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In 5, we talked about sacrifice and total commitment on a personal level: the decision to choose one path over another, with the awareness that it means giving things up Individuals do this only when they have a clear sense of the goal: the championship, the big contract, victory in the election This challenge is even greater at the organizational level As we said earlier, if people can t see it, they can t commit to it Unless your power to articulate a vision is strong, you can t call forth organizational commitment Your people have to see, hear, taste,

Her PDA is now synchronizing its Personal Information Management (PIM) software schedules, sales contacts, addresses wirelessly with her desktop computer in Los Angeles Down comes her updated calendar, down comes a skinnied down contact list she ll need today from her customer list in her Customer Relationship Management (CRM) system More news flashes: WORLD ECONOMY IS SHAKEN BY SLOW DOWN IN ASIA PACIFIC plus half a dozen e-mails, a logistics report from a shipper that manages load tracking via the wireless web LOST PACKAGE: her display reads DO YOU WANT THE TRACKING NUMBER She rises now and drops her robe on the floor, enjoying an off-color note from her boyfriend appended to a Lotus Notes document (he works in the Hong Kong office) She is singing, Shall We Dance showering to the tunes from NAPSTER downloaded to her PDA Her world phone rings and synchronizes through a Bluetooth wireless connection with her laptop The laptop is open, and she reads her morning mail Another CNN news flash: NASDAQ TAKES BEATING; another four voice mails telling her the home office can t find that Osaka shipment And now the hotel breakfast menu flashes on her PDA in English and Japanese, with prices marked clearly in Yen Down comes the menu; down comes her link to a digital expense report; down comes her recorded preferences; will she stick with the same breakfast Of course, with one exception (bacon) The FedEx tracking number of that lost package is pushed to her screen where has the package gone Through the surging droplets of water, she hears a growl: Pick up the phone, damnit It s her boss She doesn t answer She hears and sees his awful Max Headroom jabber on her PDA in another short video link as he exhorts the Tokyo sales team to make their numbers this month She wonders if anyone has ever had cleaner fingernails Another love note: Donald misses her so much will she call tonight to help with homework It s her ten year-old son Nothing is too far fetched for her Mentally, she is hard wired to her PDA, her laptop, and her networks; everything else is wireless and.

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volume (ie, the volume of blood plasma and fluid in the interstitial spaces of the tissues throughout the body) Fluid in the interstitial spaces acts as a buffer for plasma volume, protecting the vascular compartment from immediate changes associated with drinking, sweating, and so on However, over time, sustained changes in ECF volume lead to parallel changes in blood volume and ultimately arterial pressure If the vascular system is inappropriately filled on a prolonged basis, the setpoint gradually drifts To keep arterial pressure normal, the ECF volume must be kept normal In many ways, regulating the ECF volume to a level appropriate for the vascular system is the most important function of the kidneys The relationship between blood volume and total body water may appear obvious, but the relationship between total body sodium content and blood volume may not However, as discussed in 4, there is a simple relation between the volume of a compartment (essentially the amount of water) and its osmolarity: osmolarity 5 total osmoles/volume3 In other words, volume 5 total osmoles/ osmolarity Therefore, the ECF volume is determined by the total osmotic content

W H AT I T TA K E S T O B E # 1

3 Here again, we use osmolarity for simplicity, recognizing that osmolality is actually the quantity that governs osmotic flow

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Figure 7 7 The macula densa NaCl load sensor Macula densa cells in the thick ascending limb sense sodium chloride delivery by changing the uptake of salt with subsequent osmotic swelling (see Figure 7 3) Changes in cell volume lead to the release of chemical transmitters that alter renin secretion from the granular cells: When sodium chloride delivery increases, renin production decreases GFR, glomerular filtration rate

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