Male form of persistent Mullerian duct syndrome type I (hernia uteri inguinalis) presenting as an obstructed inguinal hernia: a case report

<p>Abstract</p> <p>Introduction</p> <p>Persistent Mullerian duct syndrome is a rare form of male pseudo-hermaphroditism characterized by the presence of Mullerian duct structures in an otherwise phenotypically, as well as genotypically, normal man; only a few cases have been reported in the worldwide literature. We report the case of a 30-year-old man with unilateral cryptorchidism on the right side and a left-sided obstructed inguinal hernia containing a uterus and fallopian tube (that is, hernia uteri inguinalis; type I male form of persistent Mullerian duct syndrome) coincidentally detected during an operation for an obstructed left inguinal hernia.</p> <p>Case presentation</p> <p>A 30-year-old South Indian man was admitted to our facility with a left-sided obstructed inguinal hernia of one day's duration. He had a 12-year history of inguinal swelling and an absence of the right testis since birth. Our patient had well developed masculine features. Local physical examination revealed a left-sided obstructed inguinal hernia with an absence of the right testis in the scrotum. Exploration of the inguinal canal revealed an indirect inguinal hernia containing omentum, the left corner of the uterus and a left fallopian tube. Extension of the incision revealed a well formed uterus, cervix and upper part of the vagina attached to the prostate by a thick fibrosed band. Total excision of the uterus, bilateral fallopian tubes and right testis was performed. A biopsy was taken from the left testis. The operation was completed by left inguinal herniorraphy. Histopathological examination of the hernial contents was consistent with that of a uterus and fallopian tubes without ovaries. Both testes were atrophied, with complete arrest of spermatogenesis. Post-operative karyotype analyses were negative for 46,XY and Barr bodies on buccal smear. A semen examination revealed azoospermia with a low serum testosterone level.</p> <p>Conclusions</p> <p>In cases of unilateral or bilateral cryptorchidism associated with inguinal hernia, as in our patient's case, the possibility of persistent Mullerian duct syndrome should be kept in mind in order to prevent further complications such as infertility and malignant change. Hernia uteri inguinalis is the type I male form of persistent Mullerian duct syndrome, characterized by one descended testis and herniation of the ipsilateral corner of the uterus and fallopian tube into the inguinal canal.</p

Drillstring Oscillations: The Influence of Fluid Loading and Stabilizer Effects

Drillstring vibrations can be undesirable for drilling operations. Here, attention is focused on vibrations of the upper portion of a drillstring as these vibrations can cause drillpipe wear and casing wear. A reduced-order model is developed to study the motions of a drillstring by taking fluid loading and stabilizer effects into account. In this model development, the distributed nature of the fluid loading is taken into account, and the drillstring is treated as a beam structure. Perturbation analyses are carried out with the reduced-order system, and the system responses are examined for primary and secondary (subharmonic and superharmonic) resonance excitations. The analytical-numerical results reveal the rich nature of the system behavior and help understand the drillstring motions during various resonance conditions

Additional file 1 of Primary left ventricular leiomyosarcoma: a case report

Supplementary Material

Workload-aware reviewer recommendation using a multi-objective search-based approach

Reviewer recommendation approaches have been proposed to provide automated support in finding suitable reviewers to review a given patch. However, they mainly focused on reviewer experience, and did not take into account the review workload, which is another important factor for a reviewer to decide if they will accept a review invitation. We set out to empirically investigate the feasibility of automatically recommending reviewers while considering the review workload amongst other factors. We develop a novel approach that leverages a multi-objective meta-heuristic algorithm to search for reviewers guided by two objectives, i.e., (1) maximizing the chance of participating in a review, and (2) minimizing the skewness of the review workload distribution among reviewers. Through an empirical study of 230,090 patches with 7,431 reviewers spread across four open source projects, we find that our approach can recommend reviewers who are potentially suitable for a newly-submitted patch with 19%-260% higher F-measure than the five benchmarks. Our empirical results demonstrate that the review workload and other important information should be taken into consideration in find-ing reviewers who are potentially suitable for a newly-submitted patch. In addition, the results show the effectiveness of realizing this approach using a multi-objective search-based approach