A linear regression analysis was used to describe how perceived chewing ability scores were related to OHRQoL scores.

Results: The mean chewing function score was 12.1 +/- 4.8 units. The mean OHIP-J14 summary score was 13.0 +/- 9.1 units. Perceived chewing ability and OHRQoL were significantly correlated (Pearson correlation coefficient: -0.46, 95% confidence interval [CI]: -0.52 to -0.38), indicating that higher chewing ability was correlated with lower

OHIP-J14 summary scores (p < 0.001), which indicate better OHRQoL. A 1.0-unit increase in chewing function scores was related to a decrease of 0.87 OHIP-J14 units (95% CI: -1.0 to -0.72, p < 0.001). The correlation between perceived chewing ability and OHRQoL was not substantially influenced by age and number of teeth, but by gender, years of schooling, treatment demand and denture status.

Conclusion: Patients’ perception of their chewing ability was substantially related to their ARS-1620 molecular weight OHRQoL.”
“PCR has been extensively used for amplification of DNA sequences. We conducted a study to obtain the best amplification conditions for cytochrome b (Cyt b), cytochrome c oxidase I (COI) and 12S rRNA (12S) gene fragments of Malayan gaur mtDNA. DNA from seven Malayan gaur samples were extracted for PCR amplification. Various trials and combinations were tested to determine the best Dactolisib concentration conditions of PCR mixture and profile to obtain the best

PCR products for sequencing purposes. Four selected target factors for enhancing PCR, annealing temperature, concentration of primer pairs, amount of Taq polymerase, and PCR cycle duration, were optimized by keeping the amount of DNA template (50 ng/mu L) and concentration of PCR buffer (1X), MgCl2 (2.5 mM) and dNTP mixture (200

mu M each) constant. All genes were successfully amplified, giving the correct fragment lengths, as assigned for both forward Trichostatin A manufacturer and reverse primers. The optimal conditions were determined to be: 0.1 mu M primers for Cyt b and COI, 0.3 mu M primers for 12S, 1 U Taq polymerase for all genes, 30 s of both denaturation and annealing cycles for Cyt b, 1 min of both stages for 12S and COI and annealing temperature of 58.4 degrees C for Cyt b, 56.1 degrees C for 12S and 51.3 degrees C for COI. PCR products obtained under these conditions produced excellent DNA sequences.”
“Loquat (Eriobotrya japonica Lindl.) is a subtropical fruit, with some cultivars such as ‘Luoyangqing’ (LYQ) susceptible to chilling injury (CI), while others such as ‘Baisha’ (BS) are resistant. Although loquats are non-climacteric, modulation of ethylene has an effect on ripening-related post-harvest CI. Therefore the role of ethylene signalling in the development of CI was investigated in fruit of both the LYQ and BS cultivars. Three ethylene receptor genes, one CTR1-like gene, and one EIN3-like gene were isolated and characterized in ripening fruit.

25-0.67; p=0.0002). The frequencies of

rs4819522, rs7940667 and rs1057744 minor alleles and genotypes were similar between control and NSCL/P group, without significant differences. No significant associations among cleft types and polymorphisms were observed.

Conclusion: The study suggests for the first time evidences Hydroxylase inhibitor to an association of the G allele of TBX1 rs28649236 polymorphism and NSCL/P.”
“In recent years, molecular research has translated into remarkable changes of breast cancer diagnostics and therapeutics. Molecular tests such as the 21 gene expression test (Oncotype DX (TM)) and 70 gene microarray test (MammaPrint (R)) have revolutionized the predictive and prognostic tools in the clinic. By stratifying the risk of recurrence for patients, the tests are able to provide clinicians with more information on the treatment outcomes of using chemotherapy, HER2 targeted therapy or endocrine therapy or the combination of the therapies for patients with particular genetic expressions. However, it is still questionable for clinical applications as some areas remain unclear and that the true benefit still needs prospective evaluation. Such studies are under way and are anxiously awaited. In this paper, the limitation of the molecular tests

are discussed. As we are moving towards personalized medicine, molecular profiling will not only result in better outcomes but in a certain proportion of patients, likely will spare unnecessary use of cytotoxic compounds and reduce the cost to the health care systems.”
“The mammalian pathogen Bordetella bronchiseptica SB525334 chemical structure was grown AZD9291 mw under controlled batch conditions with glutamate as the primary carbon and nitrogen

source. First, a Box-Behnken statistical design quantified the effect of Mg, sulfate, and nicotinate on the antigen filamentous hemagglutinin (FHA) formation. Using lactic acid as a secondary carbon source for pH control, Mg, and SO4 each negatively affected antigen expression, while nicotinate positively affected antigen expression. Sulfate had a stronger negative effect than Mg with 10 mM eliminating FHA altogether; the highest FHA expression (about 1,000 ng/mL) occurred when either Mg concentration or SO4 concentration, but not both, was about 0.1 mM. Using two Mg and SO4 compositions modeled to yield the greatest antigen expression, three other organic acids were compared as the secondary carbon source: acetate, citrate, and succinate. Mixtures of acetate and glutamate resulted in the greatest organic acid consumption, OD, and FHA concentration (about 1,500 ng/mL), although significant acetate accumulated during these batch processes. The mechanism leading to elevated FHA expression when acetate is the secondary carbon source is unknown, particularly since these cultures were most prone to phase shift to Bvg(-) cultures.

During the first NHANES cycle (1988-1994), learn more insulin and diabetes were independently associated with hepatitis C. However, during the later study cycles (1998-2008),

these associations were no longer significant. In contrast, other important known risk factors for diabetes and IR (male gender, non-Caucasian race, age and obesity) remained significant over all three NHANES cycles. Although HCV infection was independently associated with an increased risk of diabetes and IR in the US population over a decade ago, assessment of the later NHANES cycles shows that this relationship may have become diluted by the rapid rise of other risks for diabetes, specifically, the prevalence of obesity.”
“Objective

To analyze fine needle aspiration cytology (FNAC) mater material from 20 cases of histologically verified medullary carcinoma (MC) of the breast and correlate the cytomorphologic features with histologic appearance

to improve the diagnostic sensitivity and specificity of FNAC.

Study Design

We reviewed the cytologic features of 20 cases of MC of the breast in the archives of Ege University Hospital between Q-VD-Oph ic50 1994 and 2006.

Results

Twenty patients with an aspirate and confirmed diagnosis of MC were identified. Patient age was 30-74 years (mean, 48). The initial cytologic diagnoses were positive for cancer in 17 cases, atypical/suspicious for cancer in 2 cases and negative for cancer in 1 case. The cytologic picture was characterized by cellular smears composed of highly atypical epithelial tumor cells in loosely cohesive sheets and lying singly, admixed with polymorphous lymphocytes, plasma cells and neutrophils. Tumor cells had predominantly abundant finely granular, eosinophilic cytoplasm AZD6244 and moderate to marked nuclear pleomorphism with prominent nucleoli. Histologic examination confirmed that 11 cases were atypical MC and 9 were pure MC.

Conclusion

Breast MC is

a rare, distinct category that appears to have rather characteristic cellular features. Familiarity with the cell components is a prerequisite in cytologic accuracy. (Acta Cytol 2009;53:165173)”
“p-type nanocrystalline silicon thin films with a series of thicknesses were deposited on both glass and n-type (100) silicon wafer substrates through a low-frequency inductively coupled plasma. No H-2 dilution was employed in the growth process. The structural and electric properties of nanocrystalline silicon films were investigated by XRD, Raman spectra, and a Hall effect measurement system. The XRD patterns show an obvious enhancement of the peak intensity with increasing thickness. The crystalline volume fraction of the films ranges from 83% to 87%, depending on the film thickness. The carrier concentration of the films is in the range of 8.1 x 10(19)/cm(3) – 8.6 x 10(19)/cm(3).

In general, the expression of genes involved in alkaloid biosynthesis was highest in C roseus plants with a root-zone temperature at 12 degrees C. In N. tabacum plants, a root-zone temperature of 30 degrees C reduced the root nicotine content by 50% compared to controls, while the anabasine content was reduced by approximately 30% in plants with a root-zone temperature of 12 degrees C or 30 degrees C compared to control plants. Genes involved in the nicotine pathway were more highly expressed in plants with a root-zone temperature of 12 degrees C. Our results demonstrate that the root-zone temperature alters the biosynthesis and accumulation of alkaloids

in plant tissues. Our results also suggest that cross-talk Nepicastat nmr between the roots and shoots selleck products mediates the transcription of genes involved in alkaloid biosynthesis in different parts of the plant. (C) 2013 Elsevier B.V. All rights reserved.”
“Hyper Immunoglobulin E Syndrome, or Job’s Syndrome, is a rare multisystem disorder that classically presents in early childhood with a triad of clinical manifestations that include severe eczematous dermatitis, recurrent infections

(skin and lung), and elevated serum immunoglobulin E. Hyper Immunoglobulin E Syndrome is a relatively uncommon condition and as such requires careful consideration of a constellation of patient symptoms to correctly diagnose the underlying disease. In this report we present a unique case of a child with previously undiagnosed Hyper Immunoglobulin E Syndrome presenting with biphasic stridor associated with multiple areas of tracheal stenosis. (C) 2011 Elsevier Ireland Ltd. All rights reserved.”
“Postprandial hypoglycaemia is a severe complication of Roux-en-Y gastric bypass (RYGBP). Acarbose, an alpha-glucosidase inhibitor (AGI), is employed in its treatment. Several studies have shown that AGIs increase the postprandial levels of glucagon-like peptide 1 (GLP-1). However, an excessive level of GLP-1 is one of the factors involved in the physiopathology of this condition. We analysed the effect PRIMA-1MET mw of acarbose oral administration in eight RYBGP patients with clinically significant hypoglycaemia or dumping syndrome.

Glucose,

insulin and GLP-1 plasma levels in fasting and after ingestion of a standard meal (Ensure PlusA (R); 13 g protein, 50 g carbohydrate, 11 g fat) were measured. The test was repeated the following week with the oral administration of 100 mg of acarbose 15 min prior to the meal.

Five patients developed asymptomatic hypoglycaemia during the test (glucose level < 50 mg/dl) with inappropriately high insulin levels and exaggerated GLP-1 response. Acarbose ingestion avoided hypoglycaemia in all of the patients and increased the lowest plasma glucose level (46.4 +/- 4.8 vs. 59.0 +/- 2.6 mg/dl, p < 0.01). Acarbose ingestion decreased the area under the curve for serum insulin and GLP-1 levels at 15 min after the meal.

Then a sample of 199 women aged 18-50 years completed the questionnaire. To test reliability the internal consistency was assessed by Cronbach’s alpha coefficient. Validity was evaluated using known groups comparison.

Results: The mean age of respondents was 31.4 (SD = 5.4) years. Reliability analysis showed satisfactory result (Cronbach’s alpha coefficient = 0.71). The questionnaire discriminated well between sub-groups of women differing in infertility

and premenstrual syndrome (PMS) in the expected direction.

Conclusion: This preliminary validation study PD173074 of the Iranian version of the EHP-5 proved that it is an acceptable, reliable and valid measure of quality of life in endometriosis patients.”
“Hair cortex comedo was described originally in an article detailing 2 cases of a comedo-like clinical lesion that was histologically a keratinous plug with cornification similar to the cortex of the hair shaft. We have collected retro- and prospectively a series of 34 cases of hair cortex comedo. In our

series, there was a slight female predominance (Male: Female of 1:1.4), and the mean patient age was 28.8 years. All lesions were solitary, distributed mainly on the head and neck or trunk, and were described clinically as a blue subcutaneous papule or nodule with “”cyst”" as the most common clinical differential diagnosis. Histologic examination showed a solitary, vertically oriented, uniformly sized oval nodule of compact laminated corneocytes check details sitting in a patulous invagination lined by epithelium similar to the infundibulum, isthmus, or combinations of them; rarely matrical epithelium was identified. Entrapped melanin (30/34 cases), shadow cells (16/34 cases), and calcification (12/34 cases) were identified commonly. Remnants of a surrounding follicle were noted in 15 cases, with infundibular epithelium in 9 of the cases, isthmic epithelium in 3, and matrical or supramatrical epithelium (or both) in 3. There was an associated dense granulomatous infiltrate in the majority of the cases (25/34). SC79 chemical structure Although hair cortex comedo was thought

originally to be a variant of dilated pore of Winer, we believe that these distinctive lesions, which are characterized histopathologically by a uniformly sized vertically oriented dermal plug of laminated corneocytes with entrapped melanin and surrounding granulomatous inflammation, are likely derived from matrical or supramatrical cells (or both).”
“OBJECTIVES: This study sought to determine the level of agreement between behavioral and multidimensional pain assessment scales in term newborn infants submitted to an acute nociceptive stimulus.

METHODS: This cross-sectional study was performed on 400 healthy term newborns who received an intramuscular injection of vitamin K during the first 6 hours of life.

The effect of this, however, could be ameliorated by adding extra species at the start and end of the flowering season. The plant species that could be used to future-proof margins against global warming are discussed.”
“The creep behavior of new polymers prepared by free radical polymerization of styrene-crosslinked resins obtained from linseed oil and derived wood flour (WF) composites have been analyzed. Results of short-time flexural creep tests at different temperatures are reported. The

effects of the wood flour content and temperature are discussed. The creep deformation is significantly reduced with the incorporation of wood flour, due Roscovitine concentration to the excellent fiber/matrix interaction. The creep strain was modeled using the creep power law and the Burgers models. The parameters were determined from the best fitting of the experimental data using a nonlinear optimization method. Although both models gave a good description of the viscoelastic creep of the materials,

the Burgers model was preferred because of its Emricasan ability to predict recovery. A master curve was built using the time temperature superposition principle, and the time shifts were well fitted using Arrhenius model. There was a good superposition of the short-term master curve and long-term data for samples tested at the same time after preparation. A reduction of the creep deformation was observed when the responses of samples tested after 2 and 5 years from preparation were compared, which was attributed to aging derived from

the oxidative crosslinking of linseed oil fragments in the network. (C) 2011 Wiley Periodicals, Inc. J Appl Polym Sci 121: 2626-2633, 2011″
“Several experimental methods to measure ferroelectric hysteresis loops and to extract polarization values are compared for thin films with significant losses and different magnitudes of polarization. The analysis allows the determination of the most appropriate frequency VX-765 nmr range and technique to extract reliable values of the remanent polarization in materials with low polarization and high leakage. Examples include multiferroic YMnO(3) and Bi(0.9)La(0.1)NiMnO(6) thin films. (C) 2011 American Institute of Physics. [doi: 10.1063/1.3555098]“
“Few models concern how environmental variables such as temperature affect community structure. Here, we develop a model of how temperature affects food web connectance, a powerful driver of population dynamics and community structure. We use the Arrhenius equation to add temperature dependence of foraging traits to an existing model of food web structure. The model predicts potentially large temperature effects on connectance. Temperature-sensitive food webs exhibit slopes of up to 0.01 units of connectance per 1 degrees C change in temperature. This corresponds to changes in diet breadth of one resource item per 2 degrees C (assuming a food web containing 50 species).

(C) 2011 Wiley Periodicals, Inc. J Appl Polym Sci, 2012″
“Background: Extrapancreatic organ dysfunction is the key determinant of mortality in acute pancreatitis (AP). This study aimed to document

the frequency and duration of individual organ dysfunction in all fatalities caused by AP in a large, population-based cohort.

Methods: All deaths caused by AP in Scotland between 2000 and 2006 inclusive were analysed (n = 1024).

Results: The median time lapse between the onset of AP and death was 6 days (interquartile range [IQR] 17 days); that between the onset of organ dysfunction and death was 3 days (IQR 7 days). There was no apparent bimodal distribution. The majority of patients had single-(384 patients) or two-system (242 patients) extrapancreatic organ dysfunction. Pulmonary dysfunction was AZD6244 solubility dmso most prevalent check details (30% of organspecific entries, 198/660), followed by cardiovascular (18%, 117/660), renal (16%, 108/660), liver (11%, 71/660), gastrointestinal (9%, 59/660), haemorrhage (6%, 38/660), coagulopathy (5%, 31/660) and central nervous system (6%, 38/660) dysfunction.

Conclusions: Death in AP occurs early

in the disease course. The present findings support the primacy of pulmonary injury as the modal pattern of organ dysfunction in severe AP, with increased frequencies of cardiovascular and renal compromise in fatal AP.”
“A direct inter-conversion between conduction electron spin-current and spin wave spin-current has been experimentally realized in Pt/Y(3)Fe(5)O(12) and Pt/Y(3)Fe(5)O(12)/Pt heterostructures [Y. Kajiwara et al., Nature 464, 262 (2010)]. We investigate the dynamics of this inter-conversion in AZD3965 in vitro an in-plane spiral magnet with the nearest-neighboring

interaction and Dzyaloshinskii-Moriya interaction, using the modified Landau-Lifshitz-Gilbert equation. The calculations indicate that an unattenuated conical spin wave in the spiral magnet can be excited by a spin-torque representing a conduction-electron spin-current. The substantial role of the Dzyaloshinskii-Moriya interaction in stabilizing such unattentuated spin wave transmission is revealed. In addition, the influences of the spin-torque term and damping coefficient on the stability of the spin wave transmission are discussed. (C) 2011 American Institute of Physics. [doi:10.1063/1.3631827]“
“Our patient first developed thrombotic thrombocytopenic purpura (TTP) at age 10 years with an initial platelet count of 10,000/mu mu L. She achieved remission with plasmapheresis (PE), but suffered 2 relapses in the next 2 years, each approximately 1 year from PE, with ADAMTS13 levels of < 5%%. Early in her third remission, with vincristine (weekly xx 4 doses) and prednisone (for 2 weeks) her ADAMTS13 increased to 99%% in 24 weeks, but decreased to < 4%% in the next 38 weeks.

“
“. To evaluate T cell immunity in advanced liver disease, antigen-specific lymphoproliferative (LP) responses were prospectively studied in the context of the Hepatitis C Antiviral Long-term Treatment against Cirrhosis trial. Peripheral blood responses to hepatitis C virus (HCV), tetanus and Candida protein antigens were measured at baseline, month 12 (M12), M24, M36 and M48 in 186 patients randomized to either low-dose peginterferon-alfa-2a (PEG-IFN) only or observation. Liver histology was evaluated at baseline, M24 and M48. Patients with cirrhosis (Ishak 56) were less likely to have

positive LP responses to HCV at baseline than patients with fibrosis (15%vs 29%, P = 0.03) and had lower levels of HCV c100 responses at baseline, M24 and M48 (P = 0.11, P = 0.05, P = 0.02, respectively). For 97 patients with complete longitudinal data, the frequency of positive LP responses to HCV, tetanus and Candida antigens declined over time Selleckchem ISRIB (P < 0.003), and the slope of this decline was greater in the PEG-IFN treatment group than the observation group (P < 0.02). Lower levels of tetanus LP responses were associated with fibrosis progression and clinical outcomes (P = 0.009). Poorer CD4+ T cell proliferative function was associated with more advanced liver disease in chronic hepatitis C and may be further affected by long-term PEG-IFN treatment.”
“Graphene formed via chemical vapor deposition

was exposed to various plasmas (Ar, O(2), N(2), and H(2)) in order selleck to examine its effects on the bonding properties of graphene to metal. After exposing patterned graphene to Ar plasma, the subsequently deposited metal electrodes remained intact, enabling the successful fabrication of field effect transistor arrays. The effects of the enhanced adhesion between graphene

and metals were more evident from the O(2) plasma than the Ar, N(2), and H(2) plasmas, suggesting that a chemical reaction of O radicals imparts hydrophilic properties to graphene more effectively than the chemical reaction of H and N radicals or the physical bombardment of Ar ions. The electrical measurements (drain current versus gate voltage) of the field effect transistors before and after Ar plasma exposure confirmed that the plasma treatment is quite effective in controlling the graphene to metal bonding accurately without buy Vorasidenib the need for buffer layers. (C) 2011 American Institute of Physics. [doi:10.1063/1.3646506]“
“Background: Fat and protein sources may influence whether low-carbohydrate diets are associated with type 2 diabetes (T2D).

Objective: The objective was to compare the associations of 3 low-carbohydrate diet scores with incident T2D.

Design: A prospective cohort study was conducted in participants from the Health Professionals Follow-Up Study who were free of T2D, cardiovascular disease, or cancer at baseline (n = 40,475) for up to 20 y.

After identifying

the left ureter, the IMA is either clipped or sealed about 1.5 to 2 cm from the origin in order to preserve the autonomous plexus. Then dissection is continued on Gerota’s fascia. After lifting the rectosigmoid, dissection is continued in the avascular plane until the mesentery of the upper rectum is mobilized. Then the remaining lateral adhesions are dissected with preservation of the gonadal vessels https://www.selleckchem.com/products/jq1.html and the left ureter. The distal resection line is always in the upper rectum, which is easily identified by the lack of tenia. After sealing the mesorectum, the rectum is dissected using a linear stapler. Thereafter, a minilaparotomy above the pubic symphysis is performed and a device for protection and retraction of the wound is inserted. Dissection of the mesosigmoid and the descending colon is carried out extracorporally. The anvil of a circular stapling device is inserted in the descending Selonsertib datasheet colon, which is then returned into the peritoneal cavity. Running sutures closes the incision, and the anastomosis is carried out laparoscopically in a “”double stapling”" technique.

The video describes the efficacy and technical feasibility of laparoscopic surgery for diverticular disease and demonstrates its effect regarding perioperative morbidity and functional outcome.”
“Background: Patients with Sickle cell disease (SCD) who receive regular transfusions are at risk for

developing cardiac toxicity from iron overload. The aim of this study was to assess right and left cardiac volumes and function, late gadolinium enhancement (LGE) and iron deposits in patients with SCD using CMR, correlating these values with transfusion burden, ferritin and hemoglobin PF-02341066 cell line levels.

Methods: Thirty patients with SCD older than 20 years of age were studied in a 1.5 T scanner and compared to age- and sex-matched normal controls. Patients underwent analysis of biventricular volumes and function, LGE and T2* assessment of the liver and heart.

Results: When compared to controls, patients with SCD presented higher left ventricular (LV) volumes

with decreased ejection fraction (EF) with an increase in stroke volume (SV) and LV hypertrophy. The right ventricle (RV) also presented with a decreased EF and hypertrophy, with an increased end-systolic volume. Although twenty-six patients had increased liver iron concentrations (median liver iron concentration value was 11.83 +/- 9.66 mg/g), only one patient demonstrated an abnormal heart T2* < 20 msec. Only four patients (13%) LGE, with only one patient with an ischemic pattern.

Conclusions: Abnormal heart iron levels and myocardial scars are not a common finding in SCD despite increased liver iron overload. The significantly different ventricular function seen in SCD compared to normal suggests the changes in RV and LV function may not be due to the anemia alone.

Chest tube blood loss was quantified postoperatively in the first 24 h. Coagulation parameters were recorded at intensive care unit admission and in the patient’s first 24 h. Thromboembolic

complications were also ascertained.

RESULTS: Seventy-seven patients out of the 677 studied (11.4%) were included: ARS-1620 price PCC was solely administered in 24 patients (group 0, fresh frozen plasma in 26 (group II) and both in 27 (group III). The mean dose of PCC was 10.0 Ul/kg +/- 3.5 for group I vs 14.1 Ul/kg +/- 11.2 for group III (P = 0.09). Initial blood loss in the first hour was different between the three groups (P = 0.05): 224 +/- 131 ml for group I, 369 +/- 296 ml for group II and 434 +/- 398 ml for group III. Only group I vs group III presented a significant difference (P = 0.02). Variations of blood loss over time were no different according to the treatment groups (P = 0.12). Reductions in blood loss expressed in percentage showed no difference between the three groups after 2 h: 54.5% (68.6-30.8) for group I; 45.0% (81.6-22.2) for group II; 57.6 (76.0-2.1) for group III; (P= 0.89). Re-exploration for bleeding involved 1 patient in group I (4%), 2 in group 11 (8%) and 10 in group III (37%) (P = 0.002). Except for fibrinogen, variations of prothrombin time, activated

partial thromboplastin time and platelets with time were not different according to the treatment groups. Cerebral infarction occurred in one patient in group II.

CONCLUSIONS: Administration of low-dose of PCC significantly decreased postoperative bleeding after CPB.”
“This BMS-754807 order paper presents registration via embedded maps (REM), a deformable registration algorithm for images with varying topology. The algorithm represents 3-D images as 4-D manifolds in a Riemannian space (referred to as embedded maps). Registration is performed as a surface

evolution matching one embedded map to another using a diffusion process. The approach differs from those existing in that it takes an a priori estimation of image regions where topological changes are present, for example lesions, and generates a dense vector field representing both the shape and intensity changes necessary to match the images. The algorithm outputs both a diffeomorphic deformation field and an intensity displacement which corrects the intensity difference caused by topological changes. Multiple sets of https://www.selleckchem.com/products/BI6727-Volasertib.html experiments are conducted on magnetic resonance imaging (MRI) with lesions from OASIS and ADNI datasets. These images are registered to either a brain template or images of healthy individuals. An exemplar case registering a template to an MRI with tumor is also given. The resulting deformation fields were compared with those obtained using diffeomorphic demons, where topological changes are not modeled. These sets of experiments demonstrate the efficacy of our proposed REM method for registration of brain MRI with severe topological differences.