Coronary artery anomaly is known as one of the causes of angina pectoris and sudden death and is an important clinical entity that cannot be overlooked.The incidence of coronary artery anomalies is as low as 1%-2%of the general population,even when the various types are combined.Coronary anomalies are practically challenging when the left and right coronary ostium are not found around their normal positions during coronary angiography with a catheter.If there is atherosclerotic stenosis of the coronary artery with an anomaly and percutaneous coronary intervention(PCI)is required,the suitability of the guiding catheter at the entrance and the adequate back up force of the guiding catheter are issues.The level of PCI risk itself should also be considered on a caseby-case basis.In this case,emission computed tomography in the R-1 subtype single coronary artery proved that ischemia occurred in an area where the coronary artery was not visible to the naked eye.Meticulous follow-up would be crucial,because sudden death may occur in single coronary arteries.To prevent atherosclerosis with full efforts is also important,as the authors indicated admirably.
The role of the autopsy: 1) Whether the death is ascribable to a natural or unnatural cause and when natural, if cardiac or extra-cardiac;2) The nosology of the cardiac diseases and the mechanism of cardiac death, whether arrhythmic or mechanical;3) If the cardiac disease is inherited, screening and counselling of the next of kin is required. About 30% of sudden deaths is ascribable to genetically determined morbid entities, mostly transmissible with the autosomal dominant pattern of inheritance, so that 50% of the first degree relatives are genetically affected (“carriers”) and exposed at risk;4) If toxic or illicit drug abuse was involved.
The ocean conditions beneath the ice cover play a key role in understanding the sea ice mass balance in the polar regions.An integrated high-frequency ice-ocean observation system,including Acoustic Doppler Velocimeter,Conductivity-Temperature-Depth Sensor,and Sea Ice Mass Balance Array(SIMBA),was deployed in the landfast ice region close to the Chinese Zhongshan Station in Antarctica.A sudden ocean warming of 0.14℃(p<0.01)was observed beneath early-frozen landfast ice,from(−1.60±0.03)℃during April 16-19 to(−1.46±0.07)℃during April 20-23,2021,which is the only significant warming event in the nearly 8-month records.The sudden ocean warming brought a double rise in oceanic heat flux,from(21.7±11.1)W/m^(2) during April 16-19 to(44.8±21.3)W/m^(2) during April 20-23,2021,which shifted the original growth phase at the ice bottom,leading to a 2 cm melting,as shown from SIMBA and borehole observations.Simultaneously,the slowdown of ice bottom freezing decreased salt rejection,and the daily trend of observed ocean salinity changed from+0.02 d^(-1) during April 16-19,2021 to+0.003 d^(-1) during April 20-23,2021.The potential reasons are increased air temperature due to the transit cyclones and the weakened vertical ocean mixing due to the tide phase transformation from semi-diurnal to diurnal.The high-frequency observations within the ice-ocean boundary layer enhance the comprehensive investigation of the ocean’s influence on ice evolution at a daily scale.