위냉동(胃冷凍)이 췌액 및 담즙분비에 미치는 영향

Abstract

[한글]

Effects of gastric Freezing on Pancreatic and Biliary Secretion

Kyu Sik Choi

Department of Internal Medicine,

Yonsei University College of Medicine seoul, Korea

(Directed by Dr. Po Young Lee)

Many clinical investigators demonstrated that both regional and generalized

bypothermia reduces pancreatic functions, Moreover, it was sugested by Wangensteen

in 1958 that the gastric hypothermia might be beneficial for the treatment of upper

gastro-intestinal bleeding and duodenal ulcers. However, clinical application of

hyothermia in the care of patients has been clearly understood at present.

The purpose of the present investigation were to determine the effects of the

gastric freezing upon panceatic and biliary secretion in the dog. 16 adult dog were

divided into two groups: the slow freezing group in which the stomach of 10 dogs

was gradually frozen to 15℃, 5℃ and -10℃, and the rapid freezing group in which

the stomach of 6 dogs was frogen to -10℃ by a Gastric Freezer (Swenko Co.). During

freezing both the rectal and the gastric serosal temperatures were determined. At

the same time, secretin and pancreozymin were administered following which the

panceatic juice and the hepatic bile were collected for the measurements of volume

and the concentration of Na**+, K**+, Cl**- and HCO^^3 **-. In the case of

pancreatic juice, the enzymatic activites were also measured. The blood sample was

collected to determine the pancreatic enzyme activities in the serum.

The results may be summarized as follows:

1. During freezing to -10℃, the gastric serosal temperature was reduced to -2 to

-4℃.

2. The flow of pancreatic secretion was lowered by 51.4% in slow gastric freezing

to -10℃; in rapid gastric freezing, the magnitude of reduction amounted in only

18.4%.

3. In both groups, the level of Na**+ and K**+ in pancreatic juice remained

unchanged while there was a slight reduction in Cl**- coupled with a slight rise in

HCO^^3 **-.

4. The amylase activity of pancreatic juice during slow freezing to -10℃ was

reduced; the magnitude of reduction in the total enzymatic activity was by 54.4%.

In rapid freezing, it was also found that there was a slight reduction in the

amylase activity by 25.2% and a marked reduction in the total enzymatic activities

by 53.8%. The lipase activity in slow gastric freezing to -10℃ was decreased by

26.9% and the total activities by 62.8%. On the other hand, the activity of lipase

was not alteased by 26.9% and the total activities by 62.8%. On the other hand, the

activity of lipase was not altered by rapid freezing but the total enzymatic

activities were reduced to 37.5%. The trypsin activity in rapid freezing was

reduced by 27.1%, while the total enzymatic activities by 42.0%.

5. Both the amylase and the lipase activities in the serum showed a slight

reduction in slow freezing; but, in rapid freezing, the amylase activity was

increased by 30.4% and the lipase activity by 20%.

6. The hepatic bile flow was reduced by 53.8% in slow gastric freezing and by

43.4% in rapid gastric freezing.

7. The concentrations of Na**+ and K**+ in the hepatic bible were not altered by

the gastric freezing. However, in both groups, the concentrations of Cl**- tended

to be slightly reduced while that of HCO^^3 **- tended to be elevated.

[영문]

Many clinical investigators demonstrated that both regional and generalized bypothermia reduces pancreatic functions, Moreover, it was sugested by Wangensteen in 1958 that the gastric hypothermia might be beneficial for the treatment of upper

gastro-intestinal bleeding and duodenal ulcers. However, clinical application of hyothermia in the care of patients has been clearly understood at present.

The purpose of the present investigation were to determine the effects of the gastric freezing upon panceatic and biliary secretion in the dog. 16 adult dog were divided into two groups: the slow freezing group in which the stomach of 10 dogs

was gradually frozen to 15℃, 5℃ and -10℃, and the rapid freezing group in which the stomach of 6 dogs was frogen to -10℃ by a Gastric Freezer (Swenko Co.). During freezing both the rectal and the gastric serosal temperatures were determined. At

the same time, secretin and pancreozymin were administered following which the panceatic juice and the hepatic bile were collected for the measurements of volume and the concentration of Na**+, K**+, Cl**- and HCO^^3 **-. In the case of pancreatic juice, the enzymatic activites were also measured. The blood sample was collected to determine the pancreatic enzyme activities in the serum.

The results may be summarized as follows:

1. During freezing to -10℃, the gastric serosal temperature was reduced to -2 to -4℃.

2. The flow of pancreatic secretion was lowered by 51.4% in slow gastric freezing to -10℃; in rapid gastric freezing, the magnitude of reduction amounted in only 18.4%.

3. In both groups, the level of Na**+ and K**+ in pancreatic juice remained unchanged while there was a slight reduction in Cl**- coupled with a slight rise in HCO^^3 **-.

4. The amylase activity of pancreatic juice during slow freezing to -10℃ was reduced; the magnitude of reduction in the total enzymatic activity was by 54.4%. In rapid freezing, it was also found that there was a slight reduction in the

amylase activity by 25.2% and a marked reduction in the total enzymatic activities by 53.8%. The lipase activity in slow gastric freezing to -10℃ was decreased by 26.9% and the total activities by 62.8%. On the other hand, the activity of lipase

was not alteased by 26.9% and the total activities by 62.8%. On the other hand, the activity of lipase was not altered by rapid freezing but the total enzymatic activities were reduced to 37.5%. The trypsin activity in rapid freezing was reduced by 27.1%, while the total enzymatic activities by 42.0%.

5. Both the amylase and the lipase activities in the serum showed a slight reduction in slow freezing; but, in rapid freezing, the amylase activity was increased by 30.4% and the lipase activity by 20%.

6. The hepatic bile flow was reduced by 53.8% in slow gastric freezing and by 43.4% in rapid gastric freezing.

7. The concentrations of Na**+ and K**+ in the hepatic bible were not altered by the gastric freezing. However, in both groups, the concentrations of Cl**- tended to be slightly reduced while that of HCO^^3 **- tended to be elevated.