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R D Bush

Publications and source records attributed to R D Bush.

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Corneocytes undergo systematic changes in element concentrations across the human inner stratum corneum.

Using analytical electron microscopy of freeze-dried cryosections, physiologic elements were visualized within individual cells across the human inner stratum corneum. Human corneocytes undergo systematic changes in element composition as they advance through this region. Phosphorus is largely excluded from the stratum corneum, undergoing a precipitous drop in concentration at the granular/stratum corneum interface. The cellular potassium concentration has a profile similar to that of phosphorus but with a slower decline, thus migrating further into the stratum corneum. In contrast, the cellular chloride concentration increases in the innermost corneocyte layer, increases further in the subsequent layer or two (as potassium declines), and then decreases to values comparable to those in the innermost corneocyte. The cellular sodium concentration (per unit volume of tissue) is relatively unaltered in transit across the inner stratum corneum. The initial potassium and chloride movements are oppositely directed and have the appearance of creating an electrical charge imbalance. The position-dependent alterations in corneocyte elemental composition may reflect sequential stages of chemical maturation occurring intracellularly during stratum corneum transit, an example of which is the breakdown of filaggrin that occurs over this same region of the inner stratum corneum.

Chlorine

Retrocecal appendicitis.

The clinical presentation of 105 cases of retrocecal appendicitis was reviewed. Thirty-six percent of the patients had the classic appendicitis scenario of periumbilical pain localizing to the right lower quadrant, accompanied by anorexia, nausea and vomiting, and tenderness and guarding in the right lower quadrant. The remaining 64 percent had subtle variations of this presentation. Retrocecal appendicitis did not have a distinctive clinical pattern in our series. Twelve of the 105 retrocecal appendices were also retroperitoneal. The diagnosis was delayed in four patients and two had flank pain. Five of the twelve appendices were either gangrenous or perforated. Although the number of patients is small, we conclude that the traditional type of retrocecal appendicitis can occur in the retroperitoneal subgroup but that his anatomic variation is infrequent. The incidence in our series was 2.5 percent.

Adolescent