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Pancreas ÃÑ·Ð

1. ºÐºñ: 1500-3000 ml/day, isoosmotic alkaline fluid(pH>8.0)

¾à 20¿©Á¾ÀÇ enzyme & zymogen ÇÔÀ¯

À§Àå°üÀÇ ¼ÒÈ­ÀÛ¿ë¿¡ ÇÊ¿äÇÑ È¿¼Òµé°ú À̵é È¿¼Ò°¡ ÀûÀýÇÑ ÀÛ¿ëÀ» ÇÒ¼ö ÀÖ´Â

ÀûÁ¤ pH ȯ°æÀ» Á¦°øÇÑ´Ù.

2. ÃéÀå¾× ºÐºñÁ¶Àý

exocrine pancreas : hormonal & neural system ÀÇ »óÈ£ÀÛ¿ë¿¡ ÀÇÇØ Á¶ÀýµÈ´Ù.

1) secretin: À§»ê(Gastric acid)ÀÌ secretinºÐºñÀÇ ÁÖ ÀڱؿøÀÌ´Ù.

½ÊÀÌÁöÀå°ú °øÀå¿¡¼­ À§»êÀÇ ÀÚ±ØÀ¸·Î pH°¡ 4.5°¡ µÉ ¶§ ºÐºñµÇ±â ½ÃÀÛÇÏ¿©

water, electrolyte°¡ dzºÎÇÑ ÃéÀå¾× ºÐºñ¸¦ ÀÚ±ØÇÑ´Ù.

¹®> secretinºÐºñ¿¡ ÇÊ¿äÇÑ ÀڱؿøÀº? Gastric acid

secretinºÐºñ¿¡ ÇÊ¿äÇÑ pH threshold? 4.5

2) CCK : ½ÊÀÌÁöÀå°ú °øÀå¿¡¼­ long chain fatty acid, essential amino acid(tryptophan,

phenylalanine, valine, methionine) ¹× gastric acidÀÚüÀÇ Àڱؿ¡ ÀÇÇØ ºÐºñµÈ´Ù.

EnzymeÀÌ Ç³ºÎÇÑ ÃéÀå¾×À» ºÐºñÇϵµ·Ï ÀÚ±ØÇÑ´Ù.

3) parasympathetic nervous system(vagus nerve)

- secretin°ú CCK¿¡ ÀÇÇÑ enzyme secretionÀº afferent & efferent vagal pathway¿¡ ÀÇÇØ

Á¶ÀýµÇ°í water, bicarbonate secretionÀº hormonal effect¿¡ ÀÇÇØ Á¶ÀýµÈ´Ù.

- VIP, secretin agonistµµ vagal stimulation¿¡ ÀÇÇØ ºÐºñµÈ´Ù.

4) Bile saltsµµ ÃéÀå¾× ºÐºñ¸¦ ÀÚ±ØÇÑ´Ù.

5) Somatostatin : ¿©·¯±ºµ¥¿¡¼­ ÀÛ¿ëÇϸç ÃéÀå¾× ºÐºñ¸¦ ¾ïÁ¦ÇÑ´Ù.

6) Nitric oxide : Áß¿äÇÑ neurotransmitterÀÌÁö¸¸ ¾ÆÁ÷ ¿ÏÀüÈ÷ ¹àÇôÁöÁö ¾Ê¾Ò´Ù.

<Á¤¸®>

parasympathetic regulation: secretin, CCK, VIP

hormonal regulation: water, bicarbonate

¸ðµÎ ÃéÀå¾× ºÐºñ¸¦ ÀÚ±ØÇϳª somatostatinÀº ÃéÀå¾× ºÐºñ¸¦ ¾ïÁ¦ÇÑ´Ù.

µû¶ó¼­ somatostatinÀ» ÃéÀåÁúȯ Ä¡·áÁ¦·Î »ç¿ëÇÑ´Ù.

3. Water & Electrolyte

Bicarbonate : the ion of primary physiologic importance

120-300 mmol/d

À§»êÀ» ÁßÈ­ÇÏ¿© ÃéÀå È¿¼Ò°¡ ÇÊ¿ä·Î ÇÏ´Â ÀûÁ¤ pH¸¦ À¯ÁöÅä·Ï ÇÑ´Ù.

4. Enzyme secretion

amylolytic, lipolytic, proteolytic enzymeÀ» ºÐºñÇÑ´Ù.

1) amylolytic enzyme(amylase)

starch -> oligosaccharide, disaccharide·Î °¡¼öºÐÇØ

2) lipolytic enzyme : lipase, phospholipase A, cholesterol esterase

bile salt´Â lipase¸¦ ¾ïÁ¦Çϰí phospholipase A, cholesterol esterase´Â Ȱ¼ºÈ­½ÃŲ´Ù.

3) Proteolytic enzyme

i) endopeptidase(trypsin, chymotrypsin)

ii) exopeptidase(carboxypeptidase, aminopeptidase)

ÀÌ proteolytic enzymeÀº inactive precursors(zymogen)·Î ºÐºñµÈ´Ù.

½ÊÀÌÁöÀå Á¡¸·¿¡ ÀÖ´Â enterokinase´Â trypsinogenÀÇ lysine-isoleucine bond¸¦ ²÷¾î

trypinÀ» Çü¼ºÇÑ´Ù. ÀÌ·¸°Ô Çü¼ºµÈ trypsinÀº casecade phenomenon¿¡¼­ proteolytic

zymogenÀ» Ȱ¼ºÈ­½ÃŲ´Ù.

*¸ðµç ÃéÀåÈ¿¼ÒµéÀº ¾ËÄ®¸® ȯ°æÀÌ ÀûÁ¤ pHȯ°æÀÌ´Ù.

5. Autoprotection

precursor formÀ¸·Î ÀÖ´Â protease packingÇϰí protease inhibitor¸¦ ÇÕ¼ºÇÏ¿©

autodigestionÀ» ¹æÁöÇÑ´Ù. ÀÌ·¯ÇÑ protease inhibitor´Â acinar cell, pancreatic secretion

¿¡¼­ ¹ß°ßµÇ¸ç plasma¿¡¼­ ¥á1, ¥á2-globulin fractionÀ¸·Î ³ªÅ¸³­´Ù.