vincristine sulfate

Primary breast diffuse large B-cell lymphoma mimicking breast carcinoma: A case report and literature review.

Li Longquan L, Yao Hongxi H, Liu Siyu S, Yin Jieting J et al.

Primary breast diffuse large B-cell lymphoma (PB-DLBCL) is a rare extranodal manifestation of non-Hodgkin lymphoma (NHL) that can closely resemble breast carcinoma clinically and radiologically. This overlap may delay accurate diagnosis and appropriate treatment. We report a case of PB-DLBCL in a postmenopausal woman whose initial multimodal imaging findings were suspicious for breast carcinoma, but whose final diagnosis was established by core needle biopsy with immunohistochemical and molecular evaluation. A 59-year-old postmenopausal woman presented with a painless, palpable mass in the right breast that had been present for approximately 3 weeks. Breast ultrasonography, mammography, magnetic resonance imaging (MRI), and positron emission tomography/computed tomography (PET/CT) demonstrated a suspicious right breast mass with ipsilateral axillary lymphadenopathy, initially raising concern for breast carcinoma. Ultrasound-guided core needle biopsy showed diffuse infiltration by atypical lymphoid cells. Immunohistochemistry confirmed a B-cell phenotype, and fluorescence in situ hybridization (FISH) showed no MYC, BCL2, or BCL6 rearrangements. Bone marrow biopsy showed no evidence of marrow involvement. The final diagnosis was PB-DLBCL, non-germinal center B-cell-like (non-GCB) subtype, Ann Arbor stage IIE. The patient received 6 cycles of rituximab, cyclophosphamide, doxorubicin, vincristine, and prednisone (R-CHOP) chemoimmunotherapy. No breast-directed surgery, consolidative radiotherapy, or central nervous system prophylaxis was administered. At 6 weeks after completion of R-CHOP therapy, PET/CT showed complete metabolic resolution of the right breast lesion, with only a residual punctate calcified focus measuring approximately 0.4 × 0.4 × 0.3 cm. The Deauville score decreased from 5 at baseline to 1 after treatment, meeting Lugano criteria for complete response. No clinically significant treatment-related adverse events were documented. PB-DLBCL can closely mimic breast carcinoma on multimodal imaging. Suspicious breast imaging findings do not exclude lymphoma. Tissue diagnosis with adequate immunophenotypic and molecular evaluation is essential before definitive treatment planning to avoid misdiagnosis and unnecessary surgery.

Final-year dental students' self-perceived knowledge and self-reported clinical approaches to vital pulp therapy: a single-institution cross-sectional survey.

Sivas Yılmaz Özlem Ö, Güven Kömürcü Ayşegül A, Dinger Esma E, Ateş Melis Oya MO

Undergraduate dental education should prepare students to understand and apply contemporary vital pulp therapy (VPT) procedures in permanent teeth. However, students' self-perceived knowledge, stated treatment preferences, and self-reported clinical approaches regarding VPT may vary according to their theoretical and clinical training. This study aimed to describe final-year dental students' self-perceived knowledge, recognition of VPT procedures, stated treatment preferences, and self-reported clinical approaches regarding VPT. This single-institution cross-sectional survey was conducted among final-year dental students at a dental faculty in Türkiye in June 2025. Of 100 eligible students, 88 completed a 17-item questionnaire (response rate, 88.0%) addressing self-perceived knowledge, sources of information, treatment preferences, reported clinical approaches, rubber dam isolation, hemostatic agents, and material selection in VPT. Data were summarized descriptively using frequencies and percentages. Most students rated their self-perceived knowledge of VPT as moderate (60.2%), while theoretical courses (42.0%) and clinical practice (36.4%) were the main reported sources of VPT information. Direct pulp capping (94.3%), partial pulpotomy (Cvek; 89.8%), and indirect pulp capping (86.4%) were most frequently identified as vital pulp therapy procedures, whereas total pulpotomy was identified as a vital pulp therapy procedure by 53.4% of students. In mature teeth, direct pulp capping was reported more frequently than partial or total pulpotomy. Treatment preferences varied according to pulp exposure size, with a shift from direct pulp capping for 0-1 mm exposures to partial pulpotomy for 1-2 mm exposures and total pulpotomy or root canal treatment for exposures larger than 2 mm. Only 15.9% of students reported applying rubber dam isolation at the beginning of the treatment, and the combined response option "ferric sulfate or aluminum chloride" was selected most frequently for hemostasis (46.6%). Final-year dental students reported moderate self-perceived knowledge of VPT and recognized several commonly used VPT procedures, but their self-reported approaches varied, particularly regarding pulpotomy procedures, rubber dam timing, hemostatic-agent selection, and simplified pulp-exposure scenarios. These findings should be interpreted as self-reported educational indicators rather than objective evidence of clinical competence or broad curricular inadequacy. Multicenter studies using case-based and performance-based assessments are needed to guide undergraduate VPT teaching.

Isotopic Evidence Reveals the Nonlinear Mitigation Efficacy of Coal-derived Sulfate: Enhanced Role of TMI-Catalyzed Oxidation.

Xu Rongshuang R, Shen Jiahui J, Lin Yu-Chi YC, Yang Yuxiao Y et al.

Despite stringent SO2 emission reductions, particulate sulfate (SO42-) concentrations often exhibit a nonlinear response. To reconcile this discrepancy, this study utilized synchronous sulfur isotope (δ34S) observations of precursor SO2 and product sulfate in Nanjing across a decade (winter 2015 vs 2024). Sulfate reductions are observed to lag behind SO2, declining together with elevated δ34S values in ambient sulfate (5.7 ± 1.1‰ vs 6.2 ± 1.3‰) and significantly in SO2 (1.4 ± 1.2‰ vs 6.5 ± 1.6‰), which indicates a shift in emission structure and sulfate formation chemistry. Unexpectedly, while SO2 source apportionment demonstrates a significant decline in contribution of coal combustion to regional SO2 emissions, coal combustion remains the predominant contributor to secondary sulfate, maintaining a stable relative share. This discrepancy implies enhanced conversion efficiency for coal-emitted SO2. We attribute this to the increased contribution of co-emitted transition metal ion (TMI)-catalyzed oxidation (rising from 35.6% to 59.0%), with kinetic calculations underscoring the dominance of the Mn-surface catalysis pathway. Ultimately, these findings suggest that intensified TMI-catalyzed oxidation sustains high sulfate production from coal-emitted SO2 even under low-SO2 conditions, providing a mechanistic explanation for the nonlinear response. These results also highlight the necessity for synergistic co-control strategies within coal-dependent industries.

Comment on "Safety and Efficacy of Oral Ferric Maltol and Ferrous Sulfate for Iron Deficiency Anemia in Infants, Children and Adolescents: A Multicenter Randomized Trial".

Kaplan Fatih F