Adolescent and young adult women's misunderstanding of the term Pap smear.

OBJECTIVE: To learn more about young women's understanding of the term Pap smear. DESIGN: Self-administered survey. SETTING: UMass Memorial Adolescent Clinic. PARTICIPANTS: Female patients 14 years or older (and their mothers when available) who visited the clinic between June 10 and August 9, 2002. MAIN OUTCOME MEASURES: Accuracy of participants' written definition for the term Pap smear and knowledge that a "Pap smear" is a test for cervical cancer and not synonymous with a pelvic examination, sexually transmitted disease test, pregnancy test, or checkup. RESULTS: Three (2.7%) of the 111 adolescent participants provided an accurate definition of the term Pap smear. Sixty-eight percent mistakenly believed that a Pap smear was the same as a pelvic examination. Age, history of sexual intercourse, and having had a Pap smear correlated with a better Pap smear definition rating. CONCLUSIONS: Remarkably few patients who participated in this study understood the meaning of the term Pap smear. Confusion about gynecologic terms may hinder efforts to enhance compliance with sexually transmitted disease and cervical cancer screening. Educational initiatives are needed to improve young people's comprehension and to prevent misunderstandings about gynecologic care and miscommunication between patients and their health care providers.

Membrane localization and topology of leukotriene C4 synthase.

Leukotriene C(4) (LTC(4)) synthase conjugates LTA(4) with GSH to form LTC(4). Determining the site of LTC(4) synthesis and the topology of LTC(4) synthase may uncover unappreciated intracellular roles for LTC(4), as well as how LTC(4) is transferred to its export carrier, the multidrug resistance protein-1. We have determined the membrane localization of LTC(4) synthase by immunoelectron microscopy. In contrast to the closely related five-lipoxygenase-activating protein, LTC(4) synthase is distributed in the outer nuclear membrane and peripheral endoplasmic reticulum but is excluded from the inner nuclear membrane. We have combined immunofluorescence with differential membrane permeabilization to determine the topology of LTC(4) synthase. The active site of LTC(4) synthase is localized in the lumen of the nuclear envelope and endoplasmic reticulum. These results indicate that the synthesis of LTB(4) and LTC(4) occurs in different subcellular locations and suggests that LTC(4) must be returned to the cytoplasmic side of the membrane for export by multidrug resistance protein-1. The differential localization of two very similar integral membrane proteins suggests that mechanisms other than size-dependent exclusion regulate their passage to the inner nuclear membrane.

Myeloid expression of cytochrome P450 4F3 is determined by a lineage-specific alternative promoter.

The cytochrome P450 4F3 (CYP4F3) gene encodes two functionally distinct enzymes that differ only by the selection of exon 4 (CYP4F3A) or exon 3 (CYP4F3B). CYP4F3A inactivates leukotriene B4, a reaction that has significance for controlling inflammation. CYP4F3B converts arachidonic acid to 20-hydroxyeicosatetraenoic acid, a potent activator of protein kinase C. We have previously shown that mRNAs coding for CYP4F3A and CYP4F3B are generated from distinct transcription start sites in neutrophils and liver. We therefore investigated mechanisms that regulate the cell-specific expression of these two isoforms. Initially, we analyzed the distribution of CYP4F3 in human leukocytes and determined a lineage-specific pattern of isoform expression. CYP4F3A is expressed in myeloid cells and is coordinate with myeloid differentiation markers such as CD11b and myeloperoxidase during development in the bone marrow. In contrast, CYP4F3B expression is restricted to a small population of CD3+ T lymphocytes. We identified distinct transcriptional features in myeloid, lymphoid, and hepatic cells that indicate the presence of multiple promoters in the CYP4F3 gene. The hepatic promoter depends on a cluster of hepatocyte nuclear factor sites 123-155 bp upstream of the initiator ATG codon. The myeloid promoter spans 400 bp in a region 468-872 bp upstream of the ATG codon; it is associated with clusters of CACCT sites and can be activated by ZEB-2, a factor primarily characterized as a transcriptional repressor in cells that include lymphocytes. ZEB-2 interacts with C-terminal binding protein and Smads, and this would provide opportunities for integrating environmental signals in myelopoiesis and inflammation.