There was no difference in the values of all fasting contents at the same age by sex. 2. All the gastric contents in all ages after test meal showed the lowest values at 30 minutes, and then increased a little less than the fasting values at 2 hours in all ages. Potassium showed reversed curves in all ages. 3. There were high correlations in total acidity and free acidity, sodium and total acidity potassium and sodium, chloride and sodium, chloride and free acidity, and pepsin and age.
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2. 학위논문 > 1. College of Medicine (의과대학) > 박사
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