Adenomyosis is a nonneoplastic condition, characterized by benign invasion of ectopic endometrium into the myometrium with hyperplasia of adjacent smooth muscle. The common symptoms include dysmenorrhea, menorrhagia, and abnormal uterine bleeding, but these do not allow diagnosis. Therefore, imaging plays an important role because establishment of the correct preoperative diagnosis is critical to avoid unnecessary intervention. Magnetic resonance (MR) imaging is a highly accurate noninvasive modality for diagnosis of adenomyosis, differentiation of adenomyosis from other gynecologic disorders, and planning of appropriate treatment. Although the typical MR imaging findings are well established, adenomyosis actually varies widely in terms of histopathologic features (adenomyosis with sparse glands), growth patterns (polypoid adenomyoma, adenomyotic cyst, and miniature uterus), responses to hormonal activity (tamoxifen, decidual changes), and responses to treatment (gonadotropin-releasing hormone agonist). The MR imaging findings of adenomyosis occasionally mimic those of uterine malignancy or ovarian cancer. Furthermore, malignancy occasionally develops in otherwise benign adenomyosis. Pitfalls in diagnosis of adenomyosis include myometrial contractions, leiomyoma, adenomatoid tumor, metastases, endometrial carcinoma, and endometrial stromal sarcoma. Knowledge of the various appearances of adenomyosis and the possible pitfalls in differential diagnosis help guide the determination of appropriate treatment options.

Typical appearances of uterine leiomyoma at magnetic resonance (MR) imaging are well established, and diagnosis is usually easy. However, cases that, are extremely difficult to differentiate from other conditions are occasionally encountered. To understand the wide spectrum of MR imaging findings, such unusual appearances can be classified into three categories: degeneration and other histopathologic findings, specific types of unusual leiomyomas, and unusual growth patterns. The common types of degeneration are hyaline (>60% of cases), cystic (approximately 4%), myxoid, and red. Edema is not a phenomenon of degeneration but is a common histopathologic finding (approximately 50% of cases). Hemorrhage, necrosis, and calcification (approximately 4% of cases) may also be observed. Specific types of unusual leiomyomas include lipoleiomyoma and myxoid leiomyoma, which may have MR imaging features characteristic enough to allow differentiation from other gynecologic and nongynecologic diseases. Intravenous leiomyomatosis, metastasizing leiomyoma, diffuse leiomyomatosis, and peritoneal disseminated leiomyomatosis represent unusual growth patterns; other unusual growth patterns are retroperitoneal growth, parasitic growth, and the pattern that may occur in cervical leiomyoma. Because leiomyomas are the most common gynecologic tumors and are exclusively benign, it is important to be familiar with the variety of MR imaging appearances of uterine leiomyomas to distinguish them from other significant diseases.

With benefits to the human health, environment, economy, and energy, anaerobic digestion (AD) systems have attracted remarkable attention within the scientific community. Anaerobic digestion system is created from (bio)reactors to perform a series of bi-metabolism steps including hydrolysis/acidogenesis, acetogenesis, and methanogenesis. By considering the physical separation of the digestion steps above, AD systems can be classified into single-stage (all digestion steps in one reactor) and multi-stage (digestion steps in various reactors). Operation of the AD systems does not only depend on the type of digestion system but also relies on the interaction among growth factors (temperature, pH, and nutrients), the type of reactor, and operating parameters (retention time, organic loading rate). However, these interactions were often reviewed inadequately for the single-stage digestion systems. Therefore, this paper aims to provide a comprehensive review of both single-stage and multi-stage systems as well as the influence of the growth factors, operating conditions, and the type of reactor on them. From those points, the advantages, disadvantages, and application range of each system are well understood.

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Recent studies demonstrated that the generation of intracellular reactive oxygen species (ROS) was enhanced prior to the onset of mitochondrial membrane permeability transition (MPT), a critical step for the induction of DNA fragmentation and apoptosis. Although Ca2+ induces typical MPT that involves depolarization and swelling of mitochondria and finally releases cytochrome c into cytosol, the mechanism by which ROS induce MPT remains unclear. In the presence of inorganic phosphate, Ca2+ increased the oxygen consumption and ROS production by isolated mitochondria as determined by a chemiluminescence (CHL) method using L-012. Ca2+ increased the generation of H2O2 by some mechanism that was inhibited by cyclosporin A but not by superoxide dismutase (SOD) and trifluoperazine. Ca2+ decreased the content of free thiols in adenine nucleotide translocase (ANT) in mitochondrial membranes with concomitant increase in ROS generation. The presence of cyclosporin A, trifluoperazine, or SOD inhibited the Ca(2+)-induced increase of L-012 CHL and decrease in the free thiols of ANT. These results indicate that Ca2+ increases the generation of ROS which oxidize the free thiol groups in mitochondrial ANT, thereby inducing MPT to release cytochrome c.

Purpose: To demonstrate and evaluate uterine peristalsis on cine magnetic resonance imaging (MRI) using ultrafast imaging. Materials and Methods:Serial MR uterine images (300) were obtained from 15 normal volunteers over four menstrual phases using true fast imaging with steady-state precession (true FISP) technique over 117 seconds and videotaped. Three radiologists independently evaluated videotapes of 59 studies. Uterine peristalsis was defined as wavy movements of subendometrial myometrium or endometrium. Interobserver reliability was evaluated using a Kappa coefficient. Fifty-four studies obtained in appropriate phases were analyzed.Results: Cine MRI displayed uterine peristalsis in 30 of 59 studies; consensus reading showed direction in 23 studies. Reliability between the final consensus of the recognition of uterine peristalsis and those of the three readers was extremely concordant, with a Kappa coefficient of 0.908. Wave direction was cervico-fundal in follicular and periovulatory phases, with frequency of contraction waves being 1.2-2.3 per minute in positive studies. Conclusion:Uterine peristalsis was demonstrated on cine MR using ultrafast MRI. Direction and frequency of peristaltic waves are closely related to menstrual cycle phases. Supplementary material for this article can be found on the JMRI website at www.interscience.wiley.com/jpages/ 1053-1807/suppmat/index.html.

Diffuse uterine enlargement is a common clinical finding. Because this abnormality can represent a physiologic manifestation, benign tumor, or malignancy, the diagnostic dilemma of a diffusely enlarged uterus can be challenging. Clinical findings can provide valuable information in regard to physiologic effects, pregnancy-related changes, and hormonal causes. Cytologic examination is essential for identification of cervical and endometrial malignancies. However, since preoperative histologic examination of myometrial lesions is not possible, preoperative distinction between benign and malignant conditions is frequently difficult. Imaging thus plays an important role in evaluation of myometrial lesions. In particular, magnetic resonance (MR) imaging allows specific diagnosis of several different lesions. Signal voids and prominent vessels at MR imaging are characteristic of vascular lesions. Adenomyosis and leiomyomas can be distinguished from other lesions with MR imaging, although a variety of unusual manifestations can be seen. MR imaging findings that allow distinction between leiomyoma and leiomyosarcoma have yet to be clearly established; however, invasion, hemorrhagic necrosis, or rapid growth is suggestive of malignancy. Endometrial stromal sarcoma tends to have distinct MR imaging features that allow differentiation from benign lesions.

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