The bithorax complex iab-7 Polycomb response element has a novel role in the functioning of the Fab-7 chromatin boundary.

Expression of the three bithorax complex homeotic genes is orchestrated by nine parasegment-specific regulatory domains. Autonomy of each domain is conferred by boundary elements (insulators). Here, we have used an in situ replacement strategy to reanalyze the sequences required for the functioning of one of the best-characterized fly boundaries, Fab-7. It was initially identified by a deletion, Fab-71, that transformed parasegment (PS) 11 into a duplicate copy of PS12. Fab-71 deleted four nuclease hypersensitive sites, HS*, HS1, HS2, and HS3, located between the iab-6 and iab-7 regulatory domains. Transgenic and P-element excision experiments mapped the boundary to HS*+HS1+HS2, while HS3 was shown to be the iab-7 Polycomb response element (PRE). Recent replacement experiments showed that HS1 is both necessary and sufficient for boundary activity when HS3 is also present in the replacement construct. Surprisingly, while HS1+HS3 combination has full boundary activity, we discovered that HS1 alone has only minimal function. Moreover, when combined with HS3, only the distal half of HS1, dHS1, is needed. A ~1,000 kD multiprotein complex containing the GAF protein, called the LBC, binds to the dHS1 sequence and we show that mutations in dHS1, that disrupt LBC binding in nuclear extracts, eliminate boundary activity and GAF binding in vivo. HS3 has binding sites for GAF and Pho proteins that are required for PRE silencing. In contrast, HS3 boundary activity only requires the GAF binding sites. LBC binding with HS3 in nuclear extracts, and GAF association in vivo, depend upon the HS3 GAF sites, but not the Pho sites. Consistent with a role for the LBC in HS3 boundary activity, the boundary function of the dHS1+HS3mPho combination is lost when the flies are heterozygous for a mutation in the GAF gene. Taken together, these results reveal a novel function for the iab-7 PREs in chromosome architecture.

Making connections: insulators organize eukaryotic chromosomes into independent cis-regulatory networks.

Insulators play a central role in subdividing the chromosome into a series of discrete topologically independent domains and in ensuring that enhancers and silencers contact their appropriate target genes. In this review we first discuss the general characteristics of insulator elements and their associated protein factors. A growing collection of insulator proteins have been identified including a family of proteins whose expression is developmentally regulated. We next consider several unexpected discoveries that require us to completely rethink how insulators function (and how they can best be assayed). These discoveries also require a reevaluation of how insulators might restrict or orchestrate (by preventing or promoting) interactions between regulatory elements and their target genes. We conclude by connecting these new insights into the mechanisms of insulator action to dynamic changes in the three-dimensional topology of the chromatin fiber and the generation of specific patterns of gene activity during development and differentiation.

[The Asahi Model-Regional Mental Health Services at Department of Psychiatry and Child Psychiatry, Asahi General Hospital].

The Asahi model, Psychiatric Services of Department of Psychiatry and Child Psychiatry, Asahi General Hospital, is characterized by multiple dimensions of mental health services, such as multidisciplinary team approach, medical cooperation, specialized psychiatric treatment of acute care, clozapine and modified ECT, outreach services of home nursing and assertive community treatment, and the close and mutual coordination with housing services and social welfare services. The Asahi Model makes it possible to be deinstitutionalized, to improve patients satisfaction, to shorten hospitalization, to decrease psychiatric emergency visits and to be of service in a natural disaster. It also might prevent the relapse of schizophrenics within twelve months after discharge and improve the quality of mental health staffs trainings to support patients better. In the future, we will need to work on providing sectorized care, early psychosis intervention programs, to construct networking systems of clozapine and modified ECT, to strengthen growth of home nursing, and to take place mental health anti-stigma campaigns.

MTHFR polymorphisms C677T and A1298C and associations with IVF outcomes in Brazilian women.

The aim of this study was to investigate the association between MTHFR gene polymorphisms and IVF outcomes in Brazilian women undergoing assisted reproduction treatment. A prospective study was conducted in the Human Reproduction Department at the ABC University School of Medicine and the Ideia Fertility Institute between December 2010 and April 2012. The patient population was 82 women undergoing assisted reproduction cycles. The MTHFR polymorphisms C677T and A1298C were evaluated and compared with laboratory results and pregnancy rates. The C677T variant was associated with proportions of mature (P=0.006) and immature (P=0.003) oocytes whereas the A1298C variant was associated with number of oocytes retrieved (P=0.044). The polymorphisms, whether alone or in combination, were not associated with normal fertilization, good-quality embryo or clinical pregnancy rates. This study suggests that the number and maturity of oocytes retrieved may be related to the MTHFR polymorphisms C677T and A1298C. It is believed that folate has a crucial function in human reproduction and that folate deficiency can compromise the function of the metabolic pathways it is involved in, leading to an accumulation of homocysteine. The gene MTHFR encodes the 5-MTHFR enzyme, which is involved in folate metabolism, and C677T/A1298C polymorphisms of this gene are related to decreased enzyme activity and consequent changes in homocysteine concentration. Folate deficiency and hyperhomocysteinaemia can also compromise fertility and lead to pregnancy complications by affecting the development of oocytes, preparation of endometrial receptivity, implantation of the embryo and pregnancy. In folliculogenesis, hyperhomocysteinaemia can activate apoptosis, leading to follicular atresia and affecting the maturity of oocytes and the quality of embryos cultured in vitro. This study was performed to investigate the association between MTHFR polymorphisms and IVF outcomes in women undergoing assisted reproduction treatment.

Impact of laparoscopic colorectal segment resection on quality of life in women with deep endometriosis: one year follow-up.

PURPOSE: To evaluate the changes in quality of life (QOL) over a 1-year follow-up period in patients submitted to laparoscopic colorectal resection for the treatment of deep endometriosis. METHODS: A prospective observational cohort study (Canadian Task Force Design Classification II) involving 40 women with intestinal deep endometriosis was conducted between June 2007 and September 2008 at the Department of Obstetrics and Gynecology, Santa Casa Medical School, Sao Paulo, Brazil. Prior to the surgical procedure, all patients received magnetic resonance studies of the pelvis and rectal echoendoscopy, which suggested intestinal involvement of the disease in all cases. The patients received laparoscopic colorectal resections and treatment for other endometriotic lesions. The subjects completed the QOL SF-36 at 3 time points (T0 pre-operatively; T1 6 months post-operatively; and T2 1 year post-operatively). RESULTS: The physical functioning, role physical, social functioning and role emotional subscales evidenced the most substantial median increases for T0, T1 and T2. The pain, general health, vitality and mental health domains showed slight changes and increases in medians but did not increase to the same extent as the previous group. Significant improvements were observed in all domains of the SF-36 throughout the study period (p < 0.05). Physical health-related QOL domains showed greater improvement than mental health domains. Analyses of age, parity and body mass index as potential factors influencing the impact of surgery on QOL revealed no differences. Therefore, these factors were not used as prognostic indicators for the surgical procedure or for patient follow-up. In addition, we noted that the patients with poorest results on the initial QOL questionnaire showed the greatest improvements at the end point. CONCLUSION: The study results showed that laparoscopic colorectal segment resection for endometriosis had a positive impact on QOL in this patient group. The positive effects persisted 1 year after surgery.

Nodal-dependent mesendoderm specification requires the combinatorial activities of FoxH1 and Eomesodermin.

Vertebrate mesendoderm specification requires the Nodal signaling pathway and its transcriptional effector FoxH1. However, loss of FoxH1 in several species does not reliably cause the full range of loss-of-Nodal phenotypes, indicating that Nodal signals through additional transcription factors during early development. We investigated the FoxH1-dependent and -independent roles of Nodal signaling during mesendoderm patterning using a novel recessive zebrafish FoxH1 mutation called midway, which produces a C-terminally truncated FoxH1 protein lacking the Smad-interaction domain but retaining DNA-binding capability. Using a combination of gel shift assays, Nodal overexpression experiments, and genetic epistasis analyses, we demonstrate that midway more accurately represents a complete loss of FoxH1-dependent Nodal signaling than the existing zebrafish FoxH1 mutant schmalspur. Maternal-zygotic midway mutants lack notochords, in agreement with FoxH1 loss in other organisms, but retain near wild-type expression of markers of endoderm and various nonaxial mesoderm fates, including paraxial and intermediate mesoderm and blood precursors. We found that the activity of the T-box transcription factor Eomesodermin accounts for specification of these tissues in midway embryos. Inhibition of Eomesodermin in midway mutants severely reduces the specification of these tissues and effectively phenocopies the defects seen upon complete loss of Nodal signaling. Our results indicate that the specific combinations of transcription factors available for signal transduction play critical and separable roles in determining Nodal pathway output during mesendoderm patterning. Our findings also offer novel insights into the co-evolution of the Nodal signaling pathway, the notochord specification program, and the chordate branch of the deuterostome family of animals.

Twelve years of MSOME and IMSI: a review.

A promising method for observing spermatozoa, motile sperm organelle morphology examination (MSOME) enables the evaluation of the nuclear morphology of motile spermatozoa in real time at high magnification and has allowed the introduction of a modified microinjection procedure, intracytoplasmic morphologically selected sperm injection (IMSI). Since its development, several studies have intensively investigated the efficacy of MSOME and IMSI. The objective of the present study is to review the current literature on the MSOME and IMSI techniques. A promising method for observing spermatozoa, motile sperm organelle morphology examination (MSOME), enables the evaluation of the nuclear morphology of motile spermatozoa in real time at high magnification and has allowed the introduction of a modified microinjection procedure, intracytoplasmic morphologically selected sperm injection (IMSI). Since its development, several studies have intensively investigated the efficacy of MSOME and IMSI. The objective of the present study is to review the current literature on the MSOME and IMSI techniques.

Zelda is dispensable for Drosophila melanogaster histone gene regulation.

To ensure that the embryo can package exponentially increasing amounts of DNA, replication-dependent histones are some of the earliest transcribed genes from the zygotic genome. However, how the histone genes are identified is not known. The pioneer factors Zelda and CLAMP collaborate at a subset of genes to regulate zygotic genome activation in Drosophila melanogaster and target early activated genes to induce transcription. CLAMP also regulates the embryonic histone genes and helps establish the histone locus body, a suite of factors that controls histone mRNA biosynthesis. The relationship between Zelda and CLAMP led us to hypothesize that Zelda helps identify histone genes for early embryonic expression. We found that Zelda targets the histone locus early during embryogenesis, prior to histone gene expression. However, depletion of zelda in the early embryo does not affect histone mRNA levels or histone locus body formation. While surprising, these results concur with other investigations into Zelda's role in the early embryo, suggesting the earliest factors responsible for specifying the zygotic histone genes remain undiscovered.

The Portuguese validation of the short form of the Pelvic Organ Prolapse/Urinary Incontinence Sexual Questionnaire (PISQ-12).

INTRODUCTION AND HYPOTHESIS: Sexual well-being is an important aspect of women's life. The objective of this study was to validate the Portuguese-translated version of the short form of the Pelvic Organ Prolapse/Urinary Incontinence Sexual Questionnaire--PISQ-12. METHODS: Sixty-four women were enrolled to participate in the process of validating the PISQ-12 (study group). A further 68 subjects were allocated to a control group for comparison between the group of women with pelvic organ prolapse/urinary incontinence and the asymptomatic group. RESULTS: The PISQ-12 presented good internal consistency (Cronbach's alpha of 0.79 for the study group and 0.80 for the control group). The test-retest reliability using the intraclass correlation coefficient was 0.77. Mean score on the PISQ-12 was significantly higher in the control group than in the study group (42.7 ± 3.9 vs 27.8 ± 9.3) CONCLUSIONS: The Portuguese version of the PISQ-12 was reliable for the assessment of sexual function in women with pelvic organ prolapse/urinary incontinence.

Myeloperoxidases and polycystic ovary syndrome.

New biological markers are emerging trying to identify earlier cardiovascular high risk subjects. Myeloperoxidases have been involved in the role of atherosclerosis process, by the beginning of the endothelial dysfunction up to the plaque rupture and clinical manifestation, and it has been demonstrated that this enzyme has also a prognostic value. We aimed to assess myeloperoxidases levels in patients with polycystic ovary syndrome (PCOS) with insulin resistance (IR), considering that these women represent a high risk group for cardiovascular disease. We developed a transversal study, comprising 26 patients with PCOS and IR and 30 controls (PCOS without IR). IR was considered with HOMA-IR ≥3.0. IR absence was considered when HOMA-IR <3.0, triglycerides <200, BMI <28.7, and BMI<27.8 in patients with familial history of type 2 diabetes. All patients went through anamnesis, physical examination, transvaginal ultrasound, and blood samples. IR PCOS patients had higher levels of myeloperoxidase (22.3 × 18.1, p = 0.047), and also higher BMI. Myeloperoxidase levels correlated directly with insulin. In conclusion, IR PCOS young patients have higher myeloperoxidase levels.

Pubococcygeal activity on perineal ultrasound in incontinent women.

INTRODUCTION AND HYPOTHESIS: The aim of this study was to investigate the applicability and reproducibility of perineal ultrasound (US) in the evaluation of the pubococcygeal muscle (PCM) activity in urinary incontinent women. METHODS: Thirty women were assessed twice by two examiners who measured the angle between the lateral bundles of the PCM. The 2D US on coronal view evaluated the PCM performance during squeezing, straining, and resting. RESULTS: There was significant correlation (p ≤ 0.001) in all measurements to both examiners, except for the contraction on their second assessment. The images showed asymmetries of muscle volume and activity. Five women (16.7%) had difficulty to rest after squeezing or straining, six (20%) first opened the muscle bundles when asked to squeeze them, and eight (26.7%) had no movement during different moments. CONCLUSIONS: The 2D perineal US on coronal view is useful to evaluate PCM activity. It is easily applicable and reproducible.

Assessment of placental blood flow between 22 and 34 weeks of gestation by 3D-sonography power Doppler vascular indices.

PURPOSE: To analyze and compare the vascular flow in different parts of the placenta of normal pregnant women between 22 and 34 weeks of gestation through three-dimensional power Doppler ultrasonography (3D power Doppler) vascular indices. METHODS: This is a cross-sectional study involving 55 normal pregnant women with gestational ages between 22 and 34 weeks. The vascularization index (VI), flow index (FI) and vascularization flow index (VFI) were obtained using the virtual organ computer-aided analysis (VOCAL) method both in the region of placental cord insertion and the peripheral region of the placenta. The Wilcoxon test was applied, adopting a significance level of 5% to evaluate possible differences in these indices between study areas. RESULTS: For the three indices examined (VI, FI and VFI), a statistically significant difference was obtained between the insertion of the umbilical cord, designated as the center, and the placental periphery on both the right (p < 0.001 for VI, p = 0.001 for FI and p < 0.001 for VFI) and the left (p < 0.001 for VI, p < 0.001 for FI and p = 0.001 for VFI), taken as the average of the rates obtained in the two peripheries (p < 0.001 for VI, p < 0.001 for FI and p = 0.003 for VFI). Differences were not found when the two peripheral areas were compared or if placenta was anterior or posterior (p > 0.05). CONCLUSION: There is a statistically significant difference between the vascular indices obtained with a 3D power Doppler at different points of the placenta.

Risk factors for early-phase clozapine discontinuation: A nested case-control study.

OBJECTIVES: Safe and efficient methods for introducing clozapine to patients with treatment-resistant schizophrenia (TRS) are needed. We investigated risk factors for clozapine discontinuation in the early phase of its introduction. METHODS: We conducted a nested case-control study at 14 psychiatric hospitals in Chiba, Japan. Data from pre-registered TRS patients were collected at 7 time points within 12 weeks before and after the start of clozapine introduction. We examined the demographic data, prior and concomitant psychotropic drugs, strategies for switching from prior antipsychotics, and blood test and Global Assessment of Function results. The Clinical Global Impression-Severity Scale was retrospectively scored at 12 weeks before and after clozapine introduction. RESULTS: Of 228 patients, clozapine treatment was continued in 213 (93.4 %) and discontinued in 15 (6.6 %) patients within 12 weeks. Clinical symptoms were improved to mild symptoms with a response rate of 14.9 %. Prior antipsychotics and concomitant psychotropic drugs except for mood stabilizers were significantly decreased. Histories of smoking (OR = 3.32, 95 %CI: 1.11-9.93) and antipsychotic treatment at chlorpromazine-equivalent doses <1200 mg within the past 5 years (OR = 3.93, 95 %CI: 1.24-12.50), but not antipsychotic switching strategy, were associated with clozapine discontinuation. Eosinophilia was the most frequent reason for discontinuation (n = 3, 20 %) and was associated with concomitant valproate at 4 weeks after the introduction. CONCLUSION: Clozapine is an effective option for TRS patients (especially those treated with higher doses of prior antipsychotics) in Japan. Clinicians should be cautious about concomitant valproate in the early phase of clozapine introduction due to a high risk of eosinophilia.

Transvaginal polypropylene mesh versus sacrospinous ligament fixation for the treatment of uterine prolapse: 1-year follow-up of a randomized controlled trial.

INTRODUCTION AND HYPOTHESIS: The objective of this study was to compare the anatomical and quality of life outcomes of a posterior polypropylene mesh kit versus sacrospinous ligament fixation at the time of hysterectomy for the treatment of uterine prolapse. METHODS: Thirty-two women aged 50 to 75 years with stage III or IV (pelvic organ prolapse quantification system/International Continence Society) uterine prolapse were randomized into two groups (group 1: polypropylene mesh, Nazca R, Promedon, Cordoba, Argentina; group 2: sacrospinous ligament fixation). RESULTS: At 12-month follow-ups, we observed the same anatomical results in both groups. The median operating time, intraoperative blood loss, and perioperative complications were also equal in both groups. There were five cases (35.71%) of mesh erosion, and prolapse of the anterior vaginal wall (cystocele) occurred in 50% of the patients. CONCLUSIONS: Similar anatomical and quality of life outcomes were observed with polypropylene mesh and sacrospinous ligament fixation for the treatment of uterine prolapse. Complication rate was higher in the mesh group.

Oncological repercussions of polycystic ovary syndrome.

Polycystic ovary syndrome (PCOS) is a highly prevalent endocrine disorder that has been associated with insulin resistance and metabolic syndrome. Evidence has suggested that PCOS may be associated with the appearance of certain types of cancer, particularly endometrial, ovarian and breast cancer. The objective of this review was to collect further evidence of these correlations and to identify their possible mechanisms.

Is intensive case management screening sheet score associated with service intensity?

AIMS: Since April 2020, the new Japanese mental health system has used the Intensive Case Management Screening Sheet (ICMSS) to identify patients' needs for case management services. This study aimed to examine the association between ICMSS score and service intensity and compare the magnitude of association between ICMSS score and service intensity with other scales. METHODS: We recruited patients who received case management services from a staff member in a psychiatric outpatient service, psychiatric day-care program, or outreach team based at one psychiatric hospital. Case management service needs and functioning were assessed using ICMSS, Global Assessment Functioning (GAF), and Personal and Social Performance (PSP). The case manager also documented all services received by the participant for 2 months. The association between each scale and service duration was examined. Furthermore, the magnitude of the association between each scale and service intensity was compared. RESULTS: Overall, 138 participants were included in the analysis. The most common diagnosis was schizophrenia. Mean total service duration was weakly but significantly correlated with ICMSS (Spearman's ρ = 0.320), GAF (ρ = -0.198), and PSP (ρ = -0.275) scores. Poisson's regression models and postestimation testing showed that the coefficient for ICMSS score (B = 0.144; 95% CI = 0.141, 0.148) was significantly larger than the coefficients for GAF (B = -0.017, 95% CI = -0.017, -0.016, χ2  = 15.70, P < 0.001) and PSP (B=-0.016, 95% CI = -0.017, -0.016, χ2  = 14.64, P < 0.001) scores. CONCLUSION: ICMSS may provide preliminary information on case management service needs, but the level of service should be based on the individual needs of each patient and shared decision-making between the patient and case manager.

Zona pellucida birefringence score and meiotic spindle visualization in relation to embryo development and ICSI outcomes.

The meiotic spindle and the zona pellucida exhibit molecular order when imaged with polarized optics. This study aimed to investigate possible factors contributing to the zona pellucida birefringence score and meiotic spindle visualization, and to evaluate whether these structures may predict intracytoplasmic sperm injection outcomes. Oocytes were divided into groups according to zona pellucida birefringence and meiotic spindle visualization. In addition, the cycles were split into three groups based on the zona birefringence of transferred embryos. A positive correlation was observed between zona birefringence and meiotic spindle visualization. In addition, when the meiotic spindle was observed, the fertilization rate among oocytes with high or low zona pellucida birefringence was similar. Implantation and pregnancy rates were significantly higher when embryos derived from high birefringence oocytes were exclusively transferred (P = 0.041 and P = 0.004 respectively). Furthermore, the miscarriage rate was higher when embryos derived from low birefringence oocytes were exclusively transferred. On the other hand, the total dose of FSH negatively affected meiotic spindle visualization. Results show that selection of embryos based on zona pellucida and meiotic spindle imaging can significantly improve implantation and pregnancy rates. Moreover, the dose of FSH used for ovarian stimulation may affect the organization of the oocyte meiotic spindle.

Fetal lung volume: comparison by 2D- and 3D-sonography in normal fetuses.

PURPOSE: To compare two-dimensional ultrasonography (2D US) and three-dimensional ultrasonography (3D US) in the assessment of normal fetal lung volume. METHODS: A cross-sectional study was performed involving 50 normal pregnancies at 24-32 weeks' gestation. The following equations were used for lung volume calculation by 2D US: Eq(2D1) = 4.24 + {1.53 x [(area of base of both lungs) x 1/3 (height of right lung)]} and Eq(2D2) = [anteroposterior diameter (X) x transverse diameter (Y) x cranial-caudal diameter (Z) of the right lung x 0.152 + (X') x (Y') x (Z') of the left lung x 0.167]. For 3D US, the virtual organ computer-aided analysis (VOCAL) method was used with a 30 degrees rotation angle and the total lung volume (V3D) was obtained by summing the volumes of each lung. Regression models (R (2)) were devised to assess lung volume evolution over the course of the pregnancy. Pearson's correlation coefficient (r) was used to assess correlation among the techniques, while Friedman's test was used for means comparisons. RESULTS: Strong correlation was observed among the three techniques [V3D vs. Eq(2D2) r = 0.856; V3D vs. Eq(2D1) r = 0.838 and Eq(2D2) vs. Eq(2D1) r = 0.964; all with P < 0.001]. Mean lung volumes were 37.05 +/- 9.67, 29.79 +/- 8.79 and 12.67 +/- 4.12 ml for V3D, Eq(2D1) and Eq(2D2), respectively (P < 0.001). CONCLUSIONS: Strong correlation and significant difference was observed among the three techniques of fetal lung volume assessment in normal fetuses.

Reference range of fetal renal volume by three-dimensional ultrasonography using the VOCAL method.

OBJECTIVE: To establish reference values for fetal renal volume by three-dimensional sonography using the VOCAL (Virtual Organ Computer-Aided Analysis) method. METHODS: This prospective longitudinal study involved 57 healthy pregnant women who were examined between 24 and 34 weeks of pregnancy. Each fetal kidney was evaluated separately using the VOCAL method with a 30 degree rotation angle. For each gestational age, the following measures were obtained for the right and left kidneys: mean, standard deviation, minimum and maximum values, and the 5th, 10th, 25th, 50th, 75th and 90th percentiles. Polynomial regression models were constructed to assess the relationship between renal volume and gestational age, adjusted by the determination coefficient (R(2)). The Wilcoxon test was used to evaluate the concordance between the right and left renal volumes. Bland-Altman graphs were used to assess intra- and inter-observer variability. RESULTS: The right renal volume increased from 4.5 +/- 1.3 cm(3) at 24 weeks to 12.1 +/- 1.5 cm(3) at 34 weeks. The left renal volume increased from 4.6 +/- 0.8 cm(3) at 24 weeks to 11.9 +/- 1.1 cm(3) at 34 weeks. There was a strong correlation between both the right and left renal volumes and gestational age (R(2) = 0.975 and 0.970, respectively). There were no significant differences between the right and left renal volumes. The mean difference between repeated measures by the same examiner was -0.07 cm(3) (-0.88 to 0.75) for the right kidney and -0.21 cm(3) (-0.95 to 0.75) for the left kidney. The mean difference between repeated measures obtained by two different examiners was -0.07 cm(3) (-1.25 to 1.12) for the right kidney and 0 cm(3) (-1.53 to 1.53) for the left kidney. CONCLUSION: Reference values were generated for fetal renal volume assessed by three-dimensional ultrasonography using the VOCAL method.

[Aromatase expression in invasive and in situ ductal carcinoma present in the same breast]. / Expressão da aromatase em carcinomas de mama ductais invasivo e in situ presentes na mesma mama.

OBJECTIVE: to evaluate the expression of aromatase in simultaneously invasive ductal carcinoma (IDC) and ductal carcinoma in situ (DCIS). METHODS: forty-five surgical samples were obtained from mastectomy and quadrantectomy with simultaneous IDC and DCIS of stage I and II patients. Aromatase was evaluated using antibodies anti-aromatase and the samples classified in accordance with the number and intensity of stained cells. RESULTS: Aromatase was expressed positively in 32(71%) and negatively in 13(29%) of the cases in the IDC. The same results were obtained in the DCIS showing a perfect positive correlation. In the normal epithelium,aromatase was positive in 19(42.2%) and negative in 26 (57.8%) and a positive correlation, statistically significant was obtained when compared with IDC and DCIS(p<0.01). Concerning the normal stroma, positivity was only 7 (15.5%) showing no correlation with aromatase expression. Aromatase was positive in 36(80%) of the tumor stroma and this result was statistically significant as in the IDC and DCIS. Comparing results of aromatase expression with nuclear grade, histological grade, tumor size and age no difference was found. CONCLUSION: our results demonstrated high correlation between aromatase expression in IDC, DCIS, normal epithelium and tumor stroma showing a possible autocrine and paracrine mechanism of this enzyme in breast cancer.