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Wong Kar-wai's 1994 'Chungking Express' portrays the sensory experience of walking through a global capital where space collapses to accommodate urban housing and population density. Globalization, however, renders the subversive power of walking more illusory than it might first seem.

Objectives: Non‐alcoholic fatty liver disease (NAFLD) is suggested to be a precursor of metabolic syndrome (MetS) and could influence the risk of testosterone deficiency (TD). Fatty liver index (FLI) is a simple and useful screening tool for NAFLD. We determined the association between the risk of NAFLD assessed by FLI and TD in aging Taiwanese men, especially those without MetS. Materials and Methods: A free health screening program was conducted for men (age: >40 years) in a medical center in Kaohsiung, Taiwan. All participants underwent a physical examination; answered a questionnaire assessing demographics, medical history, and clinical symptoms of TD; and provided 20‐mL whole blood samples for biochemical, adipocytokine, and hormonal evaluations. The risk of NAFLD was evaluated using FLI. The presence of NAFLD was ruled out if FLI value was <25 and ruled in if FLI value was ≥35. Results: A total of 552 men (mean age: 54.7 ± 7.7 years) were enrolled. The prevalence rates of TD and MetS were significantly higher among men with NAFLD than those without NAFLD (both p < 0.001). FLI was significantly correlated with total testosterone (TT) and adipocytokines associated with insulin resistance, such as adiponectin, leptin, and retinol‐binding protein‐4 (RBP‐4) levels, respectively (all p < 0.001). Among men without MetS, those at risk of and with NAFLD had a 3.82 and 8.50 times higher risk of TD, respectively, than those without NAFLD after adjusting for potential covariates. Conclusion: The FLI is associated with the risk of TD in aging Taiwanese men, especially in those without MetS. Our findings also suggest that insulin resistance may be an important link among the inter‐relationships of NAFLD, MetS, and TD. Further population‐based studies with larger sample sizes of different ethnicities are warranted to confirm these preliminary results. [ABSTRACT FROM AUTHOR]

Antegrade flexible URSL is a minimal invasive option for treating distal ureteral stones in patient after urinary diversion. [ABSTRACT FROM AUTHOR]

Purpose: The aim of the study was to compare the outcomes of simultaneous supine percutaneous nephrolithotomy (sPCNL) with semi-rigid ureteroscopic lithotripsy (SR-URSL) (Group A) and SR-URSL (Group B) for treating large proximal ureteral calculus. Materials and Methods: Between January 2015 and April 2019, all patients with large proximal ureteral stones (≥10 mm) who underwent simultaneous sPCNL with SR-URSL or SR-URSL at three medical centers were retrospectively included. Two surgical options were provided based on patients and doctors' decision. The intraoperative and postoperative results, including operating time, hospital stay, need for auxiliary procedures, and complications, were compared between the two groups. Stone-free clearance was defined as the absence of fragments or a single fragment of ≤4 mm on standard radiography 1 month after surgery. Results: A total of 38 and 27 patients were included in Groups A and B, respectively. The mean stone size was 21 mm and 18.2 mm and stone-free rate (SFR) was 97% and 33% in Groups A and B, respectively. Larger ureteral stones (P < 0.001), longer operation time (P < 0.001), prolonged hospitalization (P < 0.001), higher SFR (P < 0.001), and less patients requiring auxiliary procedures (P < 0.001) were observed in Group A. No significant difference regarding complications was observed between groups (P = 0.1). Conclusion: Simultaneous sPCNL with SR-URSL is a feasible and effective treatment for large proximal ureteral stones. Even though larger stone size was observed, simultaneous sPCNL with SR-URSL results in significantly higher SFR and reduced need for auxiliary procedures, without major complications, compared to SR-URSL alone. More clinical studies are required to confirm the outcomes of the present study. [ABSTRACT FROM AUTHOR]

Provision of adequate task-oriented training can be difficult for stroke survivors with limited hand movement. The current passive devices are mainly intended for gross grasp and release training. Additional assistive devices are required to improve functional opposition. This paper investigated the functional recovery of chronic stroke patients after using a three-dimensional (3D) printed dynamic hand device (3D-DHD) as an adjunct to conducting a task-oriented approach (TOA). Ten participants were randomly assigned to either the 3D-DHD group (n = 5) or the control group (n = 5). The TOA was used for the 3D-DHD group by using the 3D-DHD twice a week for four weeks, followed by a two-week home program. Only the TOA was used for the control group. The outcome measures, including the box and blocks test (BBT) of manual dexterity and prehensile strength, were conducted at baseline and at follow-up at four and six weeks later. The 3D-DHD group exhibited significantly superior improvements to the control group in the BBT and the palmar pinch force test. Both the groups had significant within-group improvements in the BBT and in all strength measures compared with baseline measurements. The use of 3D-DHD could position stroke-affected hands in coordinated functional opposition and had the potential to facilitate manual dexterity and advanced prehensile movement. [ABSTRACT FROM AUTHOR]

This essay looks at the mobility of pregnant Mainland women in Hong Kong to expose the reverberations of the SAR government's immigration policies relating to cross-border birth tourism. Pregnant Mainland women and their children (fetuses), as emergent social subjects, embody conflict and the negotiation between population governance and economic benefits. The government denies pregnant Mainland women the right to give birth in Hong Kong based on their non-eligible status while admitting their children to be born in Hong Kong on the grounds that their children meet Hong Kong's future demand for population renewal, in this way boosting the development of childbirth tourism. However, the localism, which has had an extensive influence on Hong Kong local society in recent years, has rejected the SAR government's "population renewal" imaginary by suggesting its own "locust imaginary." The government's acceptance and the local's exclusion of the population flow between China and Hong Kong imply distinct cross-border subject imaginations. Only by contextualizing and critically analyzing the various othering identities such as the non-eligible or locusts can we better understand the cultural politics of Hong Kong birthright citizenship over recent years. [ABSTRACT FROM AUTHOR]

Environmental low-dose melamine exposure has been associated with urolithiasis risk in adults, but it is unclear if this exposure can cause early renal damage. This cross-sectional study investigated the association of this exposure and early renal damage in patients with calcium urolithiasis. We recruited patients diagnosed with upper urinary tract calcium urolithiasis from three hospitals in southwestern Taiwan between November 2010 and January 2015. All patients completed a structured questionnaire and provided one-spot urine samples for the measurement of melamine level and markers of early renal injury, including N-acetyl b- d -glucosaminidase (NAG), β2-microglobulin (β2-MG), and microalbumin. We used urinary melamine levels as an indicator of environmental melamine exposure. A total of 309 patients (mean age of 54.7 ± 12.8 years) were studied. Median urinary melamine level (μg/mmol Cr) was 1.26 (interquartile range 0.48–3.29). A significant and positive correlation was found between urinary melamine concentration and urinary NAG levels (Spearman correlation coefficient, r = 0.157, p = 0.006, n = 309). With urinary melamine levels categorized into quartiles, multivariate regression results showed the same relationship, particularly in those with first stone episode. In this group, patients with the highest quartile of urinary melamine concentration had a 3.95-fold risk (95% confidence interval = 1.43–10.94) of high NAG levels (dichotomized by median), compared to the lowest quartile after adjustment. No association was found between urinary melamine concentration and urinary microalbumin levels. In conclusion, urinary melamine is significantly associated with urinary marker of early renal tubular injury, NAG, in urolithiasis patients, especially ones with first stone episode. [ABSTRACT FROM AUTHOR]

Objectives: Metabolic syndrome (MtS) and kidney stone are two common aging diseases with male dominant. This is the first study regarding the potential impact of MtS and its components on kidney stone in aging Chinese population.Methods: A total of 694 males with a mean age of 55.6 years were enrolled. The definition of MtS was according to the modified criteria developed by the Bureau of Health Promotion in Taiwan. Subjects were classified as having a disease of kidney stones according to diagnosis by a physician with available medical records or evidence from ultrasonography judged by an investigator of urologist.Results: Using age-adjusted multivariate logistic regression analysis, our results showed that subjects with kidney stone had significantly higher prevalence of MtS (p = 0.04, OR = 1.74, 95% CI: 1.0 1-3.00). The presence of MtS had significant correlation with kidney stone (p = 0.01, OR = 1.83, 95% CI: 1.1 4-2.93), which were associated with the increment of MtS components (p < 0.01). After adjusting for age and testosterone level, abnormal blood pressure (BP) was the most significantly independent component of MtS for kidney stone among the MtS components (p < 0.01, OR = 2.81, 95% CI: 1.46-5.39).Conclusions: In aging Taiwanese males, the presence of MtS and its components are strongly associated with kidney stone. Abnormal BP is the most significant risk component of MtS for kidney stone. [ABSTRACT FROM AUTHOR]

A novel transient voltage suppressor (TVS) that features ultralow capacitance is proposed. This structure is able to reduce the input capacitance by 21.1%, and is designed to protect against electrostatic discharge (ESD) issues for high-speed ports. The device is also able to withstand IEC 61000-4-2 contact testing at ±14 kV and transmission line pulse (TLP) testing at 20 A. The device is fabricated using a typical planar Bipolar-CMOS-DMOS (BCD) process. By slotting the doping well to decrease the concentration of diodes, a TVS with an ultralow Cj is obtained without the need to add to the process procedures or without damaging the ESD capability. [ABSTRACT FROM PUBLISHER]

The article focuses on neoliberal economic human in China. Topics discussed include Michel Foucault's "The Birth of Biopolitics," video documentary "The Wenzhou Merchants," and Xiao Bin's "The Wild World of Real Estate." The publications titled "Merchant Guilds: The Rise of Mainland's New Wealthy Class" and "The Wild World of Real Estate: The Real Story Behind the Impossibly Lucrative Business' are examined.

Given the broad consensus among academic geographers that a new matrix of global city‐regions is on the rise, this paper attempts to show how urban linkage has become not only a social reality that produces various cosmopolitan identities but a discursive framework for the formulation and articulation of these identities so as to reproduce the urban networks. With a particular emphasis on the ‘imaginary of identity’ and its problems, I will explore Taipei‐Shanghai as a global city‐region first by examining the ideology inherent in the discourse of the so‐called ‘New Shanghai People’ (xin shanghai ren), a popular discourse which has recently emerged to represent the identity of transmigrants. The second part of the paper will analyze several representative cultural texts including Wang Wen‐hua’s bestsellers in Shanghai, The Protein Girl, its sequel The Protein Girl II, and Chen‐pin’s bestsellers in Taipei, a series of non‐fiction works on how to survive and succeed in Shanghai. Situating these texts in the context of the Taipei‐Shanghai linkage, I will critique the imagination of the cosmopolitan identity, enabled by the material conditions of the urban network, and further lay bare not just the intricate connections between the new geopolitical regionalism and cultural narrative of Chinese transmigrants but the intense contradictions between the flexible accumulation of capital and the production of ‘flexible citizenship’ in Aihwa Ong’s terms. [ABSTRACT FROM AUTHOR]

A simple scheme is proposed to increase the hold voltage and not change the original trigger voltage of a silicon‐controlled rectifier (SCR) to enhance its latch‐up immunity without changing the device dimensions. It is found that using the lightly doped P‐diffusion instead of the highly doped P+ diffusion as the P emitter of the anode can increase the hold voltage of an SCR. [ABSTRACT FROM AUTHOR]

The article presents a case study of a 52-year-old man with prostate cancer, who underwent laparoscopic radical prostatectomy with bilateral pelvic lymph node dissection, and had anal urinary leakage during micturition, who underwent robotic-assisted transanal repair of rectourethral fistula.

The article discusses the flexible ureteroscopy (URS0 which has enabled the treatment of tortuous ureteral stones, but is not available worldwide due to high cost, skill dependence and long operative time, making it challenging for hospitals where it is unavailable. It states that ureterolithotomy is the available method for treating stones in tortuous ureters but is more invasive and is associated with greater postoperative morbidity.

This letter demonstrates a successful method for ON-state resistance reduction up to 20% by Shallow Trench Isolation (STI) fingers and with extra NLDD implant in the fingered region simultaneously for medium power devices. This fingered region provides a multidimensional electric field that avoids MOSFET breakdown voltage decrease, and it also shortens the drain-current conduction path. Therefore, low ON-state resistance and high drain driving current is obtained in our proposed device. Careful design for structural parameters of this STI finger is needed to achieve the optimum RON performance without hurting breakdown voltage. [ABSTRACT FROM AUTHOR]

The decomposition of Chinese characters is difficult and has been rarely investigated in the literature. In this paper, we propose a novel non-negative matrix factorization (NMF) technique to decompose a Chinese character into several graphical components without considering the strokes of the character or any semantic or phonetic properties of the components. Chinese characters can usually be represented as binary images. However, traditional NMF is only suitable for representing general gray-level or color images. To decompose a binary image using NMF, we force all of the elements of the two matrices (obtained by factorizing the binary image/matrix to be decomposed) as close to 0 or 1 as possible. As a result, a Chinese character can be efficiently decomposed into several components, where each component is semantically unreadable. Moreover, our NMF-based Chinese character decomposition method is suitable for applications in visual secret sharing by distributing the shares (different character components) among multiple parties, so that only when the parties are taken together with their respective shares can the secret (the original Chinese character(s)) be reconstructed. Experimental results have verified the decomposition performance and the feasibility of the proposed method. [ABSTRACT FROM AUTHOR]

We report the case of a 56-year-old man who in a motor vehicle collision developed a pelvic fracture and complete urethra rupture. Sudden onset of intermittent severe urethral bleeding occurred and it led to life-threatening blood pressure drop and dyspnea. An angiography of internal iliac artery showed a pseudoaneurysm involving the right obturator artery. Super-selective embolization of the feeding vessel was performed with cessation of the blood flow immediately. [ABSTRACT FROM AUTHOR]

The hot-carrier-induced degradation in the high-voltage n-type lateral diffused metal–oxide–semiconductor (LDMOS) field-effect transistor is investigated. Interface state generation caused by hot-electron injection in the channel region is identified to be the main degradation mechanism. Since the gate current (Ig) consists mainly of the electron injection, Ig correlates well with the hot-carrier lifetime of the device. The impact of varying device layout parameter on the performance and hot-carrier lifetime of the device are also evaluated. Such an analysis can achieve a better design of LDMOS transistors when considering both device performance and hot-carrier reliability. [ABSTRACT FROM AUTHOR]

Purpose: To share our multicenter experience using a safe and effective method for treating large proximal ure-teral calculus by simultaneous supine percutaneous nephrolithotomy (sPCNL) and retrograde ureterolithotripsy (URSL) in the Galdakao-modified supine Valdivia position.Materials and Methods: Between December 2014 and August 2017, all patients with large proximal ureteral stones (> 15 mm) who underwent simultaneous sPCNL and retrograde URSL at three medical centers were retro-spectively reported. The ureter stone was pushed back (retrograde) with the ureteroscope and was retrieved using forceps with a nephroscope through an Amplatz sheath. Surgical methods and outcomes were described to improve our experience and management of large proximal ureteral calculi.Results: A total of 31 patients underwent simultaneous sPCNL and retrograde URSL. The mean patient age, stone size, operating time, and postoperative hospital stay were 57 years (range, 32-74 years), 20.1 mm (range, 15.0-37.9 mm), 81 minutes (range, 30-150), and 3.2 days (range, 2-7 days), respectively. There were 10 modified Clavien grade I and five grade II complications. No blood transfusions were necessary in this series. All patients were treated with double-J stents without a nephrostomy tube. Only one patient did not achieve stone-free status because of the strict stone impaction into the ureteral wall. This patient received auxiliary URSL after two months. Thereafter, the overall stone-clearance rate at three months was 100%.Conclusion: Our preliminary data showed that this modified method is safe and effective for treating large prox-imal ureteral stones. [ABSTRACT FROM AUTHOR]

Background and Aims: Metabolic dysfunction-associated fatty liver disease (MAFLD) has emerged as a valuable marker for identifying individuals at increased risk of metabolic dysfunction, liver-related complications, and cardiovascular disease. However, the association between MAFLD and testosterone deficiency (TD) in aging men remains poorly understood. This study aimed to investigate the association between MAFLD and the risk of TD in aging Taiwanese men, with a specific focus on those without metabolic syndrome (MetS)., Methods: A free health screening program was conducted for Taiwanese men aged over 40 years in Kaohsiung, Taiwan. Participants underwent physical examinations, completed questionnaires regarding demographics, medical history, and clinical symptoms of TD, and provided 20-mL whole blood samples for biochemical, adipocytokine, and hormonal evaluations. Fatty liver index was used to evaluate the risk of fatty liver. Diagnostic criteria for MAFLD included fatty liver along with overweight/obesity, type 2 diabetes, or evidence of metabolic dysregulation., Results: A total of 631 men (mean age: 54.4 ± 8.4 years) were enrolled. The prevalence rates of TD and MetS were significantly higher in men with MAFLD compared to those without (both p < 0.001). Additionally, the presence of MAFLD showed a significant correlation with adipocytokines associated with insulin resistance, such as adiponectin, leptin, and retinol-binding protein-4 (RBP-4) levels (all p < 0.001). Among men without MetS, those with MAFLD had a 3.89- and 4.74-fold higher risk of total testosterone < 300 ng/dL and TD, respectively, after adjusting for potential covariates., Conclusion: MAFLD is associated with an elevated risk of TD in aging Taiwanese men, particularly in the absence of MetS. This finding suggests that MAFLD could serve as an early predictor of TD, facilitating the identification of high-risk individuals and enabling timely interventions. Further research is needed to validate these findings and explore the underlying mechanisms linking MAFLD, TD, and MetS in diverse populations., Competing Interests: The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest., (Copyright © 2023 Liu, Huang, Lee, Lee, Huang, Geng, Chang, Lin, Juan, Wu and Hsieh.)

Environmental melamine exposure increases the risks of oxidative stress and early kidney injury. Manganese superoxide dismutase (MnSOD), glutathione peroxidase, and catalase can protect the kidneys against oxidative stress and maintain normal function. We evaluated whether their single-nucleotide polymorphisms (SNPs) could modify melamine's effects. A total of 302 patients diagnosed with calcium urolithiasis were enrolled. All patients provided one-spot overnight urine samples to measure their melamine levels, urinary biomarkers of oxidative stress and renal tubular injury. Median values were used to dichotomize levels into high and low. Subjects carrying the T allele of rs4880 and high melamine levels had 3.60 times greater risk of high malondialdehyde levels than those carrying the C allele of rs4880 and low melamine levels after adjustment. Subjects carrying the G allele of rs5746136 and high melamine levels had 1.73 times greater risk of high N -Acetyl-β-d-glucosaminidase levels than those carrying the A allele of rs5746136 and low melamine levels. In conclusion, the SNPs of MnSOD, rs4880 and rs5746136, influence the risk of oxidative stress and renal tubular injury, respectively, in calcium urolithiasis patients. In the context of high urinary melamine levels, their effects on oxidative stress and renal tubular injury were further increased.

Purpose: To share our multicenter experience using a safe and effective method for treating large proximal ure-teral calculus by simultaneous supine percutaneous nephrolithotomy (sPCNL) and retrograde ureterolithotripsy (URSL) in the Galdakao-modified supine Valdivia position., Materials and Methods: Between December 2014 and August 2017, all patients with large proximal ureteral stones (> 15 mm) who underwent simultaneous sPCNL and retrograde URSL at three medical centers were retro-spectively reported. The ureter stone was pushed back (retrograde) with the ureteroscope and was retrieved using forceps with a nephroscope through an Amplatz sheath. Surgical methods and outcomes were described to improve our experience and management of large proximal ureteral calculi., Results: A total of 31 patients underwent simultaneous sPCNL and retrograde URSL. The mean patient age, stone size, operating time, and postoperative hospital stay were 57 years (range, 32-74 years), 20.1 mm (range, 15.0-37.9 mm), 81 minutes (range, 30-150), and 3.2 days (range, 2-7 days), respectively. There were 10 modified Clavien grade I and five grade II complications. No blood transfusions were necessary in this series. All patients were treated with double-J stents without a nephrostomy tube. Only one patient did not achieve stone-free status because of the strict stone impaction into the ureteral wall. This patient received auxiliary URSL after two months. Thereafter, the overall stone-clearance rate at three months was 100%., Conclusion: Our preliminary data showed that this modified method is safe and effective for treating large prox-imal ureteral stones.

Background: Cancer stem cells (CSCs) are involved in tumor progression and drug resistance. We hypothesized that variants in CSC marker genes influence treatment outcomes in prostate cancer. Methods: Ten potentially functional single nucleotide polymorphisms (SNPs) in seven prostate CSC marker genes, TACSTD2 , PROM1 , ITGA2 , POU5F1 , EZH2 , PSCA , and CD44 , were selected for analysis of their association with disease recurrence by Kaplan-Meier analysis and Cox regression in a cohort of 320 patients with localized prostate cancer receiving radical prostatectomy. Results: We identified one independent SNP, rs2394882, in POU5F1 that was associated with prostate cancer recurrence (hazard ratio 0.32, 95% confidence interval 0.14-0.71, P = 0.005) after adjustment for known clinical predictors. Further in silico functional analyses revealed that rs2394882 affects POU5F1 expression, which in turn is significantly correlated with prostate cancer aggressiveness and patient prognosis. Conclusion: Our results suggest that rs2394882 is prognostically relevant in prostate cancer, possibly by modulating the expression of the CSC gene POU5F1 ., Competing Interests: Competing Interests: The authors have declared that no competing interest exists.

Vitamin D is an important modulator of cellular proliferation through the vitamin D receptor (VDR) that binds to DNA in the regulatory sequences of target genes. We hypothesized that single nucleotide polymorphisms (SNPs) in VDR-binding sites might affect target gene expression and influence the progression of prostate cancer. Using a genome-wide prediction database, 62 SNPs in VDR-binding sites were selected for genotyping in 515 prostate cancer patients and the findings were replicated in an independent cohort of 411 patients. Prognostic significance on prostate cancer progression was assessed by Kaplan-Meier analysis and the Cox regression model. According to multivariate analyses adjusted for known predictors, HFE rs9393682 was found to be associated with disease progression for localized prostate cancer, and TUSC3 rs1378033 was associated with progression for advanced prostate cancer in both cohorts. Vitamin D treatment inhibited HFE mRNA expression, and down-regulation of HFE by transfecting small interfering RNA suppressed PC-3 human prostate cancer cell proliferation and wound healing ability. In contrast, vitamin D treatment induced TUSC3 expression, and silencing TUSC3 promoted prostate cancer cell growth and migration. Further analysis of an independent microarray dataset confirmed that low TUSC3 expression correlated with poor patient prognosis. Our results warrant further studies using larger cohorts. This study identifies common variants in VDR-binding sites as prognostic markers of prostate cancer progression and HFE and TUSC3 as plausible susceptibility genes., Competing Interests: CONFLICTS OF INTEREST The authors declare that there are no conflicts of interest.

We present a man aged 69 years who suffered from bladder explosion during transurethral resection of the prostate. Exploratory laparotomy was performed and the bladder was primarily repaired with running sutures. This patient was discharged without symptoms of urinary dysfunction on day 8 after operation. We provide prevention methods that can decrease the risk of this important complication., Competing Interests: Conflicts of Interest: None declared., (2016 BMJ Publishing Group Ltd.)

Background: The prevalence of prostate cancer (PCa) has been increasing in recent years. Treatment strategies are largely based on the results of bone scan screening. Therefore, our aim was to investigate predictors of positive bone metastasis in newly diagnosed PCa patients., Materials and Methods: After extensive review, 336 consecutive patients newly diagnosed with PCa between April 2010 and November 2013 at our institution were enlisted in the study. Patients were divided into two groups according to bone scan results. Univariate analyses (Chi-square test for discrete variables and independent t-test for continuous variables) were applied to determine the potentially significant risk factors associated with distant bone metastasis. Binary logistic regression analyses were used to further investigate the influence of these factors on bone metastasis., Results: The patient mean age was 71.9 ± 8.6 years (range: 48 to 94 years). The mean prostate specific antigen (PSA) level and biopsy Gleason score were 260.2 ± 1107.8 ng/mL and 7.4 ± 1.5, respectively. The body mass index (BMI) for the series was 24.5 ± 3.4 kg/m2. Sixty-four patients (19.0%) had a positive bone scan result. Patients with positive bone scan results had a significantly lower BMI (23.3 ± 3.5 vs. 24.8 ± 3.3; p=0.003), a higher Gleason score (8.5 ± 1.1 vs. 7.1 ± 1.5; p < 0.001), and a higher PSA level (1071.3 ± 2337.1 vs. 69.4 ± 235.5; p < 0.001) than those without bone metastasis. Multivariate logistic regression analysis employing the above independent predictors demonstrated that a Gleason score of ≥7, clinical stage ≥T3, BMI ≤22 kg/m2, and an initial PSA level of ≥20 ng/mL were all independent predictors of bone metastasis., Conclusions: A bone scan might be necessary in newly diagnosed PCa patients with any of the following criteria: clinical stage T3 or higher, a Gleason score of 7 or higher, BMI equal to or less than 22, and a PSA level of 20 or higher.

We present the first Asian case of a 77-year-old man who developed pituitary apoplexy (PA) soon after gonadotropin-releasing hormone agonist (GnRHa) (leuprorelin) injection to treat prostate cancer. Headache, ophthalmoplegia, visual field deficit, nausea, and vomiting are the typical characteristics of pituitary apoplexy. Though the occurrence rate is rare, the consequence of this condition can vary from mild symptoms such as headache to life-threatening scenarios like conscious change. Magnetic resonance imaging is the best imaging modality to detect PA and sublabial trans-sphenoid pituitary tumor removal can resolve most of PA symptoms and is so far the best solution in consensus. We also review 11 previous reported cases receiving GnRHa for androgen deprivation therapy of prostate cancer, and hope to alert clinicians to use GnRHa with caution.