1.WTO DDA and lssues on Healthcare Services.
Journal of the Korean Medical Association 2002;45(9):1090-1097
The GATS is the first and only set of multilateral rules and commitment covering Government measures which affect trade in services. It has two parts-the framework agreement containing the rules, and the national schedules of commitments through which each Member specifies the degree of access and is prepared for foreign service suppliers. The GATS covers all services with two exceptions, i.e., services provided in the exercise of governmental authority and , in the air transport sector, air traffic rights and all services directly related to the exercise of traffic rights. Notwithstanding this very broad scope, the agreement and the negotiations taking place under it are one of the least controversial areas of the current work in the WTO. This is because of its remarkable flexibility, which allows Governments, to a very great extent, to determine the level of obligations they will assume. There are four main elements of flexibility: Member Governments choose those service sectors or subsectors on which they will make commitments guaranteeing the right of foreign suppliers to provide the service. Each Member must have a schedule of commitments, but there is no minimum requirement as to its coverage and some cover only a small part of one sector; For those services that are committed, Governments may set limitations specifying the level of market access and the degree of national treatment they are prepared to guarantee; Governments were able to limit commitments to one or more of the four re cognized "modes of supply" through which services are traded. They may also withdraw and renegotiate commitments ; In order to provide more favorable treatment to certain trading partners, Governments may take exemption, in principle limited to a 10 years’ duration, from the MFN principle, which is otherwise applicable to all services, whether scheduled or not. The agreement contains a number of general obligations applicable to all services, the most important of which is the MFN rule. But apart from these, each Member defines its own obligations through the commitments undertaken in its schedule. Because it is a basic principle of the agreement that developing countries are expected to liberalize fewer sectors and types of transactions, in line with their development situation, the commitments of developing countries are in general less extensive than those of more industrialized countries. It was this flexibility in the scheduling of commitments which put an end to the north-south controversy over services which marked the early years of th e Uruguay Round. So far, South Korea has been asked by 14 economies, including the U.S., EU, and China, to open its services market wider. According to the initial requests submitted to the World Trade Organization (WTO), these countries urged Seoul to grant greater access to the domestic medical treatment, legal services, education, finance, and distribution markets. The ministry of Foreign Affairs and Trade (MOFAT) plans to hold a related ministerial meeting today and roll out countermeasures by next March for follow-up negotiations with the nations concerned. In the initial requests, Korean newspapers reported that the U.S has demanded Seoul guarantee full access to the medical service markets and provide the same business conditions for American companies as local ones. This was, however, denied by the Korean government, while it accepted that fact that the China also called for the removal of barriers in the herbal medicine market as well as in the education. The WTO member economies have submitted initial requests for follow-up negotiations by sector to the new round of WTO talks in November last year. Thereafter, South Korea is required to come up with a response by next March to resolve the issues by the end of 2004. An agreement with the 14 countries should take effect from January 2005.
Appointments and Schedules
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China
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Commerce
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Delivery of Health Care*
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Developed Countries
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Developing Countries
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Education
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Financing, Organized
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Follow-Up Studies
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Herbal Medicine
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Korea
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Legal Services
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Negotiating
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Periodicals
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Pliability
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Seoul
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Uruguay
2.Plasma Renin Activity on Postural Change and Blood Sodium in Essential Hypertension.
Korean Circulation Journal 1972;2(2):23-45
The response of plasma renin activity and Na, K content to physiological stimuli; supine, standing after liberal salt intake and salt loading, was observed in the normal human and patients with essential hypertension. The results are as follow: 1) The substance obtained from sample that exert contractile activity to rat colon, had blood pressure raising activity. Method in this experiment was able to detect angiotensin-II for concentration of 1 ng. 2) In normal, plasma Na content of supine state with liberal salt intake showed 142.2+/-1.8 mEq/L, but it was increased to 151.0+/-5.9 mEq/L after salt loading. In standing, plasma Na content showed 141.5+/-2.5 mEq/L with liberal salt intake. 3) In normal, plasma Na content of liberal salt intake showed 142.2+/-1.8 mEq/L in supine and 141.5+/-2.5 mEq/L in standing. The pasma Na content in supine after salt loading was significantly reduced by standing (143.7+/-1.5 mEq/L). 4) In normal, plasam renin activity of supine showed 7.3+/-1.6 mg/ml with liberal salt intake and 4.8+/-1.1 ng/ml with salt loading. The plasma renin activity in standing showed 12.8+/-3.1 ng/ml witn liberal salt intake and 7.3+/-1.1 ng/ml with salt loading. In both cases the salt loading decreased the plasma renin activity significantly. 5) In normal, the plasma renin activity of liberal salt intake or salt loading was significantly increased by standing compared with that of supine state. 6) In hypertensive patients with subnormal plasma renin activity, the plasma Na content in supine state showed 144.5+/-0.7 mEq/L with diuretics and 145.5+/-3.3 mEq/L with salt loading. In hypertensive patients with normal or high plasma renin activity, the plasma Na content in supine state showed 129.5+/-7.3 mEq/L with diuretics and 136.5+/-3.0 mEq/L with salt loading. In standing, plasma Na content was 132.5+/-3.1 mEq/L with diuretics and 135.7+/-2.5 mEq/L with salt loading. In hypertensive patients, the lower renin activity cases showed higher plasam Na content. 7) In hypertensive patients with subnormal renin activity, the plasma Na content tend to decrease by standing compared with that of supine state. 8) In hypertensive cases of low renin activity, the plasma renin activity in supine was 3.6+/-1.5 ng/ml with diuretics and 2.4+/-1.1 ng/ml with salt loading, and in standing, it was 6.0+/-2.1 ng/ml. with diuretics and 3.7+/-1.9 ng/ml with salt loading. In cases of high renin activity, the plasma renin activity in supine was 9.3+/-2.3 ng/ml with diruetics and 6.0+/-1.2 ng/ml with salt loading and in standing, it was 18.0+/-3.5 ng/ml with diuretics and 9.7+/-0.5 ng/ml with salt loading. 9) In patients with essential hypertension, we found that the plasma renin activity was incrased or not. It is suggest that the increased renin activity is not the cause of essential hypertension but is caused by essential hypertension.
Animals
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Blood Pressure
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Colon
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Diuretics
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Humans
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Hypertension*
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Plasma*
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Rats
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Renin*
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Sodium*
3.Total Cystectomy for Bladder Cancer -102 Cases-.
Korean Journal of Urology 1986;27(6):859-864
Between Jan. 1971 and Dec. 1985, 102 consecutive patients underwent total cystectomy and urinary diversion for primary carcinoma of the bladder. Among the patients, planned radiation therapy (2,000 rad. for 5 days) followed by operation was done in 18 patients, therapeutic dose of radiation was given postoperatively in 8 patients and 76 patients underwent operation only The postoperative mortality rate was 3.9%. Early complications occurred in 30% of the 102 patients and included wound infection, urine leak, bowel obstruction and medical complication. An increased late complication incidence was noted among 26 patients receiving pre- or postoperative radiation (50%) compared with those not receiving radiation (32%). Staging errors by CT scanning occurred in 37% of patients, overstaging in 8 (33%) and understaging in 1 (4%). Survival was evaluated in 45 patients and the overall 5-yesr survival rate for patients with transitional cell carcinoma was 38%.
Carcinoma, Transitional Cell
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Cystectomy*
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Humans
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Incidence
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Mortality
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Survival Rate
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Tomography, X-Ray Computed
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Urinary Bladder Neoplasms*
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Urinary Bladder*
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Urinary Diversion
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Wound Infection
4.Expression of Luteinizing Hormone (LH) Gene in Rat Uterus and Epididymis.
Korean Journal of Fertility and Sterility 1999;26(2):157-161
Recent studies clearly demonstrated that the novel expression of LH gene in the rat testis, and suggested the local action of the LH-like molecule. The present study was performed to analyze the expression of the LH genes in the rat accessory reproductive organs. Expression of LH subunit genes in the rat uterus and epididymis was demonstrated by reverse transcription-polymerase chain reaction (RT-PCR) and specific LH radioimmunoassay (RIA). The LHbeta transcripts in these organs contained the published cDNA structure, the pituitary type exons 1-3, which encoded the entire LHbeta/ polypeptide. Presence of the transcripts for the alpha-subunit in the rat reproductive tissues were also confirmed by RT-PCR. In the LH RIA, significant levels of LH were detected in crude extracts from the rat ovary, uterus and epididymis. The competition cuties with increasing amount of tissue extracts were parallel with those of standard peptide, indicating that the immunoreactive LH-like materials in these tissues are similar to authentic pituitary LH molecule. In rat epididymis, the highest amount of immunoreactive LH was detected in corpus area. Our findings demonstrated that the genes for LH subunits are expressed in the rat accessory reproductive organs, and suggested that these extrapituitary LH may act as a local regulator with auto and/or paracrine manner.
Animals
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Complex Mixtures
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DNA, Complementary
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Epididymis*
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Exons
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Female
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Lutein*
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Luteinizing Hormone*
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Male
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Ovary
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Radioimmunoassay
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Rats*
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Testis
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Tissue Extracts
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Uterus*
5.The Study on the Control of Renin Secretion.
Korean Circulation Journal 1972;2(1):1-19
It is still not well documented what the basic roles for the regulation of renin secretion from the kidney take place. Since the early study on the renal ischemia for the production of hypertension was introduced, the renin-angiotensin system has been regarded as the possible pathogenetic mechanism for the renovascular hypertension. The renin-angiotensin system, however, could be activated by various stimuli, such as, the changes of intrarenal perfusion pressure, the load or concentriation of sodium at the sites of macular densa, the changes of the sympathetic nervous activity and the changes of potassium balance. To investigate the renin-angiotensin system and the influence of sympathetic nervous system on the regulation of renin secretion, the renovascular hypertension was induced in the dogs by constriction of unilateral renal artery, and the plasma renin activity was measured. The sodium load at the sites of macula densa was attained by furosemide, and then the activity of sympathetic nervous system was depressed by reserpine. The plasma renin activity was assayed by the method of Helmer and Cohn. By this bio-assay method, the plasma renin activity equivalent to 1 nanogram angiotensin-II can be measurable and the prepared plasma was found to have still vasopressor activity. The results observed in this experimental work are summarized as follows. 1. The blood pressure reached maximum on the 3rd postoperative day, and declined gradually to the level of preoperative day on the day of from the 6th to 12th day following constriction of renal artery. 3. The plasma renin activity was found to be well correlated with the increase of blood pressure, and then declined to its preoperative level with the reduction of blood pressure. It appears, therefore, that the renin-angiotensin system plays an important role in the pathogenesis of renovascular hypertension. 4. The urine flow rate in normal and reserpinized dogs was the same before administration of furosemide, but its rate was significantly increased in both groups after furosemide. The urine flow rate of reserpinized dogs, however, was significantly lower than that of the normal dogs during the first 5 minutes. 5. The urinary sodium excretion in normal and reserpinized dogs was significantly increased in both groups after administration of furosemide and there were no difference between the two groups. 6. The plasma renin activity of renal venous blood was significantly higher than that of femoral arterial blood in both groups before and after administration of furosemide. 7. The plasma renin activity of reserpinized dogs was significantly lower than that of normal dogs before administration of furosemide. After furosemide, however, the plasma renin activity was significantly increased in 30 minutes in both groups. This increase of plasma renin activity was less prominent in resepinized dogs than in normal. This results would suggest that the intrarenal mechanism regulating renin secretion also requires an intact sympathetic nervous system.
Animals
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Blood Pressure
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Constriction
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Dogs
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Furosemide
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Hypertension
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Hypertension, Renovascular
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Ischemia
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Kidney
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Perfusion
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Plasma
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Potassium
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Renal Artery
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Renin*
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Renin-Angiotensin System
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Reserpine
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Sodium
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Sympathetic Nervous System
6.Glomus tumor in rectus femoris: 1 case report-.
Journal of the Korean Cancer Association 1991;23(3):678-681
No abstract available.
Glomus Tumor*
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Quadriceps Muscle*
7.Secondary chodrosarcoma in Maffucci's syndrome: a case report.
Journal of the Korean Cancer Association 1991;23(3):674-677
No abstract available.
8.Expression of Luteinizing Hormone (LH) Subunit Genes in the Rat Ovary.
Korean Journal of Fertility and Sterility 1998;25(2):199-205
SUMMARY: The present study was performed to analyze the expression of LH genes in the rat ovary. Expression of LH subunit genes in the rat ovary was demonstrated by amplification of ovarian RNA by RT-PCR. The ovarian LHbeta transcripts contained at least two parts of the published cDNA structure, the pituitary exons 1, 2 and 3 and the part of testicular exon 1 in the major trancripts form in rat testis. Using RIA, significant amount of LH-like molecules were detected in crude ovarian extracts, and the competition curves with increasing amount of tissue extracts were parallel with those of standard peptide, indicating that the ovarian immunoreactive LH-like material is similar to authentic pituitary LH molecule. The administration of PMSG to immature rats resulted in a sharp decrease of the ovarian LH contents after 24 h post-injection. In conclusion, these findings demonstrate that genes for LH subunits are expressed in the rat ovary, and suggest that LH can play a central role in regulation of female reproduction with both endocrine (by pituitary LH) and auto- and/or para-crime (by ovarian LH) manner.
Animals
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DNA, Complementary
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Exons
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Female
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Humans
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Lutein*
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Luteinizing Hormone*
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Ovary*
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Rats*
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Reproduction
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RNA
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Testis
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Tissue Extracts
9.Musculoskeletal Tissue Banking.
Journal of the Korean Medical Association 1999;42(3):261-265
No abstract available.
Tissue Banks*
10.A Study on the Cause of Death of School Teachers in Korea.
Korean Journal of Preventive Medicine 1987;20(1):10-39
Mortality rate and causes of death are regarded as an index of strength as well as level of development of a country. However, there is no accurate data for the causes of death in Korea due to lack of systematic vital data collection system. The objective of this study was to define the causes of death of the school teachers, its changing pattern, cause-specific mortality rate, and geographic variation. The study population included all of the teachers in primary school, middle and high schools, and college who joined in Korean Teachers' Union between 1968 and 1985 that provided a total of 1,972,069 person-years to observe (1,384,911 man-years, 587,158 woman-years). There were 3,678 deaths in this period (3,377 males, 301 females). The most common cause of death was neoplasm which was followed by the diseases of circulatory system. The proportion of death of neoplasm was 1.5 times higher than that of the general population. Causes of death were classified into 5 major group (neoplasm, diseases of circulatory system, accidents and poisoning, diseases of liver, and all others). The mortality rates of diseases of circulatory system and all others for general population were 4 to 5 times higher than those for the teachers. However, mortality rates of neoplasm and diseases of liver were only about 2 times higher than those for teachers. Mortality rate of liver cancer for teachers was higher than gastric cancer mortality rate which is the reverse in general population. The crude death rate was 2.12 per 1,000 person-years for male and 1.00 for female which is one-third of the crude death rate of general population. Crude death rate of study population was higher in rural area than in urban area. However, mortality rate of neoplasm for male was higher in urban area than in rural area while mortality rates of all other causes were higher in rural area. For female, mortality rates of neoplasm and diseases of circulatory system were higher in urban area and the rates for all other causes were higher in rural area. Crude death rate was lowest in Gyeongin area and highest in Yeongnam area. The mortality of neoplasm for male accounted the highest proportion of all death in Gyeongin, Chungcheong and Yeoungnam areas while the mortality of neoplasm and mortality of circulatory system accounted the same proportion in Jeonra area. For female, the mortality of disease of circulatory system accounted the highest proportion in Gyeongin and Yeoungnam and Jeonra areas. Proportion of death due to accidents and poisoning was high in Chungcheong area and death due to all other causes was high in Yeoungnam area. The most common cause of death for male by city and province was neoplasm in Seoul, Pusan, Daegu, Gyeonggi, Chungnam, Chungbuk, Gyeongnam and Gyeongbuk. Diseases of circulatory system was the leading cause of death in the rest of city and provinces. The leading cause of death for female was diseases of circulatory system in Seoul, Incheon, Chungbuk, Chungnam, and Gyeongbuk, neoplasm in Pusan, and accident and poisons in all other cities and provinces. The mortality rates of male were above 2 per 1,000 person-years in Jeju, Gyeongbuk, Gyeongnam, Daegu, and Chungbuk, and it was below 1.5/1,000 in Seoul, Incheon and Gyeonggi. The mortality rate of female was above 1.2/1,000 person-years in Gyeongnam and Incheon while it was below 0.5/1,000 in Daegu, Geonggi Chungbuk and Jeju. The leading cause for male by school of employment was neoplasm in all levels of school with a remarkably higher rate in the professors of college. Leading cause of death for female was disease of circulatory system in primary schools, high schools and college but neoplasm in middle schools. There was no death due to liver diseases in middle and high school teachers and college professors and no death due to all other category in igh school teachers and college professors, in females. High school teachers and the highest mortality rate and college professors showed the lowest mortality rate. Temporal trend of mortality was examined in three periods; period I (1968-1974), period II (1975-1979), and period III (1980-1985). The leading cause of death for male was diseases of circulatory system in period I and II but neoplasm in period III. Such trend of decreasing diseases of circulatory system and increasing neoplasm was observed in female. Overall mortality rate was decreased over the 3 periods. The mortality rates of diseases of circulatory system, liver disease and all others were decreased in male but the mortality rates of neoplasm and accident and poisons was increased. Female showed a similar trend to male but the mortality rate of liver diseases was increased. Mortality rates of diseases of circulatory system, neoplasm and liver diseases increased with age of teachers up to 50 years of age but decreased in 60 years of age. Mean age at death due to each cause was higher in male than female by 4-10 years. However, the mean age at death of the teachers was 2-5 years lower than that of the general population in all causes of death and the sex difference in the mean age at death was smaller (2-3 years) in general population. In sex ratio of mortality, male was higher than female in almost all diseases except suicide and maintained a high ratio. The general population showed universally high ratio in male like teachers, and more or less did regular patterns in mortality with ratio smaller.
Busan
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Cause of Death*
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Chungcheongbuk-do
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Chungcheongnam-do
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Daegu
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Data Collection
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Employment
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Female
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Gyeonggi-do
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Gyeongsangbuk-do
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Humans
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Incheon
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Korea*
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Liver
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Liver Diseases
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Liver Neoplasms
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Male
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Mortality
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Poisoning
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Poisons
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Seoul
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Sex Characteristics
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Sex Ratio
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Stomach Neoplasms
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Suicide