Cutaneous angiosarcoma of the scalp is a highly aggressive vascular malignancy that predominantly affects elderly individuals and may cause severe tumor bleeding during disease progression. Hemorrhage from ulcerated tumors is often difficult to control, particularly in patients previously treated with chemoradiotherapy. We report two cases of advanced scalp angiosarcoma in which refractory tumor bleeding was successfully controlled by selective transarterial embolization. The first patient, a 75-year-old man with recurrent angiosarcoma of the frontal scalp region after multiple systemic therapies and radiotherapy, developed repeated arterial bleeding from ulcerated lesions requiring transfusion support. Angiography identified tumor-feeding branches of the superficial temporal artery and angular artery, and embolization achieved immediate hemostasis. A second embolization procedure was required for recurrent bleeding. The second patient, a 75-year-old woman, also developed persistent bleeding from a progressive scalp tumor despite chemoradiotherapy. Selective arterial embolization resulted in rapid and sustained bleeding control without major complications. These cases suggest that selective transarterial embolization may provide rapid control of refractory arterial tumor bleeding and reduce local treatment burden in selected patients with advanced scalp angiosarcoma.

Eyelid and periorbital lesions encompass a wide range of etiologies and clinical presentations, often posing diagnostic challenges. We report a case of a right lower eyelid mass that was initially referred to as a nonresolving chalazion. Clinical suspicion suggested a vascular lesion; however, magnetic resonance imaging indicated a dermoid or epidermoid cyst. Definitive diagnosis was achieved through histopathological examination of the excised specimen, which revealed a vascular thrombus originating from a true aneurysm of an artery. In the absence of a clear history of trauma, infection, or a systemic illness, an unrecognized injury was considered the most plausible explanation. To the best of our knowledge, a vascular thrombus arising from a true arterial aneurysm involving the lower eyelid has not been previously reported. This case report underscores the importance of comprehensive clinical, radiological, and histopathological evaluation in the assessment of atypical eyelid lesions.

The latissimus dorsi (LD) musculocutaneous flap remains a reliable option for breast and chest wall reconstruction because of its consistent anatomy and dependable vascularity. The flap is traditionally considered dependent on the thoracodorsal vascular pedicle, and division of this pedicle is often regarded as a contraindication to its use. We report the case of a 53-year-old woman with locally advanced right breast carcinoma who underwent modified radical mastectomy following neoadjuvant systemic therapy. During axillary dissection, the thoracodorsal vessels were intentionally ligated and divided because of dense adherence to metastatic lymph nodes, whereas the angular branch and multiple intercostal and lumbar perforators were preserved. Given the extensive postmastectomy defect, reconstruction using an LD flap was considered. Intraoperative indocyanine green (ICG) angiography demonstrated satisfactory flap perfusion despite division of the dominant pedicle, allowing successful flap inset. The postoperative course was uneventful, with only minimal marginal flap necrosis that resolved with conservative management and without the need for additional surgical intervention. This case demonstrates that thoracodorsal pedicle division does not necessarily preclude successful LD flap reconstruction when collateral vascular pathways are preserved. Intraoperative ICG angiography provides valuable real-time assessment of flap perfusion and may facilitate safe reconstructive decision-making in challenging oncologic situations.

Objective.The use of ischemic preconditioning (IPC) may delay the onset of fatigue, however, its impact on mean power (MP) and neuromuscular function remains unclear. The purpose of this investigation was to examine the impact of IPC prior to an acute bout of fatiguing resistance exercise on MP, surface mechanomyography amplitude (sMMGAMP), and sMMG MP frequency (sMMGMPF).Approach.Nineteen males randomly completed IPC on separate visits at a low (20 mmHg), moderate individualized (80% of total arterial occlusion pressure), and a supra-systolic absolute (220 mmHg) pressure. Following IPC, participants performed one-set to failure of unilateral (i.e. one leg), isotonic (i.e. constant load), concentric-only leg extensions with a submaximal load (i.e. 30% of one-repetition maximum). MP, sMMGAMP, and sMMGMPFwere assessed from concentric peak torque muscle actions performed at an angular velocity of 90°·s-1prior to and immediately following the bout of exercise. Each dependent variable was analyzed with Bayesian multilevel models (i.e. random intercepts and slopes) and the fixed effects are reported as the mean difference (Meandiff) and the 95% high-density interval (95% HDI).Main Results.There were no significant interactions or main effects of Condition for any of the dependent variables. Following the one-set to failure, however, MP (Meandiff= 68.60 ± 1.67 W; 95% HDI: 53.80-83.60), sMMGAMP(Meandiff= 0.58 ± 0.04 m·s-2; 95% HDI: 0.26-0.91), and sMMGMPF(Meandiff= 1.35 ± 0.13 Hz; 95% HDI: 0.32-2.39) decreased.Significance.The use of IPC prior to an acute bout of fatiguing resistance exercise did not attenuate the fatigue-induced decreases in MP, sMMGAMP, or sMMGMPF. These responses may be attributed to the accumulation of metabolic byproducts, decreases in muscular compliance, and/or alterations in the global firing rate of the unfused activated motor units.

Coronary artery disease remains a leading cause of mortality worldwide. Accurate detection and angular quantification of coronary calcification are important for optimizing percutaneous coronary intervention. Intravascular Ultrasound provides high-resolution visualization of plaques, where calcification typically appears as hyperechoic regions with acoustic shadowing. However, grayscale intravascular ultrasound is sensitive to imaging conditions and reconstruction algorithms, making automated calcification analysis challenging. This study aims to automate the detection of calcification and the quantification of angles. We propose a dual-branch deep learning framework that integrates raw intravascular ultrasound radio-frequency (RF) signals with polar-coordinate grayscale images. A physics-consistent complex convolution module is introduced to preserve the intrinsic physical structure of RF signals during feature extraction. The framework further incorporates phase-amplitude guided dual-path cross-attention and a shadow-aware radial A-line classifier to enhance RF-image interaction and angle estimation. Calcification angles are computed from the predicted segmentation combined with lumen centroid localization. Experiments were conducted on a multicenter development dataset from four centers, including 78 patients, 136 pullbacks, and 32,672 IVUS frames. An independent external clinical test set comprising 10 patients, 15 pullbacks, and 2,362 frames was further used for final evaluation. On the internal validation set, the proposed method achieved a Dice coefficient of 0.921 and a Hausdorff distance of 0.251 mm for calcification segmentation, with an A-line classification accuracy of 97.1% for calcification angle quantification. The model also maintained stable performance on the external clinical test set, supporting its potential generalizability in real-world clinical scenarios. Joint modeling of RF signals and grayscale intravascular ultrasound features enables accurate and robust calcification detection and angular quantification, supporting objective and reproducible clinical assessment.

Increased first-trimester nuchal translucency (NT) may be associated with chromosomal, genetic, and structural abnormalities, although some pregnancies progress with normal invasive testing and reassuring interval imaging. This case involved a 32-year-old primigravida referred at 12+5 weeks' gestation following the identification of markedly increased NT measuring 5.6 mm, with associated body wall oedema. Chorionic villus sampling demonstrated normal fluorescence in situ hybridisation (FISH) and chromosomal microarray results, while subsequent antenatal imaging showed resolution of the body wall oedema without identifiable fetal structural anomalies. Later in pregnancy, gestational hypertension developed, requiring antihypertensive therapy and induction of labour at 38 weeks. Following failure to progress and an abnormal cardiotocograph, an emergency caesarean section was performed. Intraoperatively, a previously undiagnosed unicornuate uterus with an absent left fallopian tube, ovary, uterine artery and ureter was identified. Delivery was complicated by uterine angular extension, severe uterine atony, persistent haemorrhage and difficult pelvic anatomy, progressing to massive postpartum haemorrhage with an estimated cumulative blood loss of 10 L. Despite escalation through uterotonics, compression sutures, vascular ligation, vaginal packing and Bakri balloon tamponade, definitive haemostasis required hysterectomy, excision of the cervical remnant, right internal iliac ligation, and multidisciplinary surgical input. The patient required massive transfusion and intensive care admission but recovered postoperatively. This case highlights the complexity of counselling pregnancies with isolated increased NT despite normal genetic testing and illustrates how previously occult Müllerian and urinary tract anomalies may only become evident during obstetric emergency surgery, profoundly influencing haemorrhage control and operative risk.

Photoacoustic tomography (PAT) combines optical contrast with ultrasonic penetration, yet hardware limitations and workflow constraints in practical systems inevitably introduce multiple degradation pathways including channel under-sampling, angular under-sampling, bandwidth limitations, and additive noise that severely deteriorate reconstructed image quality. Existing learning-based solutions typically specialize in a single degradation and therefore demand multiple models in practice. We present PAT-Mamba, a novel all-in-one blind restoration framework that simultaneously addresses multiple prevalent degradation types without prior knowledge of the acquisition conditions. PAT-Mamba incorporates two complementary innovations: TransMamba blocks that replace self-attention with selective state space models to capture long-range dependencies at linear complexity, enabling efficient global context propagation for artifact suppression and structural detail recovery, and Adaptive Frequency Learning Blocks (AFLB) that analyze degradation-specific frequency cues, generate learnable frequency masks, and refine frequency subbands through cross-attention and dual-branch gating. Experiments on three representative datasets demonstrate that PAT-Mamba achieves competitive or improved performance compared to state-of-the-art baselines in the majority of degradation scenarios, attaining an average PSNR of 37.04 dB on the Embryo simulation dataset (+0.91 dB over the runner-up), 30.41 dB on the in vivo Mice dataset (+0.53 dB), and 30.50 dB on the clinical Artery dataset. These results demonstrate that PAT-Mamba eliminates the need to deploy multiple specialized networks for different degradation types, while its blind restoration capability removes the requirement for prior degradation diagnosis in clinical workflows, providing a practical and efficient restoration solution for real-world PAT systems. Code is available at https://github.com/FDUlixiaoyao/PAT-Mamba.