RESUMO
A Joule-class room-temperature diode-pumped solid-state laser was developed. The energy scaling of the 100 mJ 1064â nm seed pulse was realized by a series of two diode-pumped amplifiers. The gain medium consists in free combinations of Nd:YAG ceramics bonded to sapphire transparent heat sinks, to relax the thermal load induced by the 34â kW pump power. At low repetition rate, parasitic lasing was the main limitation to energy scaling. By choosing a gain module combination producing a step-like gradual doping concentration profile, mitigation of parasitic oscillations was observed, and the system delivered 2.8 J, 800 ps pulses at 2â Hz.
RESUMO
Sturge-Weber syndrome (SWS) is a neurocutaneous syndrome characterized by angiomas. This report presents airway management using submental intubation in sagittal split ramus osteotomy under general anesthesia and aimed to explore better anesthetic management for avoiding the rupture of angiomas in a patient with SWS.
RESUMO
BACKGROUND: Glycogen storage disease (GSD) is a group of rare inherited metabolic disorders caused by enzyme deficiencies in glycogen catabolism. GSD type Ia is a congenital deficiency of the enzyme responsible for the final step in glucose production by glycolysis, resulting in impaired carbohydrate metabolism. CASE PRESENTATION: A 14-year-old boy with GSD type Ia was scheduled for a maxillary cystectomy under general anesthesia. He was taking oral sugars such as uncooked cornstarch regularly to prevent hypoglycemia. Perioperatively, glucose was administered via the peripheral vein for fasting; however, severe lactic acidosis occurred. He also developed hypercapnia because of intraoperative poor ventilation caused by hepatomegaly. CONCLUSIONS: We experienced a child with GSD type Ia who developed severe lactic acidosis despite continuous glucose infusion. Further studies are required to determine appropriate perioperative management for patients with GSD, including fasting glucose administration.