WordNet

(physiology) a shortening or tensing of a part or organ (especially of a muscle or muscle fiber) (同)muscular_contraction, muscle_contraction
the act of decreasing (something) in size or volume or quantity or scope
a word formed from two or more words by omitting or combining some sounds; "`wont is a contraction of `will not"; "`oclock is a contraction of `of the clock"
abnormally high alkalinity (low hydrogen-ion concentration) of the blood and other body tissues

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〈U〉〈C〉(…の)収縮,短縮《+『of』+『名』》 / 〈U〉(通貨・資金・支出などの)縮小,節減《+『of』+『名』》 / 〈U〉(いやなこと・よくないことを)身に負うこと,(悪習などが)身につくこと《+『of』+『名』》 / 〈C〉陣痛

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出典(authority):フリー百科事典『ウィキペディア（Wikipedia）』「2014/05/06 18:44:43」(JST)

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Contraction alkalosis refers to the increase in blood pH that occurs as a result of fluid losses (volume contraction). The change in pH is especially pronounced with acidic fluid losses caused by problems like vomiting.

Pathophysiology

There are several possible explanations for the process of alkalosis observed after volume contraction.

One popular theory is that alkalosis is simply the loss of solvent volume without a proportional loss in bicarbonate concentration or increase in carbon dioxide concentration.^[1]^[2] This explanation may be especially appropriate for the very short term after volume loss.

Another suggests that the alkalosis is due to renal compensatory mechanisms used to correct volume loss. Extracellular fluid (ECF) volume contraction is associated with decreased blood volume and decreased renal perfusion pressure. Three compensation mechanisms engage as a result:

renin secretion is increased,
production of angiotensin II is increased, and
secretion of aldosterone is increased.

Increases in angiotensin II cause increased Na⁺-H⁺ exchange in the proximal tubule and increased HCO₃^- (bicarbonate) reabsorption in the proximal tubule due to increased luminal H⁺. Increased aldosterone secretion stimulates the H-ATPase of alpha-intercalated cells of the collecting duct, which causes 1) increased distal tubule H⁺ secretion, worsening the metabolic alkalosis, and 2) increased generation of "new" bicarbonate within these same cells, which will be reabsorbed.

Additionally, increased aldosterone secretion causes increased distal tubule K⁺ secretion, in turn causing the hypokalemia seen with contraction alkalosis. Alkalosis also induces H⁺-efflux from cells through the K⁺-H⁺ exchanger, leading to hypokalemia.

Finally, it has been suggested that the term "contraction alkalosis" is actually a misnomer, and that the alkalosis observed during volume contraction is actually attributable entirely to chloride depletion, which leads to a failure of pendrin, a chloride/bicarbonate exchanger in the collecting duct.^[3]

Treatment

Treatment consists of NaCl infusion to correct ECF volume contraction and administration of K⁺ to replace urinary losses.

References

^ "Acid-Base Tutorial - Metabolic Acidosis and Alkalosis". Acid-base.com. 2004-11-18. Retrieved 2012-02-15.
^ Garella, S; Chang, BS, Kahn, SI (Nov 1975). "Dilution acidosis and contraction alkalosis: review of a concept.". Kidney international 8 (5): 279–83. PMID 536. Cite uses deprecated parameters (help)
^ Luke, RG; Galla, JH (Feb 2012). "It is chloride depletion alkalosis, not contraction alkalosis.". Journal of the American Society of Nephrology : JASN 23 (2): 204–7. doi:10.1681/ASN.2011070720. PMC 3269186. PMID 22223876. Cite uses deprecated parameters (help)

http://www.nature.com/ki/journal/v54/n6/full/4490448a.html

UpToDate Contents

全文を閲覧するには購読必要です。 To read the full text you will need to subscribe.

1. 代謝性アルカローシスの原因 causes of metabolic alkalosis
2. 代謝性アルカローシスの治療 treatment of metabolic alkalosis
3. 代謝性アルカローシスの臨床症状および評価 clinical manifestations and evaluation of metabolic alkalosis
4. 代謝性アルカローシスの病因 pathogenesis of metabolic alkalosis

English Journal

Hyperventilation-induced respiratory alkalosis falls short of countering fatigue during repeated maximal isokinetic contractions.

Sakamoto A1, Naito H, Chow CM.
European journal of applied physiology.Eur J Appl Physiol.2015 Jul;115(7):1453-65. doi: 10.1007/s00421-015-3134-8. Epub 2015 Feb 17.
PURPOSE: Hyperventilation, implemented during recovery of repeated maximal sprints, has been shown to attenuate performance decrement. This study evaluated the effects of hyperventilation, using strength exercises, on muscle torque output and EMG amplitude.METHODS: Fifteen power-trained athletes und
PMID 25688041

Molecular pathophysiology of Bartter's and Gitelman's syndromes.

Koulouridis E1, Koulouridis I.
World journal of pediatrics : WJP.World J Pediatr.2015 May;11(2):113-25. doi: 10.1007/s12519-015-0016-4. Epub 2015 Mar 9.
BACKGROUND: In the last two decades, progress in cytogenetic and genome research has enabled investigators to unravel the underlying molecular mechanisms of inherited tubulopathies such as Bartter's and Gitelman's syndromes and helped physicians to better understand not only these two pathologic ent
PMID 25754753

The effect of metabolic alkalosis on central and peripheral mechanisms associated with exercise-induced muscle fatigue in humans.

Siegler JC1, Marshall P.
Experimental physiology.Exp Physiol.2015 Apr 20;100(5):519-30. doi: 10.1113/EP085054.
NEW FINDINGS: What is the central question of this study Does metabolic alkalosis affect central and peripheral mechanisms associated with exercise-induced muscle fatigue in humans What is the main finding and its importance Inducing metabolic alkalosis before exercise preserved voluntary activat
PMID 25727892

Japanese Journal

Electrical Alternans of the T-U Wave without Change in the QRS Complex.

KANEMOTO Nariaki,AOKI Naoto,GOTO Yuichiro
Internal Medicine 31(4), 486-488, 1992
… Electrocardiogram taken 4 days later showed ventricular quadrigeminy in which the T-U wave of the first sinus beat after the ventricular premature contraction was markedly less prominent compared to the successive two sinus beats which showed marked prolongation and inverted T-U waves. …
NAID 130000770028

Two cases of saline-responsive metabolic alkalosis associated with high urinary chloride concentrations.

WAKABAYASHI YASUHISA,MISHINA TAKAO,MARUMO FUMIAKI,KIKAWADA RHUICHI
The Tohoku Journal of Experimental Medicine 150(4), 427-433, 1986
… Two Cases of Saline-Responsive Metabolic Alkalosis Associated with High Urinary Chloride Concentrations. … Med., 1986, 150 (4), 427-433-Two particular cases of saline-responsive metabolic alkalosis associated with high urinary chloride concentrations were documented. …
NAID 130003493798

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リンク元	「濃縮性アルカローシス」
関連記事	「contraction」

「濃縮性アルカローシス」

　　[★]

英: contraction alkalosis
関: 体液濃縮性アルカローシス、攣縮性アルカローシス

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濃縮性アルカローシス : 約 38 件
体液濃縮性アルカローシス : 9 件

体液の減少による炭酸水素イオン濃度の上昇と血液のアルカリ化
NaClと水の喪失による細胞外液の減少が原因となりHCO3-の体外排泄が低下して生じる。

「contraction」

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n.

短縮、収縮。(筋肉の)収縮、攣縮。(医)(腎・肝・膀胱などの)萎縮
縮小。制限。(通貨・資金などの)制限、回収、縮小。不況
(数)縮小、縮約。省略算。(文法)縮約、短縮
負債を作ること、病気にかかること、癖のつくこと
交わり/約束を結ぶこと(of)

[1] "Acid-Base Tutorial - Metabolic Acidosis and Alkalosis". Acid-base.com. 2004-11-18. Retrieved 2012-02-15.

[2] Garella, S; Chang, BS, Kahn, SI (Nov 1975). "Dilution acidosis and contraction alkalosis: review of a concept.". Kidney international 8 (5): 279–83. PMID 536. Cite uses deprecated parameters (help)

[3] Luke, RG; Galla, JH (Feb 2012). "It is chloride depletion alkalosis, not contraction alkalosis.". Journal of the American Society of Nephrology : JASN 23 (2): 204–7. doi:10.1681/ASN.2011070720. PMC 3269186. PMID 22223876. Cite uses deprecated parameters (help)

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contraction alkalosis