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Biomedical subjects

C J Fleming

Publications and source records attributed to C J Fleming.

At least 19 recordsLinked to original sources
PubMed2004

DNA sequence and analysis of human chromosome 9.

Chromosome 9 is highly structurally polymorphic. It contains the largest autosomal block of heterochromatin, which is heteromorphic in 6-8% of humans, whereas pericentric inversions occur in more than 1% of the population. The finished euchromatic sequence of chromosome 9 comprises 109,044,351 base pairs and represents >99.6% of the region. Analysis of the sequence reveals many intra- and interchromosomal duplications, including segmental duplications adjacent to both the centromere and the large heterochromatic block. We have annotated 1,149 genes, including genes implicated in male-to-female sex reversal, cancer and neurodegenerative disease, and 426 pseudogenes. The chromosome contains the largest interferon gene cluster in the human genome. There is also a region of exceptionally high gene and G + C content including genes paralogous to those in the major histocompatibility complex. We have also detected recently duplicated genes that exhibit different rates of sequence divergence, presumably reflecting natural selection.

Base Composition↗
PubMed2004

A pilot study of treatment of lentigo maligna with 5% imiquimod cream.

BACKGROUND: Lentigo maligna (LM) is an in situ form of malignant melanoma, and surgical excision is often unsatisfactory. Imiquimod cream is an immune response modifier and induces a predominantly T-helper 1 type response. OBJECTIVES: Assessment of histological and clinical response of surgically resectable LM after treatment with 5% imiquimod cream. METHODS: Six patients with LM were treated with 5% imiquimod cream daily for 6 weeks. The whole site of the original lesion was then excised. Clinical and histological and appearances were measured using clinical response and histological grading scores. RESULTS: Complete or almost complete clearance of pigmentation with minimal residual histological evidence of LM was observed in four patients, one patient showed no clinical or histological improvement, and the remaining patient had almost no residual pigmentation clinically after treatment yet histopathological changes remained as severe as before treatment. CONCLUSIONS: Topical imiquimod cream merits further investigation as a new therapy for LM.

Administration, Topical↗
PubMed2002

Cosmetic camouflage advice improves quality of life.

BACKGROUND: The subjective benefit of attendance at cosmetic clinics has not previously been reported. OBJECTIVES: To assess the effect on perceived quality of life (QoL) of cosmetic camouflage advice. METHODS: In a three-centre study, 135 individuals were invited to complete a dermatology-specific QoL measure, the Dermatology Life Quality Index (DLQI), before and 1 month after their first visit to a cosmetic camouflage clinic. RESULTS: Eighty-two completed DLQI questionnaires were returned before the camouflage clinic appointment, and 56 corresponding questionnaires were returned 1 month after. The mean age of responders was 50 years, and the mean duration of their skin conditions was 15 years. The main conditions seen were pigmentary disorders (29%), scars (22%) and vascular disorders (13%). There was a significant difference in mean DLQI scores before and after the clinic visit (9.1 vs. 5.8, P = 0.0001). CONCLUSIONS: When assessed at 1 month, attendance at a cosmetic camouflage clinic appears to improve QoL significantly.

Activities of Daily Living↗
PubMed2000

Survey of patch testing in Scotland.

We have surveyed Scottish dermatologists to establish the extent of patch testing, to assess the reasons for referral and to document resources and methods used by dermatologists. 104 questionnaires were sent to members of the Scottish Dermatological Society. 82 questionnaires (79%) were returned. 50% of respondents were consultants, 27% were trainees and 23% held staff grade or clinical assistant positions. The mean waiting time for a patch test appointment was 4.5 months. The most frequent reasons for patch testing were localized eczema, eczema not responding to conventional treatment, occupational eczema, history of contact sensitivity and eczema of uncertain cause. 17 of 82 respondents (21%) were the principal clinicians supervising patch testing in their hospitals. 11 of 17 read reactions at 2 and 4 days. Mean time spent on advising patients was 13 min per patients. 7 of 17 were dissatisfied with resources available for patient education and 16 of 17 felt they would benefit from a central source for patient information. Only 4 of 17 centres recorded patch test results on a database and 3 centres regularly reviewed their patch test results. In conclusion, we have identified areas of patch testing that require further improvement.

Dermatitis, Allergic Contact↗
PubMed2000

Accuracy of questions related to allergic contact dermatitis.

BACKGROUND: The ability of a physician to select individuals likely to benefit from patch testing depends on his or her ability to interpret responses to enquiries related to contact allergy. The significance of such responses to questions of nickel, fragrance and colophon allergy is unclear. OBJECTIVE: The specificity, sensitivity and predictive value of questions relating to nickel, fragrance and colophony allergy were determined. METHOD: A total of 258 patients attending for routine patch testing were questioned about skin reactions to nickel, fragrances and Elastoplast (Smith and Nephew Healthcare, Hull, England). All subjects were then patch tested to nickel, fragrance mix, and colophony. Responses to questions were compared with patch test results. RESULTS: The sensitivity of questions relating to nickel, fragrance, and colophony was 82%, 49%, and 71%, respectively. The specificity of the same questions was 77%, 79%, and 90%; the positive predictive value was 54%, 46% and 29%, respectively. After adjustment to include clinical relevance, the sensitivity of nickel questions rose to 100%. CONCLUSION: These data permit greater understanding of the role of patient history in selection of patients for patch testing.

Allergens↗
PubMed1999

Contact sensitivity to cigarettes and matches.

The results of patch testing with a series containing components of cigarettes and matches were reviewed. 2 years were reviewed, 1987 and 1997. 314 patients were patch tested to this series, 203 in 1987 and 111 in 1997. 31 patients had clinically relevant positive reactions to the series, 25 in 1987 and 6 in 1997. 26 patients had relevant positive tests to cigarette components in the series. There were 14 relevant positive reactions to phosphorus sesquisulfide in 1987 and one in 1997. All patients with relevant positive reactions to red match tips also had reactions to phosphorus sesquisulfide. There was a significant association between cigarette and fragrance hypersensitivity. The eczema in 3 of 4 patients who stopped smoking improved. A series containing match heads, smoked cigarette filters and remnants of tobacco from smoked cigarettes may be useful in smokers with eczema of the face, neck or hands.

Adult↗
PubMed1999

The genetics of allergic contact hypersensitivity to nickel.

We have examined evidence for familial disposition to nickel allergic contact dermatitis (Ni ACD). 258 patients attending for routine patch testing were recruited prospectively. 39 patients were diagnosed with Ni ACD. 31 of 209 1st-degree relatives (15%) of probands had a history of nickel hypersensitivity. 84 patients with no history of nickel hypersensitivity and negative patch tests to nickel were used as controls. 24 of 458 1st degree relatives of controls (5.2%) had a history of Ni ACD. The risk ratio for 1st degree relatives of a patient with Ni ACD is 2.83 (95% confidence intervals are 2.45, 3.27). This is the 1st study to present a statistic to represent risk to relatives of developing ACD. Relatives of patients with Ni ACD have an increased risk of developing the condition, but the genetic basis for this is not yet known. With currently available techniques, this value of relative risk makes a positional cloning approach to gene identification impractical.

Dermatitis, Allergic Contact↗