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All right, barked my father enthusiastically, switching gears with astonishing ease Now that s the kind of attitude I want to see! Who else feels that way The answer, of course, was that everybody felt that way First one person got up, then another, and then another Eventually, my father had the whole team on its feet, expressing its desire and determination to win Other times, particularly after a good (but losing) effort, my father would take an entirely different approach

The hydrogen ion is secreted across the apical membrane to combine with another luminal bicarbonate and the cellular bicarbonate leaves the cell across the basolateral membrane to enter the plasma The overall result is that the bicarbonate filtered from the blood at the renal corpuscle has disappeared, replaced by the bicarbonate that reenters the plasma from inside the cell Thus, no net change in plasma bicarbonate concentration has occurred as all bicarbonate filtered has combined with secreted hydrogen ion and subsequently ended up first inside the cell and then in plasma It may seem inaccurate to refer to this process as bicarbonate reabsorption because the bicarbonate that appears in the peritubular capillary is not the same bicarbonate that was filtered Yet the overall result is the same as it would be if the filtered bicarbonate had been more conventionally reabsorbed, like a sodium or potassium ion It is also important to note that the hydrogen ion that was secreted into the lumen is not excreted in the urine It has been incorporated into water Any secreted hydrogen ion that combines with bicarbonate in the lumen to cause bicarbonate reabsorption does not contribute to the urinary excretion of hydrogen ions but only to the conservation of bicarbonate Specific transporters are required for the transmembrane movements of both the hydrogen ion and the bicarbonate Active transport of hydrogen ion across the luminal membrane from cell to lumen is achieved by several distinct luminal membrane transporters First, particularly prominent in the proximal tubule is

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Perhaps you didn t realize you could have won this game But I think there s no doubt in your minds now And that s why you will win it all next year This will never happen again You will never lose another championship

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Figure 9 2 Predominant proximal tubule mechanism for reabsorption of bicarbonate Hydrogen ions and bicarbonate are produced intracellularly The hydrogen ions are secreted via an Na-H antiporter (member of the NHE family), while the bicarbonate is transported into the interstitium via an Na-3HCO3 symporter (member of the NBC family) As more sodium enters via the Na-H antiporter than leaves via the Na-3HCO3 symporter, additional sodium is removed via the Na-K-ATPase

That s what he told the team after Green Bay lost the championship game to Philadelphia in 1960 Some people have misread this kind of inconsistency as pure manipulation, an effort to keep everybody guessing, off balance, on edge, on their toes What s Coach going to do next There was some of that at play here But mainly, I think that in both cases, he was expressing his emotions honestly I think he was also using the specifics of the two defeats one sloppy and filled with mistakes, the other courageous to steer the team toward a better outcome next time It was just a matter of different situations, different tactics

regulation of hydrogen ion balanCe / 165

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

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There is a time when violent reactions are in order And there are times when purring like a pussycat and bestowing thanks and gratitude are equally desirable Each of us must learn when the time fits the response, and must tailor our action or reaction to each situation

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