• Title/Summary/Keyword: disease history

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A Study on Prescription and Management of Medicines by School-Nurses (양호교사(養護敎師)의 투약(投藥) 및 의약품관리(醫藥品管理) 실태(實態))

  • Kim, Jung Hee;Park, Jae Yong;Cha, Byung Jun
    • Journal of the Korean Society of School Health
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    • v.11 no.2
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    • pp.297-307
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    • 1998
  • The purpose of this paper is to understand the prescription and management of medicines by school-nurses. A survey was mailed to 199 school-nurses in elementary and secondary schools in Pusan from February 10 to March 31, 1997. It was shown that 97.0% of the schools have visiting school-doctors and only 29.6% have visiting school-pharmacists. 36.7% of the respondents don't know the amount of this annual health-related budget. Concerning the annual budget of purchasing medicines, 50.4% of the elementary schools spend 210,000 won to 400,000 won and 45.0% of the secondary schools spend more than 610,000 won. 56.3% of the respondents said the budget was enough, but 5% said it was not. 70.9% of the schools purchase medicines twice a year. The average number of students visiting the nurse in a year are 1,892 in elementary schools, 1.6 times per student and 2,471 in secondary schools, 1.7 times per student, respectively. The annual average number of students who were prescribed medicine a year are 1,804 in elementary schools, 1.5 times per student, 2,372 in secondary schools, 1.7 times per student. The percentage of students who are prescribed internal medicines was 45.5% in elementary, schools and 61.3% in secondary schools, respectively. To the preralence sicknesses, the wound was the most common, accounting for 42.7% in elementary and 22.6% in secondary schools. Next was abdominal pain, indigestion, and headaches in elementary schools; and colds, indigestion, and abdominal pain in secondary schools, respectively. To the dirersity of medicines prescribed: internal medicines 29 for abdominal pain, 25 for indigestion, 8 for physiological pain, 13 for headaches, 30 for colds, and 10 for eye disease; external medicines 2 for skin disease, 10 for toothaches and 31 for other sicknesses. 42.7% of the respondents said the schools have enough medicines, but 7.6% said that schools need more. 50.8% of the respondents said they get information on medicines from TV advertisements or medicine-related books, 16.6% get information from visiting pharmacists. More experienced nurse-teachers are likely to get information from visiting pharmacists, but 37.5% of the respondents who have less then four year experience in school get information through other nurse-teachers before deciding to buy medicines. To the choice of medicines: 83.9% of the respondents said that they choose safe medicines with less side-effects. 40.7% responded that they write down the prescription history daily, but 6.1% said they do this only once in two or three months. To the confidence in prescriptions, 37.7% of the respondents said they are sure of the effectiveness of the medicines they prescribe. To what extent the nurse-teachers prescribe, 50.3% said they prescribe to the level of anagelics, and 21.1% prescribe to anti-histamines and antibiotics. 80.4% said that the details of illnesses and medicines to be prescribed in school should be regulated by a school health-care law. To the problems in prescription, 79.9% of the respondents worry about abuse by students who want prescriptions but have no serious illnesses, 57.8% worrg about the lack of information on medicines and dosage. And 55.8% said they can't tell the difference between medicines whose brands are different, but bare the same ingredients. The conclusion of this study is that a health education program is necessary to prevent the misuse or abuse by students and a continuing education program for school-nurses is needed to solve the problems related to the purchasing and prescription of medicines. The criteria of the prescription of medicines also should be regulated by a school health-care law or management acts.

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The Clinical Examination of Netspeg Lens for Good Visual Acuity (시력 개선을 위한 Netspeg 렌즈의 임상적 검증)

  • Kim, Douk-Hoon;Bae, Han-Young;Kim, Sun-Tae
    • Journal of Korean Ophthalmic Optics Society
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    • v.11 no.3
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    • pp.281-291
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    • 2006
  • The aim of this study was performed the clinical test using Netspeg lens for good visual acuity on subjects with abnormal refraction status. The subjects of one hundreds adults (fifty males, fifty females, mean=21 years, range=19 to 24) were recorded. The subjects were researched the history including the systemic health, medication, genetics, allergy, systemic disease and ocular disease. The refraction test was recorded the monocular and binocular using objective method. Visual acuity was performed the binocular status using the Netspeg lens and CR-39. Stereopsis test was performed the titmus fly and TNO at near distance using Netspeg lens and CR-39. The P-VEP test was used the 16 pattern size(Bausch Lomb, production in USA) with three channels. Also Subjects viewed the p-vep stimulus with binocular vision through the corrected visual acuity using the Netspeg lens and CR-39. The contrast sensitivity test was performed the contrast sensitivity chart(pelli-Robertson, USA) at 1m distance using the Netspeg lens and CR-39. The ultrastructure of surface on the Netspeg lens and CR-39 was observed the SEM(JMS-5800, made in Japan). The results of this study was as follows: 1. In corrected visual acuity of abnormal refraction using the Netspeg lens and CR-39, the Netspeg lens wearer were acquired the good visual field and clear visual acuity comparative to CR-39 wearer in the subject vision test. however the comfort of visual acuity was similar results in the Netspeg lens and CR-39. Also the subjects of Netspeg lens wearer was good visual acuity more than CR-39 wearer and in the analysis of P-VEP, the amplitude of wave on Netspeg lens used appears to be better through the CR-39(p>0.5). Besides, on the contrast sensitivity, the Netspeg lens wearer was good results than CR-39. The value on stereopsis with TNO by Netspeg lens wearer was better than CR-39 in results. However, in the stereopsis test with Titmus, the Netspeg lens and CR-39 wearer was similar results. 2. The ultrastructure of Netspeg lens surface was the smooth and fine shape more than CR-39. Also, Netspeg lens have a fine line structure in ultrastructure. In conclusion, the results of this study conformed that the surface ultrastructure of Netspeg lens used is more specific pin hole design structure than CR-39. This study indicated that the vision of Netspeg lens used have a better than CR-39 in the corrected visual acuity for abnormal refraction eye. Therefore, In this paper, we suggested that the ultrastructure and line structure of Netspeg lens was related to good visual function. However the visual function of the aspheric Netspeg and ultra waterproof Netspeg lens was similar results.

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The Usefulness of Rapid Triple Test for Cardiac Marker in Forensic Paragnosis of Sudden Cardiac Death (심장표지물질 간이검사의 급성심장사 법의학적 사후진단 유용성에 관한 연구)

  • Lim, Chae-Won;Kim, Jin-Gak
    • Korean Journal of Clinical Laboratory Science
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    • v.49 no.2
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    • pp.108-113
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    • 2017
  • A sudden cardiac death (SCD) is defined as an unnatural sudden death caused by heart disease. To determine the cause of death, observation of the microscopic change in cardiac muscle tissue is suggested, rather than visual postmortem examination. However, this suggestion is time consuming to be applied in the field, is cost-ineffective, and is inconvenient. Therefore, the purpose of this study is to understand whether temporary inspection used to examine the cardiac marker (Myoglobin, CK-MB, cTn I) in postmortem blood via rapid cardiac triple test kit (which is used by clinics to diagnose patients with acute myocardial infarction) can effectively be utilized for the paragnosis of sudden, unnatural cardiac death. The results of postmortem examination and temporary investigation found that 23 groups (76.7%), among the 30 experimental groups, were assumed to be non-traumatic sudden cardiac deaths, which indicated a positive response (according to comparison with forensic autopsy); 4 groups, among the 10 control groups, were assumed to be cerebrovascular disease, which indicated a negative response; 1 group was assumed to be alcoholic and drug poisoning, indicating a positive response; and 1 group was assumed to be oxygen deficiency due to suffocation, indicating a positive response. Hence, it was found that the level of sensitivity and specificity of cardiac marker's temporary inspection showed significant result, 76.7% and 80% respectively. Given this, temporary inspection can be effectively used for the paragnosis of sudden cardiac death when the medical history, situation of the site, and postmortem interval are considered together. With the result of precedent research on time of first revelation and extinction in blood, and difference in concentration over time progress according to the characteristic of cardiac marker's (myoglobin, CK-MB, cTn I) individual material, further research on concentration of cardiac marker per each post time needs to be conducted in order to estimate time science death (which is required to identify the cause of death and investigation).

Clinical Manifestations and Gene Analysis of Patients with Benign Hyperphenylalaninemia (양성 고페닐알라닌혈증 환자에 대한 임상적 고찰과 유전자 분석)

  • Lee, Jeongeun;Lee, Jeongho;Lee, Dong Hwan
    • Journal of The Korean Society of Inherited Metabolic disease
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    • v.16 no.2
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    • pp.79-85
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    • 2016
  • Purpose: This study aimed to analyze genetic mutations, clinical manifestations, and treatment of patients with benign HPA in Korea. Methods: This case series study involved ten HPA patients who were referred to our hospital because of high phenylalanine concentration. We investigated their demographic features, clinical manifestations, and mutations of the PAH gene through direct DNA sequencing. Results: Among ten patients with benign HPA, two pairs of patients were related (father-daughter, mother-daughter relationship) cases, and all of them showed no specific clinical manifestations or notable past history. Their plasma phenylalanine levels ranged between 1.2 and 4.2 mg/dL. In the tetrahydrobiopterin (BH4) loading test, all patients were nonresponsive to BH4. In the confirmation test of PAH mutation analysis, we identified eleven different alleles out of twelve. The most common allele was R53H (c.158G> A). In addition, two novel PAH gene mutations, V423A (c.1268T>C) and V51A (c.152T>C), were identified. Although the patients did not receive any pharmacologic treatment or continuous phenylalanine restriction dietary therapy, their neurocognitive development was normal. Moreover, on serial outpatient follow-up tests, all patients maintained phenylalanine levels below 6 mg/dL. Conclusion: This study is the first in Korea to analyze benign HPA patients. All patients with benign HPA could maintain phenylalanine levels below 6 mg/dL with normal neurocognitive development, without continuous therapy. Therefore, performing mutation analysis and distinguishing benign HPA from phenylketonuria (PKU) are important to help improve life quality in patients with benign HPA by avoiding unnecessary lifelong therapy.

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A Study on Health Aspects of Daily Life of Elementary School Children in an Urban Area (일부도시국민학교취학아동의 보건생활에 관한 실태조사연구)

  • 구외행
    • Journal of Korean Academy of Nursing
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    • v.3 no.3
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    • pp.36-49
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    • 1973
  • This study was carried out for the objectives to collect the basic informations on the health behaviors of the elementary school children in an urban area in Korea. Seven hundred students were drawn to fill in the designed questionnaire which carries variety of Questions on health re-lated behaviors in general, eating habits, disease history, mental health, and sex education. Questionnaire were filled in by their parents. Major findings are as follows: ① 55.7% had habits of washing the hands before eating whereas 59.8% trashing their hands after toilet. The others had no idea of washing hands before eating and after toilet. ② 26,5% had habits of brushing the teeth twice a day 54.7% only once in the morning, and 2.6% once only in the evening. Thus, the idea of prevention from decayed teeth seems to be lacking among the school children. ③ Bathing habits were also inquired to get 40.3% of bathing more than once a week, 43.1% once every two weeks, and the rest of 16.6% once every one to three months. ④ 41.7% keep the regular bedding time whereas 58.3% irregular. Physical exercises were con-ducted by 76.6% on the ground while 23.5% did not practice any physical exercises at all. Of those physical exercises, rope skipping occupied 37.5%, and the other 66.9% consisted of 14 different kinds of individual type physical exercises such as gymnastic exercise. The main reasons for not enjoying exercises were different by sex; boys largely complained the inadequacy and lack of gymnastic facilities and girls felt in short of friends who could join the exercises. ⑤ 31.9% of the school children had been taking not much of food while 28.3% had unbalanced diets. Of these unbalanced diets, meat occupied 33.2% to be the priority to have an order of the following items such as vegetables, bread or noodle, and fishes as next to each. For eating habits, 88.5% take simple snack such as bread (38.4%, cookies, fruits, and candies in order. 25.8% of the children were provided such snacks or their parents regularly. Breakfast was sufficiently taken by 45.0% whereas 8.4% had never sufficiently. As to the lunch, 63.6% had sufficiently while 16.8% insufficiently. 70.6% take breakfast with all family members together and 30.4% separately. Correlation of sufficient taking of breakfast and eating together of tile family member's seems to be significant when we compare 72.5% of sufficient takers who enjoy breakfast together with the family members with 55.6% of insufficient takers who enjoy it with the family. This finding allows the investigator to point out the importance of table circumstances for children's eating. ⑥ The most common disease was catching a cold (38.8%), and the second was stomach trouble to be followed by the frequency of car sickness, headache, and skin infection. Doctors are consulted only by 23.9% when they are sick whereas 59.7% resorted to the drug stores. The lower the educational attainment of the parents, the lower the rate of visiting clinics. ⑦ 36.7% of their parents pointed out the problems of personality guidance as the most difficult thing at home 71.3% of their parents worried about and unsatisfied with their children's personality traits. Of these complains of the parents, impatience stood at the top to be tabulated at 24.1%, and 21.1% indicated narrow-mindedness. In line with this primary socialization at home, the most crucial problem seems to be related with the lack or recognition of the parents'own role when we find only 43.1% of the parents understood the importance of their own role for the home education of children; the latter group attributed tile responsibility of personality formation to the children themselves. ⑧ As to the sex educational aspects, 30.9% of children have ever asked about the physiology of reproduction or sexual matters to their parents, of those parents only 17.0% could give the constructive responses to the inquiries of the children. In companies on with these data, 25.6% recognized their own role in sex education for their own children while the large segments of the parents (51.1%) attributed the responsibility of sex education to tile low level of 38.3% who recognized the importance of sex education in the school curriculum and 25.1% of the parents insisted to wait until they get to know naturally about sex. 38.1% of the parents said they had some knowledge on sex from books while 16.9% through mass media. The next groups had common senses of sex from their own parents, school friends and other sources.

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A Study on the Incidence of Thyroid Cancer in Gender Ultrasound (초음파검사에서 성별에 따른 갑상샘 암의 빈도에 관한 연구)

  • Kwak, Eun-Suk;Lim, Cheong-Hwan;Yang, Oh-Nam
    • Journal of radiological science and technology
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    • v.38 no.2
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    • pp.145-153
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    • 2015
  • Thyroid nodules are an endocrine disease often found in clinical practice, and patients with thyroid nodules found by chance have rapidly increased alongside development of thyroid ultrasound techniques for health examination purposes. This study analyzes the subjects' general characteristics, thyroid ultrasounds, and fine needle aspiration cytology in order to find out the relationship between male and female thyroid nodules and thyroid cancer frequency. An ultrasound examination of the thyroid was performed for 32,973 individuals who visited the K Hospital of Health Examination. Subjects have no history of thyroid disease and are 20 years old or over. Data of general characteristics, diabetes) was collected by a written survey completed by the subject, and the ultrasound of the thyroid(thyroid nodules existence, size, number) and FNAC was used to find out the malignancy rate. Frequency of patients with thyroid nodule was 4,611(26.1%) in men and 5,341(34.9%) in women between 32,973 individuals. Women's prevalence rate is significantly higher than men, and the prevalence rate significantly increased with age in men and women(p < 0.05). The prevalence of multiple nodules was significantly higher in women(43.5%) than in men(35.6%), and significantly increased with age in men and women(p < 0.05). The fine needle aspiration cytology was performed in 692(men 342, women 350) subjects who showed signs of malignancy through ultrasound. Prevalence of malignancy of the nodules was higher in men(33.3%) than in women(29.4%) although it is not statistically significant. It is known that thyroid nodule prevalence in women is much higher than in men. But this study shows the men's prevalence rate was not too low compared with women, and the men showed a rather higher malignancy rate in nodules than women. It is considered that the role of thyroid ultrasound is both important in men and women.

The Eradication of Helicobacter pylori in the Duodenal Ulcer in Children and the Duodenal Recurrence (소아 십이지장궤양에서의 H. pylori 박멸과 궤양재발에 대한 연구)

  • Choe, Yon-Ho;Ko, Jae-Sung;Kim, Soon-Yeong;Yoo, Young-Mee;Seo, Jeong-Kee
    • Pediatric Gastroenterology, Hepatology & Nutrition
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    • v.1 no.1
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    • pp.30-36
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    • 1998
  • Purpose: It is well known that duodenal ulcer disease does not relapse if H. pylori is cleared from the gastric mucosa. Little is known about the recurrence of duodenal ulcer in children. The purpose of this study was to evaluate the effect of the eradication of H. pylori in duodenal ulcer in children upon the duodenal ulcer recurrence. Methods: 105 patients (M:F=78:27) diagnosed as duodenal ulcer by endoscopy in 1987~1995 were reviewed clinically, and were parted into two groups. The two treatment groups were ranitidine/antacid (RAN/ANT) and ranitidine/amoxicillin/denol (RAN/AMX/D). The latter was for H. pylori-positive children with duodenal ulcer who were diagnosed by serology and/or antral biopsies for histology, culture, and urease testing. The recurrence rates were compared between the two groups. Results: 1) 30 patients with primary duodenal ulcer underwent endoscopy for H. pylori and 27 (90.0%) of them were positive for H. pylori. 2) 27 of H. pylori-positive children received RAN/AMX/D. 23(85.2%) of them showed cure of duodenal ulcer and eradication of H. pylori. 3) The duodenal ulcer recurrence rate in RAN/ANT group was 65.3% and the rate in RAN/AMX/D was 4.3% by a year. Conclusions: There is a strong correlation between the duodenal ulceration and H. pylori infection in children, and the eradication of H. pylori in duodenal ulcer patients reduces the recurrence of the ulcer. Because of the low incidence of duodenal ulcers in children, a multicenter prospective study is required to determine the effect of treating H. pylori infetion on the long term natural history of duodenal ulcer disease.

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The Prognostic Factors in Progression of Pneumoconiosis (진폐증의 예후에 영향을 미치는 인자)

  • Kim, Hyung-Ju;Jang, An-Soo;Kim, Sang-Guk;Choi, Soo-In;Park, Sang-Hoo;Yang, Seung-Won;Seo, Jeong-Pyeong;Lee, Soong;Park, Hong-Bae;Son, Myung-Ho
    • Tuberculosis and Respiratory Diseases
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    • v.47 no.1
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    • pp.57-65
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    • 1999
  • Backround : Pneumoconiosis is the parenchymal lung disease that results from the inhalation and deposition of dust, usually mineral dust of occupational or environmental origin. Most of the pneumoconiosis can be categorized to coal workers' pneumoconiosis (CWP) in Korea. No effective treatement is currently available, and the therapy for symptomatic CWP is limited to treatment of complication. Therefore authors analyzed and reviewed clinical features and radiological findings of 95 patients with pneumoconiosis for assessing the prognostic factors in disease progression. Method: We reviewed medical records of 95 cases with pneumoconiosis including history, chest X-ray, pulmonary function test, electrocardiography, AFB stain and culture of sputum, and routine blood examination between June 1995 and June 1997 in Seonam University Namkwang Hospital. Results: All of cases are male(mean age, 57.4 years), 91 cases out of them are miners. The mean duration of exposure to dust is 18.8 years. Major clinical symptoms are dyspnea (100%), sputum (71.6%), chest pain (55.8%), cough (23.2%), and hemoptysis (6.3%). 82 % of cases are over Morgan-Seaton Grade 2 in the degree of dyspnea. Small opacity on chest x-ray is 82.1 % and large opacity is 17.9%. Small opacity has tit type (37.2%), q/q type (25.6%) and r/r type (11.5%). B type is 42.2% in large opacity. For the pulmonary function test, restrictive type is 40.3%, mixed type 19.5% and obstructive type 8.3%. The more increasing chest Xray density, the more decreasing $FEV_1$ (p<0.01). 38% of patients show tuberculosis in chest X-ray, 15.8% positive smear of acid fast bacilli in sputum. The prevalence of pulmonary tuberculosis is high in patients with poor clinical condition. The cases with the active pulmonary tuberculosis have severe dyspnea. Expired cases show 100% and 75% of positive pulmonary tuberculosis in chest X-ray and sputum examination, respectively. 75% of expired cases show the chronic cor pulmonale, who died of acute respiratory failure. Conclusion: These findings indicate that tuberculoois infection has a decisive influence on the progress and prognoois of pneumoconioois.

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Screening Test for Heart Diseases in the First Grade Elementary School Children in Busan (부산 지역 초등학교 1학년 학생들의 심장질환의 집단검진에 관한 연구)

  • Oh, Jae Min;Park, Hee Ju
    • Clinical and Experimental Pediatrics
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    • v.46 no.5
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    • pp.490-494
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    • 2003
  • Purpose : We'd like to determine the incidence of congenital heart disease and arrhythmia in elementary school children in Busan, and to provide adequate prevention and treatment. Methods : A total of 23,802(male 12,909, female 10,893) 1st grade elementary school children living in Busan were studied. All children were 7-8 years old. We obtained their medical history by questionnaire and checked elecrocardiography(ECG). Subsequent screening tests including a 2nd ECG, chest X-ray, phonocardiogram and CBC for the students who had abnormal findings at the first screening test. The third screening test was done for students who had cardiac murmurs or abnormal ECG findings in the second screening test by echocardiogram, treadmill test and 24-hour Holter monitoring. Results : Among 23,802 children participants, 605(2.54%) had abnormal ECG findings at the first screening test. Q wave abnormality(0.58%) was observed most frequently, and complete right bundle branch block(RBBB)(0.26%), sinus tachycardia(0.24%), right axis deviation(0.22%) and ventricular premature contraction(VPC)(0.21%) followed in order. Four hundred and twenty four children participated in the second ECG screening test. Two hundred and two children(47.6%) had an abnormality such as sinus tachycardia(18.8%), VPC(17.8%), or complete RBBB(17.3%). After completing the third examination including echocardiogram, we couldn't find the students with ventricular tachycardia (VT) or SVT at the third arrhythmia screening test. Conclusion : A high incidence of arrhythmia was found in the 1st grade elementary school children in Busan despite their healthy appearances, although fatal heart diseases were not noted. Early diagnosis, adequate preventative measures and treatment will prevent and decrease the frequency of emergent situations like syncope and sudden death.

Efficiency and Side Effects of Sorafenib Therapy for Advanced Hepatocellular Carcinoma: A Retrospective Study by the Anatolian Society of Medical Oncology

  • Berk, Veli;Kaplan, Mehmet Ali;Tonyali, Onder;Buyukberber, Suleyman;Balakan, Ozan;Ozkan, Metin;Demirci, Umut;Ozturk, Turkan;Bilici, Ahmet;Tastekin, Didem;Ozdemir, Nuriye;Unal, Olcun Umit;Oflazoglu, Utku;Turkmen, Esma;Erdogan, Bulent;Uyeturk, Ummugul;Oksuzoglu, Berna;Cinkir, Havva Yesil;Yasar, Nurgul;Gumus, Mahmut
    • Asian Pacific Journal of Cancer Prevention
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    • v.14 no.12
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    • pp.7367-7369
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    • 2013
  • Background: Inoperable and metastatic hepatocellular carcinoma (HCC) is associated with a poor prognosis and low chemotherapeutic efficiency. Sorafenib is an oral multi-kinase inhibitor exerting its effects via the RAF/MEK/ERK pathway, vascular endothelial growth factor receptor (VEGFR) and platelet derived growth factor receptor beta (PDGFR-${\beta}$) tyrosine kinases. Randomized studies have shown a significant contribution of sorafenib to life expectancy and quality of life of cancer patients. The aim of the present study is to evaluate the efficacy and side effects of sorafenib therapy in Turkey. Materials and Methods: Data for 103 patients (82 males, 21 females) receiving sorafenib therapy in 13 centers from February 2008 to December 2012 were evaluated. Median age was 61 years and median ECOG performance status was 1 (range: 0-2). 60 patients (58%) had hepatitis B, 15 patients (15%) had hepatitis C infection and 12 patients (12%) had a history of alcohol consumption. All of the patients had Child scores meeting the utilization permit of the drug in our country (Child A). Results: A total of 571 cycles of sorafenib therapy were administered with a median of four per patient. Among the evaluable cases, there was partial response in 15 (15%), stable disease in 52 (50%), and progressive disease in 36 (35%). Median progression-free survival was 18 weeks and median overall survival was 48 weeks. The dose was reduced only in 6 patients and discontinued in 2 patients due to grade 3-4 toxicity, 18 patients (17%) suffering hand-foot syndrome, 7 (7%) diarrhea, and 2 (2%) vomiting. Conclusions: This retrospective study demonstrated better efficacy of sorafenib therapy in patients with advanced HCC compared to the literature while progression-free survival and overall survival findings were comparable. The side effect rates indicate that the drug was tolerated well. In conclusion, among the available treatment options, sorafenib is an efficient and tolerable agent in patients with inoperable or metastatic HCC.