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Infants admitted in the neonatal unit commonly present with feeding problems such as decreased oral intake and feeding intolerance. These infants may suffer from complex diseases such as prematurity or congenital malformations. The origin of these feeding problems may be disease-specific or may be secondary to many factors such as severity of the illness, concomitant medication and surgical interventions. "Healthy" preterm infants may have an immature nervous system leading to immature oral intake, and failure to coordinate sucking, swallowing and breathing. They may also have an immature motor gastro-intestinal function. Infants with bronchopulmonary dysplasia or central nervous system lesions are particularly prone to feeding problems. Recently, developmental changes in pharyngoesophageal physiology in the preterm infant were described explaining poor feeding in infants under 34 weeks. The physiology of distal esophageal motility has been described in healthy, preterm infants using water perfused manometry, but data on preterm infants with associated pathology are very limited.Term infants with severe congenital malformations also often present with feeding problems. In some cases, underlying respiratory, neurological or cardiac pathology impedes the ability to take oral feeds. In children with esophageal atresia, motility disorders are primarily due to the intrinsically disturbed development of the esophagus. End-to-end anastomosis of the esophagus can disturb vagal innervations, vascular supply or cause traction on the lower esophagus. In infants with congenital diaphragmatic hernia, multiple factors may play a role in the disturbed gastro-esophageal function leading to poor feeding. Development and position of lungs, stomach and lower gastrointestinal tracts are abnormal in those patients. Moreover, repositioning of the abdominal organs into the abdominal cavity can result in disorders based on numeric manometric parameters. For 15 years, we have had a unique setting of highly specialized clinical units focusing on pharyngeal as well esophageal dysphagia within the University Hospitals of Leuven. The current PhD project is part of an ongoing international collaboration between the KU Leuven (Experimental ORL, N Rommel) and the University of Adelaide, Australia (School of Paediatrics and Reproductive Health, T Omari) focusing on paediatric dysphagia. For three years, the clinical research has been expanded to adult dysphagia and become part of the Translational Research Centre for Gastrointestinal Disorders (TARGID). With this project we are now expanding the research to neonates.
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Esophagogastric Junction --- Manometry --- physiology --- methods
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Esophagogastric junction --- Esophagus --- Peptic ulcer --- Stomach --- Surgery
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Esophagitis, Peptic --- Gastroesophageal Reflux --- Esophagogastric Junction --- surgery --- surgery --- physiopathology
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Esophageal Sphincter, Lower --- Muscle Relaxation --- Esophagogastric Junction --- Esophagogastric Junction --- Gastroesophageal Reflux --- physiology --- physiology --- physiopathology --- drug effects --- physiopathology
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GASTROESOPHAGEAL REFLUX --- ESOPHAGEAL DISEASES --- ESOPHAGOGASTRIC JUNCTION --- ESOPHAGITIS --- GASTRIC ACID --- GASTROESOPHAGEAL REFLUX --- ESOPHAGEAL DISEASES --- ESOPHAGOGASTRIC JUNCTION --- ESOPHAGITIS --- GASTRIC ACID
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Nitric Oxide --- Arginine --- Muscle, Smooth --- Colon --- Esophagogastric Junction --- Receptors, Adrenergic --- pharmacology --- physiology --- physiology --- innervation --- physiology --- physiology
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Dietary Fats --- Gastrointestinal Motility --- Triglycerides --- Esophagogastric Junction --- pharmacology --- drug effects --- pharmacology --- drug effects
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Among malignant tumors, adenocarcinomas of the esophagogastric junction show the highest increase in incidence over the past three decades in Western industrialized countries. Accordingly, much effort is being devoted to basic and translational research in order to combat this frequently deadly disease. This special volume, with contributions from experts in the field, covers all aspects of adenocarcinomas of the esophagogastric junction. Etiology, pathogenesis, classification, and clinical staging are discussed, and there is special emphasis on state of the art treatment techniques. The latter range from endoscopic mucosal resections or limited surgical resections for early cancers to multimodality treatment options for locally advanced tumors. Emerging quality issues in surgical management are also addressed. Detailed attention is paid to other important recent developments, including molecular response prediction in multimodality treatment and early metabolic response evaluation by PET and PET-CT during neoadjuvant treatment. The diagnosis of micrometastases and its potential impact on therapeutic strategies are explored, and the use of sentinel node technology is assessed. This volume will be of interest to all clinicians concerned with the diagnosis and management of this malignancy.
Esophagogastric junction -- Cancer. --- Esophagogastric junction --- Adenocarcinoma --- Carcinoma --- Esophagus --- Stomach --- Esophagogastric Junction --- Neoplasms, Glandular and Epithelial --- Upper Gastrointestinal Tract --- Gastrointestinal Tract --- Neoplasms by Histologic Type --- Digestive System --- Neoplasms --- Anatomy --- Diseases --- Medicine --- Oncology --- Health & Biological Sciences --- Cancer --- Adenocarcinoma. --- Esophagogastric junction. --- Esophageal sphincter --- Gastroesophageal junction --- Junction, Esophagogastric --- Medicine. --- Internal medicine. --- Respiratory organs --- Oncology. --- Medicine & Public Health. --- Internal Medicine. --- Pneumology/Respiratory System. --- Diseases. --- Tumors --- Respiratory diseases --- Medicine, Internal --- Clinical sciences --- Medical profession --- Human biology --- Life sciences --- Medical sciences --- Pathology --- Physicians --- Sphincters --- Oncology . --- Pneumology. --- Respiratory organs—Diseases.
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