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Background: Dysphagia is a common symptom that can be due to disease, but can also occur without a known cause. Today, we know that the coordination of swallowing and respiration is essential for a safe swallow. Swallowing consists of several subsecond events. To study these events, it’s important to use modalities with high temporal resolution. In the first study in this thesis, we examined young healthy individuals with simultaneous videofluoroscopy, videomanometry and respiratory recordings, all with high temporal resolution. We know that dysphagia is more common in elderly and in patients with gastroesophageal reflux disease, (GERD).Whether this increased incidence of dysphagia in elderly is due to a disease process or is part of normal ageing is somewhat unclear. Furthermore, we believe that the increased incidence of dysphagia in GERD patients is due to reflux of gastro-duodenal content into the pharynx and larynx, which likely alter the sensory nerves of the mucosa which might deteriorate the sensitivity. To evaluate these two groups, we used our young healthy controls as a reference. However, to be able to use this control group, we used the same technique, modalities and protocol as in the study with young healthy volunteers. All of the above described studies were mostly experimental studies. Of this reason we wanted to perform a more clinical study and as swallowing maneuvers are the main treatment for dysphagia, caused by functional (neuromuscular) dysfunction. The aim of this study was to evaluate different swallowing maneuvers by intraluminal pharyngeal manometry in healthy volunteers. Material and Methods: We examined all volunteers in our first three studies, with simultaneous videofluoroscopy, videomanometry and respiratory recordings, all with high temporal resolution. In the young group, the onset of 13 predetermined swallowing and respiratory events and the surrounding respiratory phase pattern were studied in different body positions and differe

Objective response assessment is important to describe the treatment effect of anticancer drugs. Standardization by using a "common language" is also important for comparison of results from different trials. In contrast to clinical results, which can be subjective, diagnostic imaging provides a greater opportunity for objectivity and standardization. It was generally accepted that a decrease in tumor size correlated with treatment effect; as a result, imaging was adopted for lesion measurement in the World Health Organization (WHO) criteria in 1979. However, because of some limitations of the WHO criteria, the Response Evaluation Criteria in Solid Tumors (RECIST) were introduced in 2000. In RECIST, imaging was recognized as indispensable for response evaluation of solid tumors. Nevertheless, the widespread use of multidetector computed tomography and other imaging innovations have made RECIST outdated, with a concomitant need for modifications. Meanwhile, newer anticancer agents with targeted mechanisms of action have demonstrated an inherent limitation and unsuitability of anatomic tumor evaluation that assesses only lesion size. In addition, the effect of these new drugs changes the paradigm according to which tumor response or response rate is measured. Complete and partial responses cannot be the end points in all clinical trials; in some cases, disease control or progression-free survival may be the more relevant end point.