Background-Somatostatin has been used to prevent pancreatitis after endoscopic retrograde cholangiopancreatography but its eVect on acute non-biliary pancreatitis is still unclear. Aim-The purpose of this study was to evaluate the function of the sphincter of Oddi (SO) and the eVect of somatostatin on patients with non-biliary pancreatitis. Methods-Twenty patients (18 males, two females) with acute pancreatitis (alcoholic 18, idiopathic two) received SO manometry within one week after admission. After baseline measurement, a bolus dose of somatostatin (Stilamin, Serono) 250 µg was infused slowly, and SO manometry was repeated after five minutes. Continuous infusion of somatostatin 250 µg/h was given for 12 hours after SO manometry. Serum amylase, lipase, glucose, and C reactive protein (CRP) levels were examined before and after somatostatin infusion. Results-SO manometry was unsuccessful in six patients due to contracted sphincter. In the remaining 14 patients, high SO basal pressure (SOBP >40 mm Hg) was found in seven patients. After somatostatin infusion, mean SOBP decreased from 48.8 (29) to 31.9 (22) mm Hg (p<0.01). One patient had a paradoxical reaction to somatostatin (SOBP increased from 30 to 50 mm Hg) while the other 13 patients had a fall in SOBP after somatostatin. One patient developed abdominal pain with a serum amylase level of 2516 IU/l after SO manometry. No other side eVects or changes in amylase, lipase, glucose, or CRP levels were observed in the other 19 patients after SO manometry and somatostatin infusion. Discussion-Sphincter of Oddi dysfunction is common in patients with acute non-biliary pancreatitis and in most cases somatostatin can relax the sphincter. (Gut 2001;49:843-846) Keywords: acute alcoholic pancreatitis; sphincter of Oddi; somatostatin Gall stone disease, alcohol abuse, and sphincter of Oddi (SO) dysfunction are the common causes of acute pancreatitis.1 2 The action of alcohol on the SO is still controversial. According to some studies, alcohol induces SO relaxation 3 4 but in another human study local instillation of alcohol into the duodenum resulted in an increase in SO motility.5 High SO basal pressure (SOBP) has been found in up to 89% of patients with idiopathic recurrent pancreatitis. [6][7][8] Both natural somatostatin and its synthetic long acting analogue (octreotide) are potent inhibitors of pancreatic enzyme secretions but their eVect on the diseased pancreas is still unclear.9-12 Previous studies have shown that somatostatin can relax the SO allowing free drainage of pancreatic secretions into the duodenum. 13 14 In a recent metaanalysis, somatostatin was found to be more cost eVective than other agents in the prevention of pancreatic injury after endoscopic retrograde cholangiopancreatography. 16However, the action of somatostatin on the SO during the acute stage of pancreatitis is unclear.

At present, there is no study that simultaneously addresses the apparent differences between bacterial and host factors in patients with bleeding and nonbleeding Helicobacter pylori-related ulcer diseases. Therefore, we designed this prospective study to evaluate whether there are identifiable differences between the two groups of patients whose H. pylori-related peptic ulcer diseases present with bleeding or dyspepsia. From July 1996 to November 1996, consecutive patients presenting with upper gastrointestinal bleeding or dyspepsia were enrolled if H. pylori-related ulcer diseases were confirmed. Fifteen clinical, endoscopic, histologic, and serologic factors were tested for association with ulcer bleeding by a logistic regression analysis. In the study period, bleeding occurred in 39 out of 119 patients with H. pylori-related peptic ulcer diseases. Multivariate analysis showed that ingestion of nonsteroidal antiinflammatory drugs (NSAIDs; p = 0.0156; odds ratio = 5:4), ulcer size > or = 1 cm (p = 0.0033; odds ratio = 4:2), and low bacterial density (p = 0.0030; odds ratio = 4:1) were independent factors associated with the risk of bleeding. There were no associations between ulcer bleeding and age, sex, smoking, alcohol consumption, the histologic grade of gastritis, location and number of ulcers, and the cytotoxin-associated gene (CagA) status of H. pylori strain. Therefore, we concluded that H. pylori-related ulcer patients who use NSAIDs or have large ulcers are more likely to present with upper gastrointestinal bleeding; that the CagA-bearing strains are not associated with the development of bleeding complication in patients with peptic ulcer diseases; and that the exact reason concerning the association between low bacterial density and ulcer bleeding merits further investigation.

The objective of this study was to develop a social skills scale for high school students in Taiwan. This study adopted stratified random sampling. A total of 1,729 high school students were included. The students ranged in age from 16 to 18 years. A Social Skills Scale was developed for this study and was designed for classroom teachers to fill out. The test-retest reliability of this scale was tested by Pearson's correlation coefficient. Exploratory factor analysis was used to determine construct validity. The Social Skills Scale had good overall test-retest reliability of .92, and the internal consistency of the five subscales was above .90. The results of the factor analysis showed that the Social Skills Scale covered the five domains of classroom learning skills, communication skills, individual initiative skills, interaction skills, and job-related social skills, and the five factors explained 68.34% of the variance. Thus, the Social Skills Scale had good reliability and validity and would be applicable to and could be promoted for use in schools.

Summary. Alpha‐thalassaemia is a common disease in Taiwan. A feature useful in diagnosis is the excess of of β‐chains that result from impaired alpha‐chain production. These excess chains assemble into β4 tetramers (i.e. Hb H) which can be detected by its rapid anodal migration on alkaline electrophoretic media as seen in Hb H disease. However, this technique cannot, and conventional Hb H inclusion staining rarely can visualize α‐thalassaemic traits due to small quantities of Hb H formed in these patients. The staining for Hb H inclusion bodies uses brilliant cresyl blue (BCB) or methylene blue (MB) as an oxidant to denature Hb H as intracellular inclusions. We have improved the technique of Jones (who modified the original method in order to obtain enriched young red cells) by prolonging the incubation time from 30 min to 3 h. The sensitivity of this modified improved method was 91% for detecting obligatory α‐thalassaemic traits as shown in table. No false positive results were seen in β‐thalassaemia or in others. We believe this can be used as a confirmatory test in heterozygous α1‐thalassaemia and homozygous β2‐thalassaemia.