Anti-androgen therapy is commonly used for prostate cancer and it has been reported to induce severe hyperglycemia. Diabetic chorea is characterized by acute uni- or bilateral chorea or ballismus and hyperintensity of the striata on T1-weighted magnetic resonance imaging (MRI) images, and is associated with changes in the blood glucose level. We report here a case of diabetic chorea caused by severe hyperglycemia induced by anti-androgen therapy. A 71-year-old man received a diagnosis of prostate cancer and was given leuprorelin acetate (11.25mg, every 3 months) and bicalutamide (80mg/day). After the third injection of leuprorelin acetate, he developed involuntary movements of the right extremities. His glucose and hemoglobin A1c levels were found to be markedly elevated (691mg/dl and 19.5%, respectively), and brain MRI showed high-intensity areas in the left striatum on T1-weighted imaging. The diagnosis was diabetic chorea and he was admitted to our department. His involuntary movements diminished immediately after intravenous infusion of 500 ml saline. His blood glucose level was decreased after initiation of basal/bolus insulin therapy and discontinuation of leuprorelin acetate, but he gradually developed involuntary movement of right extremities again.

Objective: The benefits of combining cancer screenings with clinical surveys have become increasingly obvious as cancer morbidity and mortality have steadily increased. This paper discusses a study on the current status of and issues surrounding breast cancer screening in a clinical survey. The study also investigated the patients' awareness of the benefits of breast cancer screening. A secondary aim of the study was to promote mammographic screening.;Subjects and Methods: During the 72 months between April 1999 and March 2005, a total of 36,505 women underwent clinical surveys in our hospital. In October 2002, mammographic examination was included as an optional part of the routine physical examination. We evaluated the results of breast cancer screening with or without mammographic examination and used a questionnaire to investigate the patients' awareness of the benefits of breast cancer screening.;Results: Compared with the pre-2001 results, the detection rate of breast cancer significantly increased after 2003 when physical examination was combined with mammographic examination. Our study also found that both elderly patients and those residing in the suburbs of Sapporo City tended to choose physical examination alone rather than combining it with mammographic examination. An analysis of the questionnaires collected from these patients indicates they had a poor understanding of and lacked awareness of the benefits of mammographic examinations during breast cancer screenings.;Conclusions: The inclusion of mammographic screenings with clinical surveys was found to be significantly useful in the detection of breast cancer. Further continued education is needed for women, particularly the elderly and residents in the suburbs, so they understand the benefits of breast cancer screening by mammographic examination for the early detection of breast cancer and, consequently, decreased mortality of the disease.
Breast neoplasm screen NOS ; Clinical ; benefits ; Awareness ; Surveys