Evaluation of sexual misconduct complaints: The Oregon Board of Medical Examiners, 1991 to 1995

OBJECTIVE: In 1991 the Oregon Board of Medical Examiners initiated a separate category for the complaint of sexual misconduct. Investigated complaints of sexual misconduct brought to the Oregon Board of Medical Examiners were analyzed for the years 1991 to 1995 to serve as a baseline. Comparison was made to the Federation of State Medical Boards sexual misconduct data for 1991 and 1992.STUDY DESIGN: One hundred complaints brought against 80 licensees were evaluated by practitioner's degree, age group, sex, specialty, and disposition of complaints for the years 1991 to 1995. The allegations were classified into behavior categories of sexual impropriety, sexual transgression, and sexual violations.RESULTS: Sexual misconduct was the allegation in 5.9% of the complaints investigated for the study period. Oregon had more sexual misconduct complaints than the average reported to the Federation of State Medical Boards for the years 1991 and 1992. Most (72%) complaints came from the patients or their families. Two female physicians (2.4%) had sexual boundary complaints. Sexual misconduct complaints increased by a risk ratio of 1.44 with advancing age by decades. Allegations classified into behavior categories according to severity revealed 39% sexual impropriety, 31% sexual transgression, and 30% sexual violation. Reportable disciplinary actions occurred only with multiple allegations of sexual impropriety (6.5%) and for sexual transgression (27%) whereas sexual violation allegations often had one complainant but there were 54% reportable disciplinary actions. Family practice, obstetrics and gynecology, and psychiatry had the highest incidence of sexual misconduct complaints whereas psychiatry and obstetrics and gynecology had the highest incidence of reportable disciplinary actions. Twenty-five percent of the closed cases resulted in reportable disciplinary actions. This analysis is discussed in relationship to legal and ethical issues and the goal of zero tolerance.CONCLUSIONS: Oregon has a higher percentage of sexual misconduct complaints than the average for 42 states reporting to the Federation of State Medical Boards for the years 1991 and 1992. Analysis of the Oregon Board's experience for the study years will provide a baseline for future evaluation and as an educational resource for the Oregon Board of Medical Examiners and professional and specialty societies. Ethical standards, the reporting and investigative processes, and the legal framework are in place and lessen the incidence of sexual misconduct and work toward zero tolerance. (Am J Obstet Gynecol 1997;176:1340-8.)     

重组人绒毛膜促性腺激素β-亚基对C57BL小鼠免疫应答反应及抗血清特征的研究

采用福氏性剂，对C57BL小鼠进行重组hCGβ和天然hCGβ免疫应签反应的比较研究，结果表明：两者引发的抗血清性质相似，与hCG有较高的亲和力（K（γβ）≈5．86×108／mol／L，Kaβ≈8．18×108／mol／L）；抗血清能有效地抑制（125）I－hCG与睾丸受体的结合，结果提示重组hCGβ抗血清与天然hCGβ抗血清相似，具有中和hCG的生物活性能力，重组hCGβ可作为免疫避孕疫苗的抗原。     

渗出性胸膜炎临床证型的影像学辨证探讨

应用Ｘ线、超声检查对１００例，２１０例次的本病临床证型进行了对照观察，发现各临床证型均有影像学的特征，Ⅰ型邪郁少阳为胸腔内有少量胸水，Ⅱ型饮停胸胁为具有中等量以上的胸水，Ⅲ型络脉不和为胸水较前有吸收和／或伴有纤维化征象，Ⅳ型无症状为胸膜已无异常发现或增厚粘连并经超声检查证实无胸水。但在各证型中尚有不少病例宜按影像检查所见重新确定证型施治。根据本组观察，认为Ｘ线及超声检查所见，可作为本病临床辨证提供可靠的客观依据     

论谓项量化、主项质化理论在语言逻辑中的价值与影响

哈米尔顿的谓项量化理论揭示了量化命题中的简单换位规律 ,突破了原有三段论的规则 ,增加了大量新的三段论式。德摩根的主项质化理论给传统的逻辑方阵增添了新的内容 ,八个命题之间存在着紧密的内在联系 ,谓项量化、主项质化命题有着广泛的思维空间和运用价值 ,且语言表达灵活多样。哈米尔顿和德摩根都对联项“是”作了深入研究、赋予新的内涵 ,给逻辑注入了新的活力。     

前列康宝的药理学研究

实验结果表明，前列康宝具有明显的抗前列腺增生，抗炎及改善微循环作用。     

加味通关液超声雾化吸入治疗Ⅱ型呼吸衰竭的临床观察

为观察中药超声雾化对呼吸衰竭的疗效,采用本院研制的加味通关液超声雾化吸入治疗Ⅱ型呼吸衰竭患者27例,并与可拉明组30例对照。结果显示:治疗组临床治愈显效率70.3％,SaO_2上升达38.4％,咳嗽、呼吸困难、咯痰好转率、平均治疗时间与对照组比较均有显著性差异(P<0.05)。     

电化学治疗转移性体表肿瘤疗效分析

1994年7月至1995年8月采用电化学治疗转移性体表肿瘤53例，其中颜面部2例，颈部32例，胸壁4例，腋窝6例，腰骶部1例，腹股沟8例。总有效率达92％。临床实践表明：电化学治疗体表肿瘤操作方便，安全有效，疗程短，损伤小，无任何并发症，尤其是对应用其他疗法无效的体表肿瘤仍有效。     

黄连种子胚后熟期间的生理生化变化及激素的影响

黄连种子需要在低温条件下才能解除休眠。本文对黄连种子层积在室外和冰箱两种条件下,种胚后熟过程中的淀粉酶活性及DNA、蛋白质的变化规律作了测定,并对ABA处理后种子的生理生化变化作了研究。     

Seven-year survivor with malignant melanoma of the anus without radical surgery

We report a case of a long-term survivor with malignant melanoma of the anus who did not undergo radical surgery. A 71-year-old woman who presented with anal bleeding and anal tumor underwent an excisional biopsy in September 1985. The biopsy specimen was a lobulated, polypoid, pigmented mass 2 cm in diameter, that had been located on the anterior wall of the anus. A satellite nodule 7 mm in diameter was found on the left wall of the anus at the level of the dentate line. Both tumors were histologically diagnosed as malignant melanoma. The primary tumor was 6 mm thick. Melanoma cells were present microscopically at the cut end of the rectum. Because of her history of ischemic heart disease, the patient rejected our recommendation that she undergo radical surgery, and received 10 courses of carboplatin 20 mg intramuscularly and OK-432 10 K.E. (Klinische Einheit) intradermally every week. A single, pigmented metastatic inguinal lymph node developed and was excised in June 1987. A recurrent tumor was detected in the rectum in October 1992, so again we recommended radical surgery. The patient rejected radical surgery again, and received 12 courses of carboplatin 10 mg intramuscularly every 2 weeks. She died of disease at home in July 1993 after surviving for 7 years and 10 months. An autopsy was not performed. This case shows that local excision of the primary lesion may be appropriate to preserve the quality of life of patients with early-stage malignant melanoma of the anus.     

辨证治疗中风病248例临床分析

本文通过对２４８例中风病临床分型分析，以气虚血瘀证最多，占３８．３１％，其次为阴虚风动证，肝阳暴亢，风火上扰证。本组病人不论是出血性中风，还是缺血性中风，均采用中药辨证治疗基础上，口服中成药及静脉滴注活血化瘀针剂以加强活血化瘀、涤痰通络这一治疗法则，总有效率为８４．２７％，其中出血性中风和缺血性中风的总有效率分别为８６．９５％和８３．２４％，对血液流变学、脑出血患者治疗前后脑ＣＴ对照观察，认为 一