By Z. Koraz. State University of New York College Maritime College at Fort Schuyler. 2019.
Based on the performed analysis of the study authors conclude that a rate of one life threatening event every 1000 examinations order zenegra toronto erectile dysfunction medications. The authors conclude that stress echocardiography in the real world is a safe method but it can occur and possible serious complications order zenegra with a mastercard erectile dysfunction non prescription drugs. The Dobutamine stress echocardiography indicate a high degree of sensitivity buy zenegra from india impotent rage definition, specificity and accuracy as a non-invasive diagnostic method compared to invasive diagnostics i. The diagnostic accuracy of pharmacological stress echocardiography for the detection of coronary artery disease: a meta-analysis. Stress echocardiography for the diagnosis and risk stratification of patients with suspected or known coronary artery disease: a critical appraisal. Safety of Stress Echocardiography (from the International Stress Echo Complication Registry). American Society of Echocardiography American Society of Echocardiography recommendations for performance, interpretation and application of stress echocardiography. The prognostic Value of Doppler echocardiographic-derived coronary flow reserve is not affected by concomitent antiischemic therapy at the time of testing. Using blood plasma as the sample fluid, high-to-moderate abundance proteins covering a 6 order-of- magnitude concentration range have been quantitated without sample pretreatment [3-5]. Moreover, these strategies are limited in their multiplexing capacity (135 peptides targeted in a single method represents one of the largest multiplexed panels quantified to date ) and depth of quantitation (quantitation of sub ng/mL proteins remain a challenge). This study used matched proteomic samples to assess, in a side-by-side manner, the quantitative potential and multiplexing ability of this combination of methods. Scaled-up plasma digests were prepared according to a denaturation/digestion (deoxycholate/trypsin) procedure developed previously in our laboratory . The deoxycholate surfactant was insolubilized through acidification and pelleted through centrifugation. From the optimizations, the top 3 transitions per peptide were chosen regardless of the precursor Medimond. Plasma protein quantitation was determined by either linear regression analysis of 7-point peptide standard curves (for the 1D analyses) or peptide relative response measurements (for the 2D analyses). Prior to quantitative evaluation, a number of preliminary optimizations were performed. In regards to the latter, 348 of the 654 scheduled peptides (corresponding to 151 proteins) passed the screening test in the 1D analyses. Considering the 306 rejected peptides, 62 were removed due to interferences from non-target ions, while 244 failed detection altogether since they were of low abundance. In the 2D analyses, a total of 381 peptides (177 proteins) passed the interference test while 273 were rejected due to interference (121 peptides) or detectability issues (152 peptides). Instituting serial LysC-trypsin digestion enhanced digestion efficiency, but did not improve digestion for the peptide targets of interest. In comparing the two methodologies, a total of 51 peptides (40 proteins) were observed only by the 2D method, while 18 peptides (14 proteins) were detectable only by the 1D method. The result of these preliminary analyses was a list of interference-free peptides from which the quantifier transitions were selected for reproducibility and quantitative assessment. The high reproducibility and sharp chromatographic peaks (average peak width at half height of 5. Nonetheless, the 312 qualified peptides (equates to 142 plasma proteins) demonstrated excellent signal stability (6. The calibration curves for the qualified peptides demonstrated good linearity (average R of 0. The determined concentrations spanned 6 orders of magnitude (31 mg/mL for albumin to 44 ng/mL for myeloblastin) and were inferred from the peptide that generated the highest calculated concentration. This enabled the concentrations of 177 plasma proteins (inferred from 381 peptides), spanning an 8 order-of- magnitude range (31 mg/mL for albumin to 556 pg/mL for matrix metalloproteinase-9, to be determined. Included in this list were 23 low-abundance proteins that were below the concentration limit determined by the 1D analysis. The enhanced sensitivity of the 2D fractionation method enabled tissue leakage products, such as myoglobin (a diagnostic indicator of myocardial infarction), to be quantified. An added advantage of the 2D fractionation method is that it enabled 18 moderate abundance proteins with plasma concentrations above 44 Medimond. A further indication of the reliability of these two methods is that similar plasma protein 2 concentrations were obtained regardless of the method and data analysis strategy used (R of 0. Using the same control, the plasma protein concentrations determined from these new curves were found to be nearly equivalent to those 2 found during method development (discussed above), as evidenced by a R value of 0. To assess for interferences in the diseased samples when a single transition per peptide but multiple peptides per protein are monitored, we prepared peptide relative response plots for all target proteins. Assessing the linearity and examining the deviations with peptide extracted ion chromatograms enabled chemical interferences to be identified. Since only the quantifier transitions are monitored, higher peptide multiplexing can be achieved. The determined concentrations span 6 orders of magnitude (from 31 mg/mL for albumin to 44 ng/mL for myeloblastin), which covers the reported range of high-to-moderate abundance plasma proteins. This enabled 23 additional proteins below and 18 proteins above 44 ng/mL to be quantitated within an 8 order-of-magnitude concentration range (31 mg/mL to 556 pg/mL). Importantly, similar concentrations were found between the methods despite being derived from different samples and different analysis strategies. Although additional development of the 2D method is necessary to improve the quantitative performance, the current version is robust and can already be used to obtain improved sensitivity and high specificity in pre-clinical protein biomarker verification/validation studies. Thorough inspection of the remaining Fifty articles which appeared to be relevant by full-text 7 artclices were meeting our inclusion criteria. And extensive assessment of references yielded two more studies making a total of 9 primary studies that met our inclusion criteria. However, there was no existence of statistical heterogeneity for specificity (heterogeneity chi-squared = 2. Its high negative predictive value and low negative likelihood ratio suggesting increased accuracy in ruling out lesions that are not haemodynamically significant. Global burden of cardiovascular diseases: part I: general considerations, the epidemiologic transition, risk factors, and impact of urbanization. Global and regional mortality from 235 causes of death for 20 age groups in 1990 and 2010: a systematic analysis for the Global Burden of Disease Study 2010. Meta-analysis of the diagnostic performance of stress perfusion cardiovascular magnetic resonance for detection of coronary artery disease. Journal of cardiovascular magnetic resonance : official journal of the Society for Cardiovascular Magnetic Resonance 2010;19(12):1 4. Diagnostic performance of stress cardiac magnetic resonance imaging in the detection of coronary artery disease: a meta-analysis. Cardiac magnetic resonance myocardial perfusion imaging for detection of functionally significant obstructive coronary artery disease: A prospective study. Quantitative magnetic resonance perfusion imaging detects anatomic and physiologic coronary artery disease as measured by coronary angiography and fractional flow reserve. Validation of magnetic resonance myocardial perfusion imaging with fractional flow reserve for the detection of significant coronary heart disease. Evaluation of cardiac magnetic resonance imaging parameters to detect anatomically and hemodynamically significant coronary artery disease.
The systems we used were consisted of : Vivid 7 Dimension digital ultrasound system 100mg zenegra with mastercard impotence massage, Version 7 discount zenegra 100mg fast delivery impotence symptoms signs. Table-1 In animal experiment buy 100 mg zenegra overnight delivery erectile dysfunction most effective treatment, segmental systolic function Z rose and diastolic function Peak E and Peak E/E time fell in single 50% coronary artery stenosis. Both of systolic and diastolic segmental functions are deteriorated from a single 50% coronary artery stenosis significantrly. They are deteriorating significantly as the number of lesions of 50% stenosis increases. But no significant difference is observed between lesions of triple 50% stenosis and single 75% stenosis. Discussion Reduction of coronary artery blood flow starts from 50% stenosis, thogh flow reserve starts reducing (2) from 75% stenosis. The results also remind us the invasive coronary artery intervention should be done to regain normal left ventricular segmental wall function quickly and positively, but not only to relieve chest pain. Internal Medicine,Kochi General Rehabilitation Hospital,Kochi,Japan e-mail: m6537099@fc4. Endothelin-1 levels are increased in patients with heart disease,particularly in acute myocardial infarction or congestive heart diseases,as well as in renal dysfunction. During heart failure,endothelin-1 levels have been demonstrated to increase in parallel with the functional capacity and severity of the disease. The relationship between endothelin-1 and left ventricular systolic function was evaluated. Patients and methods This prospective observational study involved patients with chronic congestive heart failure who were admitted to the Department of Internal Medicine of,Kochi General Rehabilitation Hospital. Forty patients (17 men and 23 women,aged 6498 years)with chronic congestive heart failure were evaluated. Exclusion criteria included acute myocardial infarction,unstable angina,and renal dysfunction ( serum creatinine> 1. Relationships between the variables were evaluated by Spearmanss correlation analysis and p values<0. However,endothelin-1 levels did not correlated with left ventricular end-diastolic volume, left ventricular end-systolic volume, or left ventricular ejection fraction (Fig. This is probably why endothelin-1 levels were not correlated with left ventricular ejection fraction(Fig. In cases of heart failure with preserved ejection fraction,endothelin-1 levels were elevated. Therefore it appears that endothelin-1 levels did not correlated with left ventricular ejection fraction because approximately half of the patients in this study were of heart failure with preserved ejection fraction. It is suggested that endothelin-1,in particular plays an important role in chronic congestive heart failure with preserved ejection fraction(2). Trends in prevalence and outcome of heart failure with preserved ejection fraction. Almazov Cardiac remodeling has clinical significance in coronary heart disease patients. Resent years some studies have revealed new mechanisms of left ventricular hypertrophy and systolic dysfunction. M-mode and two-dimensional echocardiogram was performed (Vivid7, General Electric). Association of the peroxisome proliferator-activated receptor gene L162V polymorphism with stage C heart failure / T. Riyadh, Saudi Arabia 2 Prof of Anesthesia & Pain Management Unit, Dept of Pharmacology, Univ. Riyadh, Saudi Arabia Summary In patients with ischemic heart disease, impairment of left ventricular diastolic function commonly 1 occurs before systolic dysfunction [ ]. Diastolic dysfunction presents as a range of severity from mild, with little clinical effect, to severe. This form of cardiac failure remains under recognized in the postoperative 2 setting, as the clinical features are similar to systolic cardiac failure allowing for a misdiagnosis [ ]. It is therefore important to make the distinction between these two forms of heart failure as their management is different. The diagnostic criteria for diastolic heart 4 failure in the postoperative heart have been described [ ]. Diastolic heart failure can complicate the postoperative course therefore, its recognition is crucial for appropriate care. The usual method of assessing cardiac failure by the relationship between ventricular filling pressure and stroke volume does not distinguish between systolic and diastolic heart failure. According to the European criteria, a normal cardiac index in 9 the face of pulmonary edema suggests diastolic heart failure [ ]. The chief points to help in the diagnosis of diastolic heart failure in the postoperative heart are: 1. Every effort should be made to identify patients who had or are at risk to develop diastolic heart failure. Chronically uncontrolled hypertension is the most common predisposing factor for diastolic heart failure should be sought 14 and aggressively treated prior to surgery[ ]. There is a high incidence of diastolic dysfunction among 15 normotensive patients with diabetes mellitus [ ]. Tight glycemic control decreases the risk of heart failure in patients with diabetes. Any reversible 18 19 predisposing factors is to be corrected prior to surgery [ ] [ ]. Myocardial ischemia in the postoperative cardiac surgical patient significantly slows active myocardial relaxation during early diastole. Positive pressure ventilation can lower ventricular filling thereby reducing preload and it usually reduces afterload enhancing ventricular emptying during systole. The effect on cardiac output depends on whether the effect on preload or afterload predominates. If the patient is, normovolemic and intrathoracic pressure are within normal the effect on afterload reduction predominates resulting in an increase in the cardiac output. The increase in stroke volume leads to increase in systolic blood pressure during lung inflation results in a phenomenon known as reverse pulsus paradoxus. The beneficial effects of positive pressure ventilation on cardiac output are reversed by hypovolemia leading to decreased 21 22 cardiac output and hypotension [ ] [ ]. Pericardial constriction or tamponade causes increased resistance to diastolic filling and become a contributing factor. Ventricular pacing is what most surgeons resort to at the end of an open heart  procedure but this leads to loss of the atrial contribution and promotes diastolic dysfunction. Atrio-ventricular sequential pacing is better as it will enhance ventricular filling. Anesthesia invariably leads to vasodilation by redistribution of blood volume to the periphery causing a relative state of hypovolemia. In addition, patients with low normal systolic function, pulmonary hypertension, or right heart failure will suffer depressed contractility because of anesthesia. Under these circumstances, a vasopressors infusion prior to induction of anesthesia would prevent redistribution and hypotension.
Effect of Histological characteristics of the uterine environment melatonin on photoperiod responses buy zenegra in united states online garlic pills erectile dysfunction, ovarian secretion of and corpus luteum during early embryogenesis and the estrogen and coital responses in the domestic cat cheap zenegra amex erectile dysfunction doctor in jacksonville fl. Journal of the American Veterinary Medical progesterone cheap zenegra erectile dysfunction injections cost, and sexual behavior during the normal Association 191, 1207-1211. Effect of housing and environmental enrichment on reproductive cyclicity and Seal, U. Immunoreactive luteinizing tigrina (Leopardus tigrinus) and margay (Leopardus wiedii). Reproductive endocrinology of the red wolf Determination of reproductive status in the serval and (canis rufus). Ovarian relation to subjective temperament assessment in clouded and endocrine responses in the cat after coitus. Excretion of radiolabeled estradiol in the cat (Felis catus, L): A preliminary report. Impact of social management on reproductive, concentration in response to stress and postoperative pain adrenal and behavioural activity in the cheetah (Acinonyx in client-owned cats and correlation with objective clinical jubatus). Relationships during the coitus-induced luteal and ovarian-stimulatory effects of equine and human phase and the estrous period without mating. Biology of chorionic gonadotropins administered singly and in Reproduction 25, 15-28. General and comparative Endocrinology 137,148- pregnancy and pseudopregnancy in the domestic cat. Abortion induction in the cat using prostaglandin F2 There are two ways to live: you can live as if nothing is a miracle; you can live as if everything is a miracle. El anlisis de hormonas en heces ha sido adaptado con xito en nueve especies de felinos silvestres para caracterizar su funcin endocrina normal y se esperaba que esta tcnica se pudiera adaptar con facilidad al lince ibrico. Todas las hembras mostraron pronunciados cambios estacionales en los niveles de estrgenos, con concentraciones superiores a los valores de referencia a partir del mes de enero y disminuciones hasta los niveles ms bajos anuales entre los meses de mayo y agosto. Las hembras tambin mostraron un aumento en las concentraciones de estrgenos antes o durante las cpulas en seis de siete eventos reproductivos. En cambio, se observ que las fuctuaciones en las concentraciones de los metabolitos de los progestgenos no se correspondan con la temporada de cra, sino que disminuan ligeramente entre octubre y diciembre para aumentar de nuevo en enero. En los machos, se observ una estacionalidad moderada, con las mayores concentraciones de andrgenos en heces entre diciembre y junio, aunque los niveles eran lo sufcientemente elevados en todos los meses para respaldar la posibilidad de produccin de semen a lo largo de todo el ao. Los resultados confrman que la estacionalidad reproductora en la hembra de lince ibrico se puede demostrar mediante la observacin de cambios en la excrecin de metabolitos de los estrgenos en las heces. Los machos slo muestran una leve estacionalidad en las hormonas gonadales, lo cual parece concordar con su capacidad de engendrar progenie a lo largo de todo el ao. A diferencia de los anlisis de estrgenos, los progestgenos en heces no son buenos indicadores del estado reproductivo en el lince ibrico, dado que los metabolitos 1) mantienen concentraciones altas durante ms de nueve meses al ao, y 2) no muestran un aumento claro durante la gestacin. Por lo tanto, el anlisis de hormonas en heces es menos informativo en el lince ibrico que en otros felinos ya estudiados. Fecal hormone monitoring previously has been adapted successfully to nine wild felid species to characterize normative endocrine function. Our expectation was that this technique could be easily adapted to the Iberian lynx. The source of study animals was the El Acebuche breeding population within the Doana National Park, Spain. Daily fecal samples collected from April 2004 through June 2006 from adult females (n=4) and males (n=4) were analyzed using enzyme-immunoassays validated for the Iberian lynx. All females showed marked seasonal changes in estrogen metabolites with concentrations increasing above baseline in January and declining to nadir from May through August. Females also exhibited increased estrogen concentrations before or during copulation in six of seven breeding events. In contrast, fuctuations in progestogen metabolite concentrations did not correspond to the breeding season, but rather decreased slightly from October through December before increasing again in January. There was no difference in either estrogen or progestogen patterns between pregnant lynx and females that copulated but failed to conceive. Males showed modest seasonality with the highest fecal androgen concentrations measured from December through June, although levels were suffciently high in all months to support the possibility of year-long sperm production. Results confrm that reproductive seasonality in the female Iberian lynx can be affrmed by changes in fecal estrogen metabolite excretion. Males show only mild gonadal hormone seasonality, which appears consistent with the ability to produce offspring throughout the year. Contrary to estrogen analyses, fecal progestogen is a poor indicator of reproductive status in the Iberian lynx as metabolites 1) are sustained at high concentrations for more than nine months of the year and 2) fail to show clear elevations during pregnancy. Thus, fecal hormone monitoring is less informative in the Iberian lynx than in previously studied felids. As a component of current recovery efforts, an ex situ management programme was established to develop a reservoir population to 343 produce animals for eventual reintroduction. However, these animals also are invaluable for developing a base of biological information for this rare species, including in the area of reproductive physiology and endocrinology. The species is well known to be a seasonal breeder that generally produces one to three cubs from March through June after a gestation of ~60 Days (Palomares et al. A powerful tool for generating T knowledge about the endocrinology of reproduction is monitoring hormonal metabolites in voided feces. This technology has revolutionized our understanding of the similarities and differences in reproductive mechanisms within the diverse species of the family Felidae (Brown, 2006; Brown et al. To date, fecal hormone monitoring techniques have been validated and proven effective for assessing reproduction and stress status in diverse felid species, ranging from the Pallas cat (Brown et al. Especially important has been understanding the fundamental reproductive biology of species to allow enhanced natural breeding management or the development of artifcial insemination or in vitro fertilization/embryo transfer (Brown et al. This monitoring approach also has been applied successfully to certain free-ranging wild carnivores, including for studying how social dominance and dynamics alter stress response and survival in Kalahari meerkats (Young et al. Thus, a logical step in the recovery of the Iberian lynx was to apply this previously successful hormonal tracking technology to understand the dynamics of seasonality in both sexes and the specifcs of the females reproductive cycle and pregnant luteal phase. Our fndings also complimented a parallel investigation by colleagues who compared endocrine profles in the male Iberian lynx to those of the closely related Eurasian lynx (Lynx lynx) (Dehnhard et al. In that study, there was a tendency for fecal testosterone concentrations to be slightly elevated in both species during the months of March and April, which coincided with the presumed breeding season and the peak in sperm production in the Eurasian lynx (Jewgenow et al. Given these preliminary fndings, and because our laboratory had previously used non-invasive hormonal monitoring successfully in eight other felid species (Brown et al. The goal was to document seasonal hormone patterns, identify normative estrous cycle patterns and determine if there were differences in excretion patterns between pregnant and copulating, but non-pregnant females. Each sample was placed in a labeled plastic bag and stored at -20 c until analysis. All animals were wild-caught, six from the Sierra Morena Mountains and two from Doana national Park. Male and female lynxes were kept in separate, but adjacent enclosures until breeding season onset. Breeding pairs were established taking into account genetic and behavioral factors (Vargas et al. Husbandry procedures during the breeding season at El Acebuche Breeding center are described in Vargas et al.
We did not prove any statistically significant differences of average scores in different coping strategies buy generic zenegra line cialis causes erectile dysfunction, except for 2 zenegra 100mg online erectile dysfunction due to zoloft, in 1st measurement among the patients with different types of thyreopathies order 100mg zenegra otc yellow 5 impotence. During 2nd measurement, the patients with thyroid carcinoma use coping strategy of humour significantly less frequently (p < 0. During 2nd measurement there were not proved any statistically significant differences of averages in other coping strategies among the patients with different types of thyreopathies. We did not find statistically significant differences of averages in any of the coping strategies in patients with different types of thyreopathies within 3rd measurement. During 2nd and 3rd measurements, any statistically significant differences in averages of satisfaction were not found out. Statistically significant difference in averages with quality of live among the patients with different types of thyreopathies was not proved in any of the measurements. Statistically significant difference in averages of anxiousness among the patients with different types of thyreopathies was not proved in any of the measurements. Higher average scores of state anxiety in patients with carcinoma were indicated on the edge of significance during 2nd and 3rd measurements compared to other ills. During 2nd measurement there was indicated difference in variances on the edge of significance, where the highest variance was in the results of patients with carcinoma. Statistically significant difference in depression among patients with different types of thyreopathies was not proved within any measurement. Comparing the average scores of locus of control there were not found any statistically significant differences in 1st and 3rd measurements. A higher tendency to externality (external locus of control) and the feeling they cannot influence their lives were indicated in patients with carcinoma on the edge of statistical significance during 2nd measuring compared to other patients. Comparison of patients with different types of thyreopathies brought interesting results (see Tab. The patients with nodular goitre were significantly more satisfied with life at the time of surgery than other patients. Variables Nodular goitres at the time of surgery QoL line - life satisfaction ed. Comparison of results in patients with different types of thyreopathies thyreopathies is in patients with thyroid carcinoma. Only a small amount of these was in our researched file, but we will try to indicate statistically significant and marginally significant differences and trends. The biggest differences appear after 3 months since surgery when patients with carcinoma score lower in coping strategies as humour, suppression of competing activities and focus on and venting emotions, as well as in locus of control. In the period after 3 and 6 months since surgery the patients with carcinoma are more anxious compared to the others and score lower in comprehensibility. Bigger interindividual differences can be captured in carcinomas compared to the others after 3 and 6 months since surgery in coping strategy in religious coping and in social Psychosocial Factors in Patients with Thyroid Disease 299 support from friends. Support from friends is probably related to what the patients referred to during the interviews; some of them hid till the end of observation from their family and friends that thyroid cancer had been found out with them. Tschuschke (2004) also refers on similar findings, for example a tendency to apply mechanisms of suppression and increased level of anxiety in patients with carcinoma. Statistically significant difference in average scores of life satisfaction was not proved, neither in total quality of life within the observed period, nor in patients with hyperthyroidism, or in patients with carcinoma. We found out a statistically significant difference in average scores in patients with nodular goitre and a significant linear decrease of life satisfaction was proved (always for p < 0. Patients with nodular goitre, who underwent total thyroidectomy, had lower level of life satisfaction in 3rd measuring on the edge of significance compared to those who underwent hemithyroidectomy. We attribute this finding to the fact that nodular goitre recently undergoing total intervention experienced more changes in life than those with hemithyroidectomy. Statistically significant difference in averages of locus of control was not proved during the follow up period in patients with nodular goitre. The patients with nodular goitre, who had already undergone hemithyroidectomy, had higher tendency to internality (internal locus of control) with 3rd measurement on the edge of significance compared to those who had undergone total thyroidectomy. Differences on the edge of significance in average scores of locus of control were indicated in patients with hyperthyroidism and carcinoma within the observed period. During operation follow up, the linear trend to higher internality (internal locus of control) was indicated on the edge of significance in patients with hyperthyroidism. Concerning nodular goitres, there occur a significant reduction in the level of life satisfaction and total quality of life during the half-year follow up; in other types of thyreopathies, significant changes of these variables do not occur in any direction. This corresponds with our finding resulting from interviews that people who had some difficulties before intervention adapt better and express higher satisfaction with their status than people who did not have any problems (most often nodular goitres). Last-mentioned disease can be considered as the most serious from the viewpoint of control loss over the situation development (comp. Caption: means that the given variable was dealt with a linear increase means that the given variable was dealt with a linear decrease depicted curve illustrates course of a quadratic trend ed. Follow up results of patients with different types of thyreopathies since sugery during the period of six months in selected variables Caption: (double line) statistically significant trend in time _ _ _ _ _ _ _ (dashed line) statistically insignificant trend in time Fig. All above mentioned categories appeared in the group of patients and in the control group. In category family, they reported close people, mainly those that are somehow depended on them (children, old parents). Patients, more than the controls, had more answers connected with health of close people. During follow up, patients didnt change their understanding of content of individual categories. Patients frequently reported life goals as good old age, or mental well-being, while the control group reported more leisure and education. During the follow up of patients with thyreopathy changes occurred in the distribution of frequencies (significant and the significance edge) for more than half the categories. It seems that during follow up of patients there was, on the edge of significance, a sign of decline for family and increase for health. Apparently there is also a change in the spiritual dimension category; its importance (with probands who recorded it) is highly evaluated within 3 months after surgery. We have a reason to believe that the patients rather overevaluated (idealized) a situation while evaluating satisfaction for individual categories, sometimes slightly also after 3 months; therefore we cannot objectively assess the shift over time or differences between patients and control group. All observed groups assessed life conditions and material security as the least satisfactory, patients at the time of surgery recorded little satisfaction with mental well-being and after 3 to 6 month showed little satisfaction with category work. The answers of respondents in the quality of life were categorized into 11 (or 12) areas that occurred both in patients and controls. Patients put more emphasis on life securities and care for close people dependent on them. In connection with their own illness they were apparently aware of what would happen to their children or parents dependent on them if something happened to them. Respondents of all groups mentioned as the most frequent and the most important goals family and health. Spiritual dimension category was little recorded but the people that recorded it saw its importance right after family and health (comp. Patients frequently reported categories of good old age and mental well-being because these areas can be threaten by the disease.