Objective: The comparative effect of telmisartan and valsartan upon insulin resistance and adipocytokines in nondiabetic patients with mild hypertension is unclear.
Methods: Fifty nondiabetic patients with untreated mild hypertension were randomly assigned to telmisartan (40 mg/day) and valsartan (80 mg/day) groups and were switched in a crossover manner at 3-month intervals. Serum leptin, adiponectin, hsCRP and the HOMA-R were measured before and at 3 months during each treatment period.
Results: The HOMA-R significantly improved over the 3 months in the high insulin resistance group (HOMA-R>/=2.5) during the telmisartan treatment period (p=0.042), but not during the valsartan period. Both telmisartan and valsartan significantly decreased serum leptin levels in each female group during each treatment period (p<0.001 and p<0.001, respectively), but not in the male groups. Serum adiponectin did not increase in either treatment group. Serum hsCRP levels also significantly decreased in the high hsCRP subjects (>/=0.1) of both treatment groups (p=0.044 and p=0.015, respectively).
Conclusions: Telmisartan significantly improved insulin resistance, possibly through the effect on PPAR-gamma, while both telmisartan and valsartan significantly decreased serum leptin levels in female groups and hsCRP in both genders, suggesting no significantly different effects on adipocytokines by either drug in nondiabetic patients with mild hypertension.

Gifu University School of Medicine has introduced a new learning method for medical science, named tutorial system. To assess the efficacy of the method, we conducted a questionnaire survey of students' medical knowledge, attitudes to learning, communication ability, and social behavior. The questionnaire was given to instructors/attending physicians involved in clinical education. Results of the evaluation were compared to those of previous medical students. Our results suggest that the tutorial system in our medical school result in an improvement over the previous curricula.

Irritable bowel syndrome (IBS), one of the most common gastrointestinal disorders, and is common in childhood. It is characterized by abdominal pain or discomfort with no organic or metabolic etiology. The abdominal pain and discomfort are associated with changes in defecation or stool form. We report a pediatric patient with IBS, who was successfully treated with acupuncture and moxibustion.
The patient was a 10-year-old girl, who had developed IBS 3 years previously. She had abdominal pain accompanied by bowel movements with soft stool five times per day. The patient was treated with acupuncture and moxibustion according to the theories of traditional Chinese medicine. In addition, we used the Gastrointestinal Symptoms Rating Scale (GSRS) to evaluate her quality of life. She received acupuncture and moxibustion treatment at two sessions/week during the first 6 weeks, followed by only one session/week later. One month after the treatment was started, her GSRS score began to improve and her abdominal pain and bowel movements were reduced. Compared with baseline, her GSRS score was improved at 2 months and 1 year after the acupuncture was started. In conclusion, acupuncture and moxibustion treatment was effective in the present pediatric IBS patient.

[Objective]There are few reports of inpatients who received acupuncture treatment in departments of internal medicine in Japan. The aim of this analysis is to clarify such information by reviewing patients who received acupuncture treatment during admission to our department of internal medicine at Gifu University Hospital. Our department is organized into three subdepartments of cardiology, respirology, and nephrology.
[Methods]We surveyed the chief complaint for acupuncture treatment, basic disease for admission and the number and period of acupuncture treatment of inpatients who received acupuncture treatment in our department from July 2004 through March 2007.
[Results]Two hundred and sixty-six patients received acupuncture treatment and they had 429 symptoms.
The chief complaint was the side effects of chemotherapy for cancer treatment (n = 84), that is, nausea, anorexia, dysethesia and so on. Other symptoms were dyspnea or shortness of breath (n = 49), pain originating from cancer (n = 38), pain originating from skeletal muscle (n = 38), anorexia (n = 25), and general fatigue (n = 18). Several symptoms were cough, edema, constipation or diarrhea, conscious disturbance, insomnia, paralysis, etc.
Of the chief complaints, 86.4%were closely connected with diseases or treatments for admission.
The mean number of patients who received acupuncture was 10.0/day. This was equal to about 20%of all patients (53beds) per day in our department.
[Conclusion]There were many patients whose chief complaints for acupuncture were closely connected with disease for admission. It is suggested that acupuncture treatment is accepted as one of treatments of internal medicine for inpatients in our department.