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 ; China ; Commerce ; Delivery of Health Care* ; Developed Countries ; Developing Countries ; Education ; Financing, Organized ; Follow-Up Studies ; Herbal Medicine ; Korea ; Legal Services ; Negotiating ; Periodicals ; Pliability ; Seoul ; Uruguay

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 ; Cystectomy* ; Humans ; Incidence ; Mortality ; Survival Rate ; Tomography, X-Ray Computed ; Urinary Bladder Neoplasms* ; Urinary Bladder* ; Urinary Diversion ; Wound Infection

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 ; Blood Pressure ; Colon ; Diuretics ; Humans ; Hypertension* ; Plasma* ; Rats ; Renin* ; Sodium*

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 ; Blood Pressure ; Constriction ; Dogs ; Furosemide ; Hypertension ; Hypertension, Renovascular ; Ischemia ; Kidney ; Perfusion ; Plasma ; Potassium ; Renal Artery ; Renin* ; Renin-Angiotensin System ; Reserpine ; Sodium ; Sympathetic Nervous System

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 ; Complex Mixtures ; DNA, Complementary ; Epididymis* ; Exons ; Female ; Lutein* ; Luteinizing Hormone* ; Male ; Ovary ; Radioimmunoassay ; Rats* ; Testis ; Tissue Extracts ; Uterus*

This study was undertaken to observe relationships between patterns of feeding, supplementary-feeding and various maternal, family, and socioeconomic charactereistics in Hae Cheog Apartment area in Cheongdam-dong, Kangnamku, Seoul on July 2 to 12 in 1982. The results were based on a questionnaire from 179 mothers who have the last-born child under two vears old. Results were as follows: 1) In socio-demographic characteristics, most of mothers were 25 to 30 years old and 52.0% of index children were under 6 months old. About 56. 0,00 of families were the salaries and 47. 0% of them earn over 500,000 won a month. 40. 8% of mothers were college graduates and 81.60 of mothers had no occupation. 2) 89.4% of mothers received prenatal care in pregnancy of the index children and mothers.-who have delivered the child in medical institute were 88.3%. Mothers who recieved education of breast care and feeding technique through prenatal care were 22.4%, 31.8,,o respectively. 3) In the feeding method, 44. 1% of mothers took the breast feeding, ~4. 0% of them chose the artificial feeding, and 20. 756 of them chose the mixed feeding. Mothers who changed the method from breast feeding to artificial feeding were 10.6% and only 0.60 of mothers: changed from artificial feeding to breast feeding. 4) According to the questionnaire, 37 mothers have already finished lactation (no relation with the beginning of weaning food). In breast feeding, one mother has lactated for 46 months,. one has lactated for 7-9 months, four have lactated for 1012 months, and seven have continued the lactation over 12 months. In artificial and mixed feeding, as the same phenomenon, most of mothers have lactated for more than 12 months. 5) The reasons for feeding method were as follows: in breast feeding,, 64. 6% of them took the-method because they thought the breast milk nutrious, in artificial feeding, 34.90 of them chose it because they had occupation and in the mixed feeding, 6716% of mothers took the method because of lack of their breast milk. In the case of changing! the method from breast feeding to artificial feeding, 42.1% of them answered that they ~d to change the method because of lack of breast milk. 6) In most of cases; the 4th month was the proper period to begin t4 weaning food and 32.5 of breast feeding children and 27.6% of artificial feeding children ;began the weaning food in 4th month. After 4th month; there was no difference between breast feeding and artificial feeding in the beginning of weaning food. 7) In the matter of menstruation, 29.8% of mothers who had breast feeding started their menstruations in 3 months and the rest of them delayed until 12 months. 40% of mothers who had artificial feeding began to menstruate after 2 months and all the rest started within 5 months. 8) The birth interval between the index child and next new child (would-be-born): In breast feeding, the interval of 1824 months had a majority as 50.0,x, and in the artificial feeding, the interval of over 24 months marked 66.7% of them. It was analyzed hat the birth interval of artificial feeding was wider than that of breast feeding. 9) In the desirable number of children, the mothers who had breast feeding wanted two sons and two daughters as proper children. Those who want two children in disregard of the sex (son or daughter) were 89.3% of breast feeding, and 80.00 of artificial feeding respectively. Mothers who had breast feeding wanted two children rather than onechild. 10) In the family planning practice, the rate of practice were 41.9%in breast feeding, and 58.1% in artificial feeding respectively. In the case of breast feeding, the using rate of family planning practice in men was higher than in women.
Adult ; Birth Intervals ; Breast ; Breast Feeding ; Child ; Education ; Family Planning Services ; Feeding Methods ; Female ; Humans ; Infant ; Lactation ; Male ; Menstruation ; Milk, Human ; Mothers ; Nuclear Family ; Nutritional Support ; Occupations ; Pregnancy ; Prenatal Care ; Surveys and Questionnaires ; Salaries and Fringe Benefits ; Seoul ; Weaning

No abstract available.
Electric Stimulation* ; Pelvic Floor*

No abstract available.
Urinary Bladder Neoplasms* ; Urinary Bladder*

This study is designed to evaluate the clinical characteristics and the outcomes of the management of gestational trophoblastic disease diagnosed at our hospital. With a retrospective review of hospital record from 1989 to 1998, we analysed 54 cases of gestational trophoblastic disease by the clinical characteristics and the outcomes of management. The results are as follows 1. The incidence of the gestational trophoblastic disease compared with delivery is one per 341 deliveries and is decreasing with time(from one per 252 deliveries at 1989 to one per 694 deliveries at 1998). 2. The most frequent age is 20-29 years old(61,1%). 3, The most frequent gravity and parity is 0-2 times(68.5%) and 0-1 time(79.6%) respectively. 4. The symptoms and signs are amenorrhea(94.4%), vaginal bleeding(74,1%), abdominal pain( 33.3%), hyperemesis gravidarum(25.9%), excessive uterine enlargement(24.1%), anemia(18.5%), hyperthyroidism(7.4%), theca lutein ovarian cyst(3.7%), and preeclampsia (1.9%). 5. We divided the patients by the uterine size for gestational age; large for date 50%, normal for date 44.4%, and small for date 5.6%. 6. The antecedent pregnancies of patients with persistent gestational trophoblastic tumor are hydatidiform mole 87.5%, abortion 12.5% in middle risk group and hydatidiform mole 66.7%, term pregnancy 22.2%, abortion 11,1% in high risk group. 7. We divided the patients with persistent gestational trophoblastic tumor by the FIGO staging system; stage I 70.6%, stage II 5.9%, stage III 11.8%, stage IV 11,8%. 8. The regimens of treatment are consisted of D & E only(59.3%), D & E with prophylactic chemotherapy(9.3%), D & E with chemotherapy(25.9%), and D & E with chemotherapy and hysterectomy(5.6%). Complete remissions are shown in 100% of D & E only and D & E with prophylactic chemotherapy, in 85.7% of D & E with chemotherapy, and in 33.3% of D & E with chemotherapy and hysterectomy. Dividing the patients with persistent gestational trophoblastic tumor by the WHO prognostic scoring system, complete remissions are shown in 75% of middle risk group and in 77.8% of high risk group. 9. The duration of chemotherapy for complete remission is 2.5 cycles & 77.5 days in middle risk group and 4 cycles & 130.1 days in high risk group. 10. The subsequent pregnancies after complete remission of gestational trophoblastic disease are term delivery 81%, spontaneous abortion 9.5%, induced abortion 4.8%, and preterm delivery 4.8%.
Abortion, Induced ; Abortion, Spontaneous ; Drug Therapy ; Female ; Gestational Age ; Gestational Trophoblastic Disease* ; Gravitation ; Hospital Records ; Humans ; Hydatidiform Mole ; Hysterectomy ; Incidence ; Lutein ; Parity ; Pre-Eclampsia ; Pregnancy ; Retrospective Studies ; Trophoblastic Neoplasms

No abstract available.
Appendicitis* ; Dichlorodiphenyl Dichloroethylene*