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Is intravesical stent position a predictor of associated morbidity?
Dominik Abt,Livio Mordasini,Elisabeth Warzinek,Hans-Peter Schmid,Sarah Roberta Haile,Daniel Stephan Engeler,Gautier Müllhaupt 대한비뇨의학회 2015 Investigative and Clinical Urology Vol.56 No.5
Purpose: Temporary drainage of the upper urinary tract by use of internal ureteral stents is a common procedure that is often associated with a variety of symptoms. The role of intravesical stent position in associated morbidity is controversial. Materials and Methods: The German version of the ureteral stent symptom questionnaire (USSQ) was completed by 73 patients with an indwelling ureteral stent the day before stent removal. Intravesical stent position was classified into 3 categories by x-ray before stent removal. The influence of intravesical stent position on USSQ score was analyzed, including subscores and single items. Results: Intravesical stent position showed no significant influence on associated morbidity. The median USSQ total score in all patients was 77.5 (range, 30–147). Patients with ipsilateral stents (69.0; range, 30–122) tended to have lower total scores than did those with tangential (86.5; range, 30–122) or contralateral (77.0; range, 31–147) stents, but the differences were not statistically significant (p=0.35). The USSQ subscores for urinary symptoms (p=0.80), body pain (p=0.80), general health (p=0.16), work performance (p=0.07), additional problems (p=0.81), and all of the USSQ single items of interest in the context of stent length also did not differ significantly between the three groups. Conclusions: Intravesical stent position did not significantly influence associated morbidity in our study. An appropriate stent length should be chosen to avoid dislocation. However, complex calculations of optimum stent length, time-consuming manipulations, and costly stock holding of various stent sizes to obtain the perfect stent position do not seem worthwhile.
Dames, Sonja A,Bang, Eunjung,Haü,ssinger, Daniel,Ahrens, Thomas,Engel, Jü,rgen,Grzesiek, Stephan American Society for Biochemistry and Molecular Bi 2008 The Journal of biological chemistry Vol.283 No.34
<P>T-cadherin is unique among the family of type I cadherins, because it lacks transmembrane and cytosolic domains, and attaches to the membrane via a glycophosphoinositol anchor. The N-terminal cadherin repeat of T-cadherin (Tcad1) is approximately 30% identical to E-, N-, and other classical cadherins. However, it lacks many amino acids crucial for their adhesive function of classical cadherins. Among others, Trp-2, which is the key residue forming the canonical strand-exchange dimer, is replaced by an isoleucine. Here, we report the NMR structure of the first cadherin repeat of T-cadherin (Tcad1). Tcad1, as other cadherin domains, adopts a beta-barrel structure with a Greek key folding topology. However, Tcad1 is monomeric in the absence and presence of calcium. Accordingly, lle-2 binds into a hydrophobic pocket on the same protomer and participates in an N-terminal beta-sheet. Specific amino acid replacements compared to classical cadherins reduce the size of the binding pocket for residue 2 and alter the backbone conformation and flexibility around residues 5 and 15 as well as many electrostatic interactions. These modifications apparently stabilize the monomeric form and make it less susceptible to a conformational switch upon calcium binding. The absence of a tendency for homoassociation observed by NMR is consistent with electron microscopy and solid-phase binding data of the full T-cadherin ectodomain (Tcad1-5). The apparent low adhesiveness of T-cadherin suggests that it is likely to be involved in reversible and dynamic cellular adhesion-deadhesion processes, which are consistent with its role in cell growth and migration.</P>