The estrogenic status of patients with breast cancer may influence the prognosis and the response to treatment and is currently assessed by immunological measurement of serum estradiol. This does not account for estrogenic or anti-estrogenic activity related to growth factors able to activate the estrogen receptor, to anti-estrogenic drugs or to exogenous supply of estrogen-like compounds. We developed a recombinant bioassay based on a mammary cell line expressing luciferase in an estrogen receptor-dependent way. In a human serum matrix the MELN system was able to detect the transcriptional activity of estradiol, growth factors (epidermal growth factor (EGF), insulin at insulin-like growth factor 1 (IGF-1)-like concentrations), xeno-estrogens (diethylstilbestrol, phytoestrogens) and tamoxifen in a dose-dependent manner. The intra- and inter-assay variations were <6% and ≤15%, respectively, whatever the estradiol concentration; the functional sensitivity was <10 pmol/l equivalents of estradiol. We assessed the overall estrogenic activity of serum (OEAS) in 16 healthy women and in 24 women with advanced breast cancer. The correlation between OEAS and serum log1017-β–estradiol (E2) was good for healthy women (r2 = 0.8568) but poor for patients (r2 = 0.0563). Assessment of the OEAS/E2 ratio as a prognostic and predictive factor would be of interest in clinical prospective trials involving ER+ breast cancer patients.
Topological Derivatives for Semilinear Elliptic Equations
The form of topological derivatives for an integral shape functional is derived for a class of semilinear elliptic equations. The convergence of finite element approximation for the topological derivatives is shown and the error estimates in the L∞ norm are obtained. The results of numerical experiments which confirm the theoretical convergence rate are presented.
Most research has mainly focused on the decline of the subjective experience in Alzheimer’s disease (AD). However, few attempts have been made to evaluate whether subjective experience may be maintained in AD. In this narrative review, we attempt to provide a positive view, according to which patients with AD can enjoy, to some extent, subjective experience during memory retrieval. Memory and expression difficulties (e.g., aphasia) limit the ability of patients with AD to describe their memories, resulting in a little specificity of reported memories. However, according to the “authentic subjective experience” view, we propose in this study that the ability to mentally relive these memories could be preserved in the patients. By proposing the authentic subjective experience view, we attempt to provide an alternative view to the general consideration that the patients suffer a diminished subjective experience. This view can contribute to a larger clinical framework that gives a positive meaning to the subjective experience of patients with AD. Furthermore, several clinical and empirical implications can be drawn from the authentic subjective experience view, including the possibility to evaluate behavioral correlates of the subjective experience in AD.