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Modern approach to benign oesophageal disease comprises endoscopic, laparoscopic and open surgical procedures. The indication for a surgical procedure is in some patients obvious, but in some patients less clear. It is important for patients and for healthcare professionals to have equal goals and expectations of a surgical procedure. The aim of this chapter is to convey to the reader a surgeon’s
When selecting an instrumental procedure to assess oral and pharyngeal swallowing dysfunction videoradiography is the only technique where the entire swallowing sequence could be analyzed. Accordingly this is an excellent tool for the dysphagia therapist in the management of dysphagic patients.
To a higher degree, older adults will live to old age in their own homes with the assistance of home care services. One effect of this is an increased number of people working in the home environment. This paper presents the results from a research project that studied the physical environment in Swedish home care. Innovations to support the home care situation were developed, with the aim of cont
Systemic disease may result in dysphagia through numerous mechanisms. For example, salivary gland impairment may result in xerostomia, which as well as resulting in painful mucosal blisters and ulcers may impair oral function. Acute or chronic inflammatory processes may result in strictures in the esophagus and/or pharynx. Furthermore, altered biomechanics of oral, pharyngeal, and esophageal muscu
The oral cavity, pharynx, and esophagus constitute three anatomically and functionally integrated areas that are involved in swallowing. They are made up of muscular tubes surrounded by cartilages and bones. Swallowing is controlled by the brain stem in the central nervous system where the swallowing center is located.
Normal pharyngeal swallow is coordinated in a precise and exact manner. It is controlled from a swallowing center in the brain stem. Normal swallowing is adjusted to bolus volume temperature and viscosity. Abnormal pharyngeal swallow may lead to misdirected swallowing that challenges the airways. Inefficient transportation into the esophagus, stomach, and bowel may lead to dehydration and malnutri
Dysphagia is common in the elderly. This is mainly due to neurodegenerative abnormalities in the central nervous system. The elderly may be able to compensate, to a certain degree, for deterioration of function but the reserve capacity is much less than in younger. Understanding of the normal ageing process as well as disease processes common in the elderly is important for diagnosis and treatment
The physiological process of swallowing is not only a simple transfer of liquids or food boluses from the oral cavity to stomach, but also a complex succession of voluntary and involuntary phases that involve complex deformations and require the entire functionality of the oropharyngeal apparatus. When this functionality is affected, people experience dysphagia, which is described as a combination
In the past decade, high throughput screening (HTS) has changed the way biochemical assays are performed, but manipulation and mechanical measurement of micro- and nanoscale systems have not benefited from this trend. Techniques using microbeads (particles approximately 0.1-10 mum) show promise for enabling high throughput mechanical measurements of microscopic systems. We demonstrate instrumentat
Many biological processes are influenced by the mechanical rigidity of surrounding tissues. Now, a combination of experiments and mathematical modelling has been used to describe the precise molecular and physical mechanism by which cells sense and respond to the mechanical properties of their extracellular environment through integrin-based adhesions.
Vinculin is an essential and highly conserved cell adhesion protein, found at both focal adhesions and adherens junctions, where it couples integrins or cadherins to the actin cytoskeleton. Vinculin is involved in controlling cell shape, motility, and cell survival, and has more recently been shown to play a role in force transduction. The tail domain of vinculin (Vt) contains determinants necessa
How individual cells respond to mechanical forces is of considerable interest to biologists as force affects many aspects of cell behaviour. The application of force on integrins triggers cytoskeletal rearrangements and growth of the associated adhesion complex, resulting in increased cellular stiffness, also known as reinforcement. Although RhoA has been shown to play a role during reinforcement,
Motile cilia are unique multimotor systems that display coordination and periodicity while imparting forces to biological fluids. They play important roles in normal physiology, and ciliopathies are implicated in a growing number of human diseases. In this work we measure the response of individual human airway cilia to calibrated forces transmitted via spot-labeled magnetic microbeads. Cilia resp
