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Background: Since the first report of a diaphragmatic hernia from Ambroise Paré’s necropsy in 1610, the Bochdalek hernia (BH) of the congenital diaphragmatic hernia (CDH) has been the most common types with high morbidity and mortality in the neonatal period. Due to the nature of the disease, CDH associated with pregnancy is too infrequent to warrant reporting in the literature. Mortality of obstruction or strangulation is mostly due to failure to diagnose symptoms early. Data sources and study selection: A systematic literature search of maternal BH during pregnancy was conducted using the electronic databases (PubMed and EMBASE) from January 1941 to December 2020. Because of the rarity of the disease, this review included all primary studies, including case reports or case series that reported at least one case of maternal BH in pregnant. Searches, paper selection, and data extraction were conducted in duplicate. The analysis was performed narratively regardless of the control groups’ presence due to their rarity. Results: The search retrieved 3450 papers, 94 of which were deemed eligible and led to a total of 43 cases. Results of treatment showed 16 cases in delayed delivery after hernia surgery, 10 cases in simultaneous delivery with hernia surgery, 3 cases in non-surgical treatment, and 14 cases in hernia surgery after delivery. Of 16 cases with delayed delivery after hernia surgery, 13 (81%) cases had emergency surgery and three (19%) cases had surgery after expectant management. Meanwhile, 10 cases underwent simultaneous delivery with hernia surgery, 6 cases (60%) had emergent surgery, and 4 cases (40%) had delayed hernia surgery after expectant management. 3 cases underwent non-surgical treatment. In this review, the maternal death rate and fetal/neonatal loss rate from maternal BH was 5% (2/43) and 16% (7/43), respectively. The preterm birth rate has been reported in 35% (15/43) of maternal BH, resulting from maternal deaths in 13% (2/15) of cases and 6 fetal loss in 40% (6/15) of cases; 44% (19/43) of cases demonstrated signs of bowel obstruction, ischemia, or perforation of strangulated viscera in the operative field, resulting from maternal deaths in 11% (2/19) of cases and fetal-neonatal loss in 21% (4/19) of cases. Conclusion: Early diagnosis and surgical intervention are imperative, as a gangrenous or non-viable bowel resection significantly increases mortality. Therefore, multidisciplinary care should be required in maternal BH during pregnancies that undergo surgically repair, and individualized care allow for optimal results for the mother and fetus.

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ZnO 50 nm/Ag 10 nm/SnO 2 50 nm (ZAS) tri-layer films were deposited on a glass substrate by RF and DC magnetron sputtering and then underwent rapid thermal annealing in a low vacuum of 1×10-3 Torr to investigate the effects of post-deposition annealing on the optical and electrical properties of the films. The peak intensity of the XRD pattern related to the ZnO (002) peak of the annealed films was higher than that of the as-deposited film and the full width at half-maximum of the ZnO (002) diffraction peak of the annealed films was smaller than that of the as-deposited film. Therefore, the crystallinity of ZnO was improved by rapid annealing. However, crystallization of the Ag interlayer and SnO 2 surface layer were not significantly affected by the annealing temperature, compared with the ZnO bottom layer. From the observed electrical properties and optical band gap, it was concluded that the blue shift in the optical band gap is related to the carrier density of the films. The band gap increased from 4.19 eV to 4.24 eV, with the carrier density increasing from 7.09 × 10 21 cm −3 to 7.77 × 10 21 cm −3. However, the film annealed at 450 o C showed a decreased band gap energy of 4.17 eV due to the decreased carrier density of 6.80 × 10 21 cm −3. The as-deposited ZAS films showed a sheet resistance of 11.0 Ω/□ and a visible transmittance of 80.8%, whereas the films annealed at 450 o C had a higher visible transmittance of 82.3% and a lower sheet resistance of 6.55 Ω/□. The results indicate that ZAS thin films may be possible substitutes for conventional Sn-doped In 2 O 3 transparent electrodes in various optoelectronic devices.

ZnO/Ag/SnO 2 (ZAS) tri-layer films were prepared on glass substrates via RF and DC magnetron sputtering, and then the influence of the thickness of the ZnO and SnO 2 layers on the optical and electrical properties of the ZAS films was investigated. As deposited ZnO 50 nm/Ag 10 nm/SnO 2 50 nm films showed a higher figure of merit, 1.08 × 10 -2 Ω -1 , than the other films due to a high visible transmittance of 80.8% and a low resistivity of 1.21 × 10 −4 Ωcm. From the observed results, it can be concluded that the ZnO 50 nm/Ag 10 nm/SnO 2 50 nm tri-layer films can be used as a substitute for conventional transparent conducting oxide films in various opto-electrical applications.

(1) Background: Remifentanil is used for intraoperative pain control; however, it has several side effects, such as hypotension and opioid-induced hyperalgesia. We aimed to determine whether an intraoperative remifentanil infusion may increase postoperative opioid consumption in patients undergoing total knee arthroscopy (TKA) under femoral nerve block (FNB) in addition to general anesthesia. (2) Methods: We randomly assigned 66 patients who underwent total knee arthroplasty to the remifentanil (R) and control (C) groups. All patients underwent FNB and popliteal artery and posterior capsule of the knee (iPACK) block in addition to sevoflurane-based general anesthesia. Postoperative pain control was achieved using intravenous patient-controlled analgesia (IV-PCA) fentanyl. We recorded IV-PCA fentanyl consumption at various postoperative timepoints, numerical rating scale (NRS) scores, intraoperative changes in vital signs and index of nociception (qNOX), ephedrine consumption, postoperative side effects, satisfaction, and sleep quality. (3) Results: The primary outcome (the cumulative IV-PCA fentanyl usage within 48 h postoperatively) was significantly lower in the C group (541.1 ± 294.5 µg) than in the R group (717.5 ± 224.0 µg) (p < 0.001). The secondary outcome (the cumulative IV-PCA fentanyl usage within 12, 24, and 72 h) was lower in the C group than in the R group and the mean arterial pressure was lower in the R group than in the C group from immediately after tourniquet on to immediately after tourniquet off. The heart rate was lower in the R group from immediately after incision to immediately after irrigation. There was no significant between-group difference in the perioperative qNOX and NRS scores at rest and activity except for NRS scores at 72 h postoperatively. Ephedrine use was higher in the R group than in the C group (p = 0.003). There was no significant between-group difference in the incidence of postoperative nausea and vomiting, nor in the postoperative satisfaction and sleep quality. (4) Conclusions: Avoiding intraoperative remifentanil infusion may reduce total opioid consumption in patients undergoing FNB before TKA.