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UPOINT System: A Diagnostic/Therapeutic Algorithm for Chronic Prostatitis/Chronic Pelvic Pain Syndrome
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Phil Hyun Song
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Urogenit Tract Infect 2020;15(2):27-32. Published online August 31, 2020
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DOI: https://doi.org/10.14777/uti.2020.15.2.27
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Abstract
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- Chronic prostatitis/chronic pelvic pain syndrome (CP/CPPS) is a common condition that significantly affects the quality of life. On the other hand, urologists find it challenging to treat this disorder effectively. To date, the Urinary, Psychosocial, Organ-Specific, Infection, Neurological/Systemic, and Tenderness (UPOINT) system is the only classification tool that can improve the treatment outcomes significantly compared to monotherapy. This review focused on the most recent advances in the diagnosis and treatment of CP/CPPS.
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Host-Pathogen Interactions in Urinary Tract Infections
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Young Hwii Ko, Jae Young Choi, Phil Hyun Song
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Urogenit Tract Infect 2019;14(3):71-79. Published online December 31, 2019
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DOI: https://doi.org/10.14777/uti.2019.14.3.71
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Abstract
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- Urinary tract infections (UTIs) are classified by the host condition. Uncomplicated infections are caused most commonly by uropathogenic Escherichia coli (UPEC) and affect otherwise healthy people, whereas complicated infections are commonly caused by species, such as Proteus mirabilis, and affect patients with underlying difficulties, such as a urinary tract abnormality or catheterization. The outcome of infection caused by these bacteria is dictated by the immune response to the UTI and the host factors that influence the susceptibility to disease. This review focuses on the host pathogen interactions in UTI, including an identification of additional virulence factors and therapeutic or prophylactic targets, particularly by UPEC and P. mirabilis.
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Ureteral Obstruction Caused by Aspergilloma in a Non-Immunosuppressive Patient
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Jun Bo Chang, Phil Hyun Song, Jae Young Choi
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Urogenit Tract Infect 2016;11(3):118-120. Published online December 31, 2016
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Abstract
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- Although rarely, aspergillosis can cause obstructive uropathy. This generally occurs in patients with immunosuppressive conditions. Herein, we report a case of aspergilloma that caused ureteral obstruction in a 79-year-old man with no immunosuppressive conditions. A computed tomography revealed that his left pelvocalyceal system and ureter showed mild dilation, without a definite obstructive lesion. The fungal bezoar was removed using an ureteroscopy. The patient was successfully treated with antifungal medication.
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Recurrent Urinary Tract Infection by Bladder Stone Resulting from Subureteral Injection Polydimethylsiloxane (Macroplastique®) for Treatment of Vesicoureteral Reflux
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Jae Young Choi, Hyun Tae Kim, Young Hwii Ko, Young Hwan Lee, Phil Hyun Song
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Urogenit Tract Infect 2016;11(2):62-65. Published online August 31, 2016
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Abstract
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- While endoscopic subureteral injection of bulking agents has become a first-line therapy for the treatment of vesicoureteral reflux (VUR), mainly due to its high success rates with minimal complications, polydimethylsiloxane (PDS) administration can be associated with bladder calcification in a minority of patients. A 10-year-old girl with prior history of subureteral administration of PDS as a treatment modality for bilateral VUR six years ago showed recurrent lower urinary tract symptoms, including dysuria, frequency, and urgency, for the past 6 months. She was admitted to our institution for right pyelonephritis with hydronephrosis. Radiologic examination had revealed two yellowish impacted stones attached to the previous site of PDS administration without recurrence of VUR. The stones were completely removed by cystolitholapaxy. This study suggests that such a late-complication should be considered in patients with recurrent urinary tract infection or lower urinary tract symptom despite complete disappearance of VUR by prior subureteral administration therapy.
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Clinical Significance of Toll-Like Receptor and Toll-Like Receptor Blocker
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Jae Young Choi, Phil Hyun Song, Young Hwii Ko
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Urogenit Tract Infect 2016;11(1):1-6. Published online April 30, 2016
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Abstract
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- The mammalian Toll-like receptor (TLR) family, consisting of 13 members, plays an important role in innate recognition of specific patterns of microbial products. TLR-dependent recognition subsequently causes an activation of antigen-specific adaptive immunity. TLR-mediated signaling pathways consist of two pathways that induce gene expression: the myeloid differentiation primary response gene 88 (MyD88)-dependent pathway and Toll/interleukin-1 receptor-domain containing adaptor protein-inducing interferon--dependent pathway. Synthetic TLR agonists, as well as TLR antagonists, affect and manipulate the host defense systems, and some of these immunomodulating agents may help to overcome intrinsic disturbances of the TLR system to offer new treatment options in urinary tract infection (UTI). Future studies are necessary to clarify additional associations between TLRs and severity of UTI, which may help in developing new treatment options.
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Current Updates in Pharmacokinetics and Pharmacodynamics of Fluoroquinolones
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Young Hwii Ko, Phil Hyun Song
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Korean J Urogenit Tract Infect Inflamm 2015;10(1):1-6. Published online April 30, 2015
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Abstract
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- The ultimate goal of antimicrobial treatment is to decrease the morbidity and mortality related to infection. Maximizing these outcomes requires an understanding of the complex interactions between the drug administered, the host, and the infecting pathogen. Pharmacokinetics, which deals with the disposition of a drug in the body, focuses on such parameters as absorption, distribution, and elimination. Pharmacodynamics more specifically focuses on the interaction between the drug concentration at the site of action over time and the resulting antimicrobial effect. Use of quinolones has increased in vitro activity against several important pathogenic organisms as well as augmented pharmacokinetic parameters. These properties result in enhanced pharmacodynamic characteristics and should improve therapeutic outcomes against selected pathogens. In this article the pharmacokinetics and pharmacodynamic potential of these quinolones, particularly fluoroquinolones, is reviewed.
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Memokath Stent Insertion for the Management of Bilateral Ureteral Obstructions from Retroperitoneal Fibrosis
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Phil Hyun Song, Yoon Seob Ji, Jong Min Kim, Hee Chang Jung
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Korean J Urogenit Tract Infect Inflamm 2012;7(1):63-67. Published online April 30, 2012
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Abstract
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- Retroperitoneal fibrosis is a rare disease characterized by the presence of a retroperitoneal tissue, consisting of chronic inflammation and marked fibrosis, which often causes ureteral obstruction. Surgical approach is necessary to preserve the renal function, and this is achieved by ureteral stent. The Memokath stent is a new thermo-expandable shape-memory metallic stent. Herein, we report our recent experience of a patient with retroperitoneal fibrosis, which involves bilateral ureter, who underwent successful bilateral Memokath stent insertion.
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