Enantiospecific total synthesis of ent-5-senceioyloxy-10,11-epoxythapsan-10-ol

Enantiospecific total synthesis of optical antipode of the sesquiterpene 5-senecioyloxy-10,11-epoxythapsan-10-ol has been described. (R)-Carvone has been employed as the chiral starting material and a combination of intramolecular alkyation and Criegee fragmentation are employed for intramolecular stereospecific transfer of the chirality. An intramolecular diazoketone cyclopropanation and regioselective cyclopropane ring cleavage reactions have been employed or the creation of the three requisite contiguous quaternary carbon atoms.

Design and analysis of rate aware ad hoc 802.11 networks

802.11 WLANs are characterized by high bit error rate and frequent changes in network topology. The key feature that distinguishes WLANs from wired networks is the multi-rate transmission capability, which helps to accommodate a wide range of channel conditions. This has a significant impact on higher layers such as routing and transport levels. While many WLAN products provide rate control at the hardware level to adapt to the channel conditions, some chipsets like Atheros do not have support for automatic rate control. We first present a design and implementation of an FER-based automatic rate control state machine, which utilizes the statistics available at the device driver to find the optimal rate. The results show that the proposed rate switching mechanism adapts quite fast to the channel conditions. The hop count metric used by current routing protocols has proven itself for single rate networks. But it fails to take into account other important factors in a multi-rate network environment. We propose transmission time as a better path quality metric to guide routing decisions. It incorporates the effects of contention for the channel, the air time to send the data and the asymmetry of links. In this paper, we present a new design for a multi-rate mechanism as well as a new routing metric that is responsive to the rate. We address the issues involved in using transmission time as a metric and presents a comparison of the performance of different metrics for dynamic routing.

Online association policies in IEEE 802.11 WLANs

In this paper, we study the performance of client-Access Point (AP) association policies in IEEE 802.11 based WLANs. In many scenarios, clients have a choice of APs with whom they can associate. We are interested in finding association policies which lead to optimal system performance. More specifically, we study the stability of different association policies as a function of the spatial distribution of arriving clients. We find for each policy the range of client arrival rates for which the system is stable. For small networks, we use Lyapunov function methods to formally establish the stability or instability of certain policies in specific scenarios. The RAT heuristic policy introduced in our prior work is shown to have very good stability properties when compared to several other natural policies. We also validate our analytical results by detailed simulation employing the IEEE 802.11 MAC.

High-Resolution Magic Angle Spinning Nmr-Studies Of P-31 And B-11 In Fast Ion Conducting Agi-Ag2o-P2o5 And Agi-Ag2o-B2o3 Glasses

Silver iodide-based fast ion conducting glasses containing silver phosphate and silver borate have been studied. An attempt is made to identify the interaction between anions by studying the chemical shifts of31P and11B atoms in high resolution (HR) magic angle spinning (MAS) NMR spectra. Variation in the chemical shifts of31P or11B has been observed which is attributed to the change in the partial charge on the31P or11B. This is indicative of the change in the electronegativity of the anion matrix as a whole. This in turn is interpreted as due to significant interaction among anions. The significance of such interaction to the concept of structural unpinning of silver ions in fast ion conducting glasses is discussed.

Stability of CU(2)Ln(2)O(5) compounds - Comparison, assessment and systematics

Phase diagram studies show that at ambient pressure only one ternary oxide, Cu(2)Ln(2)O(5), is stable in the ternary systems Cu-Ln-O (Ln = Tb, Dy, Ho, Er, Tm, Yb, Lu) at high temperatures. The crystal structure of Cu(2)Ln(2)O(5) can be described as a zig-zag arrangement of one-dimensional Cu2O5 chains parallel to-the a-axis with Ln atoms occupying distorted octahedral sites between these chains. Four sets of emf measurements on Gibbs energy of formation of Cu(2)Ln(2)O(5) (Ln = Tb, Dy, Ho, Er, Tm, Yb, Lu; Y) from component binary oxides and one set of high-temperature solution calorimetric data on enthalpy of formation have been reported in the literature. Except for Cu2Y2O5, the measured values for the Gibbs energies of formation of all other Cu(2)Ln(2)O(5) compounds fall in a narrow band (+/-1 kJ mol(-1)) and indicate a regular increase in stability with decreasing ionic radius of the lanthanide ion. The values for the second law enthalpy of formation, derived from the temperature dependence of emf obtained in different studies, show larger differences, as high as 25 kJ mol(-1) for Cu2Tm2O5. Though associated with an uncertainty of +/-4 kJ mol(-1), the calorimetric measurements help to identify the best set of emf data. The trends in thermodynamic data correlate well with the global instability index (GII) based on the overall deviation from the valence sum rule. Low values for the index calculated from crystallographic information indicate higher stability. Higher values are indicative of the larger stress in the structure.

Excimer laser refractive surgery : corneal wound healing and clinical results

Although the first procedure in a seeing human eye using excimer laser was reported in 1988 (McDonald et al. 1989, O'Connor et al. 2006) just three studies (Kymionis et al. 2007, O'Connor et al. 2006, Rajan et al. 2004) with a follow-up over ten years had been published when this thesis was started. The present thesis aims to investigate 1) the long-term outcomes of excimer laser refractive surgery performed for myopia and/or astigmatism by photorefractive keratectomy (PRK) and laser-in situ- keratomileusis (LASIK), 2) the possible differences in postoperative outcomes and complications when moderate-to-high astigmatism is treated with PRK or LASIK, 3) the presence of irregular astigmatism that depend exclusively on the corneal epithelium, and 4) the role of corneal nerve recovery in corneal wound healing in PRK enhancement. Our results revealed that in long-term the number of eyes that achieved uncorrected visual acuity (UCVA)≤0.0 and ≤0.5 (logMAR) was higher after PRK than after LASIK. Postoperative stability was slightly better after PRK than after LASIK. In LASIK treated eyes the incidence of myopic regression was more pronounced when the intended correction was over >6.0 D and in patients aged <30 years.Yet the intended corrections in our study were higher for LASIK than for PRK eyes. No differences were found in percentages of eyes with best corrected visual acuity (BCVA) or loss of two or more lines of visual acuity between PRK and LASIK in the long-term. The postoperative long-term outcomes of PRK with two different delivery systems broad beam and scanning laser were compared and revealed no differences. Postoperative outcomes of moderate-to-high astigmatism yielded better results in terms of UCVA and less compromise or loss of two more lines of BCVA after LASIK that after PRK.Similar stability for both procedures was revealed. Vector analysis showed that LASIK outcomes tended to be more accurate than PRK outcomes, yet no statistically differences were found. Irregular astigmatism secondary to recurrent corneal erosion due to map-dot-fingerprint was successfully treated with phototherapeutic keratectomy (PTK). Preoperative videokeratographies (VK) showed irregular astigmatism. However, postoperatively, all eyes showed a regular pattern. No correlation was found between pre- and postoperative VK patterns. Postoperative outcomes of late PRK in eyes originally subjected to LASIK showed that all (7/7) eyes achieved UCVA ≤0.5 at last follow-up (range 3 — 11 months), and no eye lost lines of BCVA. Postoperatively all eyes developed and initial mild haze (0.5 — 1) into the first month. Yet, at last follow-up 5/7 eyes showed a haze of 0.5 and this was no longer evident in 2/7 eyes. Based on these results, we demonstrated that the long-term outcomes after PRK and LASIK were safe and efficient, with similar stability for both procedures. The PRK outcomes were similar when treated by broad-beam or scanning slit laser. LASIK was better than PRK to correct moderate-to-high astigmatism, yet both procedures showed a tendency of undercorrection. Irregular astigmatism was proven to be able to depend exclusively from the corneal epithelium. If this kind of astigmatism is present in the cornea and a customized PRK/LASIK correction is done based on wavefront measurements an irregular astigmatism may be produced rather than treated. Corneal sensory nerve recovery should have an important role in the modulation of the corneal wound healing and post-operative anterior stromal scarring. PRK enhancement may be an option in eyes with previous LASIK after a sufficient time interval that in at least 2 years.

Carbon dioxide and methane exchange between a boreal pristine lake and the atmosphere

Lakes serve as sites for terrestrially fixed carbon to be remineralized and transferred back to the atmosphere. Their role in regional carbon cycling is especially important in the Boreal Zone, where lakes can cover up to 20% of the land area. Boreal lakes are often characterized by the presence of a brown water colour, which implies high levels of dissolved organic carbon from the surrounding terrestrial ecosystem, but the load of inorganic carbon from the catchment is largely unknown. Organic carbon is transformed to methane (CH4) and carbon dioxide (CO2) in biological processes that result in lake water gas concentrations that increase above atmospheric equilibrium, thus making boreal lakes as sources of these important greenhouse gases. However, flux estimates are often based on sporadic sampling and modelling and actual flux measurements are scarce. Thus, the detailed temporal flux dynamics of greenhouse gases are still largely unknown. ----- One aim here was to reveal the natural dynamics of CH4 and CO2 concentrations and fluxes in a small boreal lake. The other aim was to test the applicability of a measuring technique for CO2 flux, i.e. the eddy covariance (EC) technique, and a computational method for estimation of primary production and community respiration, both commonly used in terrestrial research, in this lake. Continuous surface water CO2 concentration measurements, also needed in free-water applications to estimate primary production and community respiration, were used over two open water periods in a study of CO2 concentration dynamics. Traditional methods were also used to measure gas concentration and fluxes. The study lake, Valkea-Kotinen, is a small, humic, headwater lake within an old-growth forest catchment with no local anthropogenic disturbance and thus possible changes in gas dynamics reflect the natural variability in lake ecosystems. CH4 accumulated under the ice and in the hypolimnion during summer stratification. The surface water CH4 concentration was always above atmospheric equilibrium and thus the lake was a continuous source of CH4 to the atmosphere. However, the annual CH4 fluxes were small, i.e. 0.11 mol m-2 yr-1, and the timing of fluxes differed from that of other published estimates. The highest fluxes are usually measured in spring after ice melt but in Lake Valkea-Kotinen CH4 was effectively oxidised in spring and highest effluxes occurred in autumn after summer stratification period. CO2 also accumulated under the ice and the hypolimnetic CO2 concentration increased steadily during stratification period. The surface water CO2 concentration was highest in spring and in autumn, whereas during the stable stratification it was sometimes under atmospheric equilibrium. It showed diel, daily and seasonal variation; the diel cycle was clearly driven by light and thus reflected the metabolism of the lacustrine ecosystem. However, the diel cycle was sometimes blurred by injection of hypolimnetic water rich in CO2 and the surface water CO2 concentration was thus controlled by stratification dynamics. The highest CO2 fluxes were measured in spring, autumn and during those hypolimnetic injections causing bursts of CO2 comparable with the spring and autumn fluxes. The annual fluxes averaged 77 (±11 SD) g C m-2 yr-1. In estimating the importance of the lake in recycling terrestrial carbon, the flux was normalized to the catchment area and this normalized flux was compared with net ecosystem production estimates of -50 to 200 g C m-2 yr-1 from unmanaged forests in corresponding temperature and precipitation regimes in the literature. Within this range the flux of Lake Valkea-Kotinen yielded from the increase in source of the surrounding forest by 20% to decrease in sink by 5%. The free water approach gave primary production and community respiration estimates of 5- and 16-fold, respectively, compared with traditional bottle incubations during a 5-day testing period in autumn. The results are in parallel with findings in the literature. Both methods adopted from the terrestrial community also proved useful in lake studies. A large percentage of the EC data was rejected, due to the unfulfilled prerequisites of the method. However, the amount of data accepted remained large compared with what would be feasible with traditional methods. Use of the EC method revealed underestimation of the widely used gas exchange model and suggests simultaneous measurements of actual turbulence at the water surface with comparison of the different gas flux methods to revise the parameterization of the gas transfer velocity used in the models.

Total synthesis ofdl-9(11)-dehydrotestosterone anddl-testosterone

17β-Hydroxy-des-A-androst-9-en-5-one (II, R=OH), prepared fromtrans-1β-hydroxy-8-methyl-4, 5-(3′-methyl-4′-methoxybenzo)-hydrindane (I, R=CH3)′, has been converted intodl-9(II)-dehydrotestosterone (IV, R=OH) anddl-testosterone (IX) in very short sequences of steps, albeit in poor yields.

Eläimen tuttuus ja vieraus : Fenomenologisen empatiateorian uudelleentulkinta ja sen sovellus vieraslajisia eläimiä koskevaan kokemukseen

Within the field of philosophy, animals have traditionally been studied from two perspectives: that of self-knowledge and that of ethics. The analysis of the differences between humans and animals has served our desire to understand our own specificity, whereas ethical discussions have ultimately aimed at finding the right way to treat animals. This dissertation proposes a different way of looking at non-human animals: it investigates the question of how non-human animals appear to us humans in our perceptual experience. The analysis focuses on the empathetic, embodied understanding of animals diverse movements and other expressions. The theoretical point of departure for the research is phenomenological philosophy, in particular Maurice Merleau-Ponty s phenomenology of the body. Edmund Husserl s and Edith Stein s analyses of empathy and embodiment are also crucial to the work. In this tradition, empathy means understanding the other s experience through her bodily expressions and seeing the other body as living, as well as motivated and directed towards the surrounding world. The dissertation both explicates and criticizes the earlier phenomenological notions of empathy and human specificity. In order to elucidate the fundamental structures of our experience of non-human animals, it also applies the phenomenological method, which consists of a phenomenological reduction and a free variation of the different aspects of experience. It is shown that our experiences of non-human animals involve a recognition of both similarities and differences. This recognition, however, is not primarily based on intellectual comparisons but is lived as an embodied relationship to another body, and its manifestations vary from one instant to the next. The analysis also reveals that the object of empathy is not the other s experience as such, not even as it is manifested by the other s movements, but rather the other s embodied situation, enriched by elements that remain outside the scope of the other s experience. The dissertation shows that human existence is intertwined with the existence of non-human animals on four levels: those of empathetic sensations, reciprocal communication, experience of the surrounding world and self-definitions. The animals different modes of perception prove to expand our understanding of what is perceivable and how things can be perceived. The presence of non-human animals in our perceptual world is revealed as something that both shows us the limits of our own embodiment and enables us to overcome these limits in empathetic acts. Finally, it is demonstrated that the life of non-human animals is intertwined with ours in a far more complex way than has been presupposed in traditional descriptions of human-animal differences.

Why Don't Students Talk? Causes of Foreign Language Communication Apprehension in English Classes: A Comparison of High Apprehensive and Low Apprehensive Upper Secondary Students.

OBJECTIVES. Oral foreign language skills are an integral part of one's social, academic and professional competence. This can be problematic for those suffering from foreign language communication apprehension (CA), or a fear of speaking a foreign language. CA manifests itself, for example, through feelings of anxiety and tension, physical arousal and avoidance of foreign language communication situations. According to scholars, foreign language CA may impede the language learning process significantly and have detrimental effects on one's language learning, academic achievement and career prospects. Drawing on upper secondary students' subjective experiences of communication situations in English as a foreign language, this study seeks, first, to describe, analyze and interpret why upper secondary students experience English language communication apprehension in English as a foreign language (EFL) classes. Second, this study seeks to analyse what the most anxiety-arousing oral production tasks in EFL classes are, and which features of different oral production tasks arouse English language communication apprehension and why. The ultimate objectives of the present study are to raise teachers' awareness of foreign language CA and its features, manifestations and impacts in foreign language classes as well as to suggest possible ways to minimize the anxiety-arousing features in foreign language classes. METHODS. The data was collected in two phases by means of six-part Likert-type questionnaires and theme interviews, and analysed using both quantitative and qualitative methods. The questionnaire data was collected in spring 2008. The respondents were 122 first-year upper secondary students, 68 % of whom were girls and 31 % of whom were boys. The data was analysed by statistical methods using SPSS software. The theme interviews were conducted in spring 2009. The interviewees were 11 second-year upper secondary students aged 17 to 19, who were chosen by purposeful selection on the basis of their English language CA level measured in the questionnaires. Six interviewees were classified as high apprehensives and five as low apprehensives according to their score in the foreign language CA scale in the questionnaires. The interview data was coded and thematized using the technique of content analysis. The analysis and interpretation of the data drew on a comparison of the self-reports of the highly apprehensive and low apprehensive upper secondary students. RESULTS. The causes of English language CA in EFL classes as reported by the students were both internal and external in nature. The most notable causes were a low self-assessed English proficiency, a concern over errors, a concern over evaluation, and a concern over the impression made on others. Other causes related to a high English language CA were a lack of authentic oral practise in EFL classes, discouraging teachers and negative experiences of learning English, unrealistic internal demands for oral English performance, high external demands and expectations for oral English performance, the conversation partner's higher English proficiency, and the audience's large size and unfamiliarity. The most anxiety-arousing oral production tasks in EFL classes were presentations or speeches with or without notes in front of the class, acting in front of the class, pair debates with the class as audience, expressing thoughts and ideas to the class, presentations or speeches without notes while seated, group debates with the class as audience, and answering to the teacher's questions involuntarily. The main features affecting the anxiety-arousing potential of an oral production task were a high degree of attention, a large audience, a high degree of evaluation, little time for preparation, little linguistic support, and a long duration.

The structure of 11[alpha]-hydroxycon-1,4-dienine-3-one monohydrate

C22H31NO2.H2 O, M r = 359" 5, orthorhombic,P2~212 ~, a= 10.032 (1), b= 11.186 (1), C = 17.980 (1)/~,, U= 2017.48/~3, Z = 4, D x = 1.276 Mg m -a, 2(Cu Kct) = 1.5418/~, # = 0.69 mm -~,F(000) = 784, T = 293 K. Final R = 0.05 for 1972 unique reflections with I > 3o(/). Ring A is planar, and rings B and C adopt a chair conformation. Rings D and E are envelopes, with C(14) and C(20) displaced from their respective ring planes by 0-616 (2) and 0.648 (3)/~. The A/B ring junction is quasi-trans,whilst ring systems B/C and C/D are trans fused about the bonds C(8)-C(9) and C(13)-C(14) respectively.The D/E junction shows cis fusion.

Maskuliinisuuden rakentuminen alakoulussa

Objectives: Inspiration for this study came from the public discourse and concern for boys poor school achievement, as well as from the author s own perceptions. There was an interest to know if this concern is justified and what are its underlying causes. Previous studies have shown that masculinity is one of the key aspects of boys' poor school achievement. The objective of this research is to study the construction of masculinity in primary school and how this construct of masculinity is manifested by school achievement. Based on previous studies, the pursuit of hegemonic masculinity does not fit with good school grades. If a boy succeeds in school, this success must be compensated for by means of different factors demonstrating hegemonic masculinity. Methods: The research material was obtained by using the etnographic method. The research settled itself feministic school-etnographic research field. The research subjects comprised pupils and teachers of a 5th grade comprehensive school class (10-11-year-olds) in the Uusimaa county. There were twenty-nine (29) pupils (18 boys and 11 girls) in this class and five (5) different teachers who taught the class. The research material was composed of field notes and researcher's diary based on researcher's observations, short group discussions with pupils and interviews of five boys. The field notes consisted of twenty-six (26) lessons and also observations of breaks and eating periods. In short group discussions the researcher discussed with all the pupils that were given a permission for interview. The material was analysed with thematic and analytic reading that led to the writing of an analysis. Results and conclusions: The most salient result of this study was that different masculinities are constructed in primary school. The majority of boys aimed at hegemonic masculinity and the school community strongly supported this. This was shown in speech and in behaviour. School success and mainstream masculinity could be compatible, but success also required compensatory aspects. In addition to these observations, the researcher was able to identify a group of boys which truly wanted to achieve well in school and did not care to strive for hegemonic masculinity. Thus, there should be more room and opportunities for different kinds of masculinity in the school environment. Teachers and the overall school environment should support the different ways of being a boy, and it seems there is a need for gender sensitive pedagogy.

Sairaanhoitajat työn imussa? Palkkatyön sisällön ja kulttuuristen lähtökohtien tasapainossa

Tutkimuksen tavoitteena on selvittää, mikä saa pitkän työuran tehneet sairaanhoitajat innostumaan työstään. Taustalla on yhteiskunnallinen tilanne, jossa työelämän vetovoimaisuuden lisääminen ja ikääntyvien työntekijöiden työssä jaksaminen ovat keskeisiä poliittisia tavoitteita. Aihetta lähestytään positiivisesta psykologiasta lähtöisin olevan työn imun käsitteen avulla. Se on määritelty pysyväksi, ”myönteiseksi, tunne- ja motivaatiotäyttymyksen tilaksi, jota luonnehtivat tarmokkuus, omistautuminen ja uppoutuminen työhön” (Hakanen 2009a, 9). Tutkimuksessa kysytään, voidaanko työn imua ymmärtää myös sosiologisesta näkökulmasta. Oletuksena on, että käsitteen taustalla on muutakin kuin psykologisesta perinteestä käsin jäsentyvää vaihtelua. Empiirisen aineiston muodostavan 11 sairaanhoitajan koko työuraa ja nykyistä työtä koskevat tiettyihin teemoihin ankkuroidut syvähaastattelut. Otosta poimittaessa on etsitty sellaisia haastateltavia, jotka kokevat kantavansa työn imua. Aineiston analyysitapana on käytetty matriisin avulla sovellettua kvalitatiivista sisällönanalyysiä. Työn imua hahmotetaan analyysissä henkilöhistoriallisten haastatteluiden – menneen, nykyisen ja tulevan – kautta. Pyrkimyksenä on etsiä tarinoita mahdollisesti yhdistävää kulttuurista muotoa ja ymmärtää, mihin se perustuu. Analyysin nojalla vastuurationaalisuuden käsite (esim. Korvajärvi 1986) näyttäisi jäsentävän osan haastateltavien suhteesta työhönsä. Avain työn imun löytymiseen näissä tarinoissa on kuitenkin se, kuinka haastateltavilla on ollut henkilökohtainen halu mennä eteenpäin ja kykyä ratkaista ongelmia työuransa aikana ja nykyisessä työssään. Tämä havainto tulkitaan Max Weberin (1922; 1980) käsitteiden – arvorationaalisen ja päämäärärationaalisen toiminnan väliseen suhteen – avulla. Tulokseksi syntyy oletus siitä, että analyysin kohteena olevissa tarinoissa on kyse yhteisestä kulttuurisesta tarinasta siitä, millainen on hyvä ihminen, miten hyvä ihminen toteuttaa itseään työssä ja miten hän tekee työtään: tarmokkaasti, omistautuen ja uppoutuen. Henkilökohtainen halu mennä eteenpäin ja kyky ratkaista ongelmia nojaa sairaanhoitajien erityiseen eetokseen, kutsumustyöhön ja hoivan moraaliin tavalla, joka on rakenteellisesti yhtäläinen protestanttisuutta leimaavan yksilöllisen jumalasuhteen kanssa. Lisäksi analyysin perusteella esitetään, että työn imun edellytys on arvorationaalisen eetoksen lisäksi oikeanlainen, riittävät työn voimavarat sisältävä ympäristö, jossa hoitotyön keskeiset palkinnot on mahdollista saavuttaa. Tällöin palkkatyön sisältö kohtaa kulttuuriset lähtökohdat, ja tulos näkyy työn imuna. Keskeisimmät taustoittavat lähteet ovat Henriksson, Lea & Wrede, Sirpa (toim.) (2004a). Hyvinvointityön ammatit ja Hakanen, Jari (2009a). Työn imun arviointimenetelmä (Utrecht Work Engagement Scale). Sosiologisen tulkinnan kannalta tärkein teoreettinen lähde on Weber, Max (1980): Protestanttinen etiikka ja kapitalismin henki.

Peritoneal dialysis and neurological outcome in infants and small children

Although improved outcomes for children on peritoneal dialysis (PD) have been seen in recent years, the youngest patients continue to demonstrate inferior growth, more frequent infections, more neurological sequelae, and higher mortality compared to older children. Also, maintain-ing normal intravascular volume status, especially in anuric patients, has proven difficult. This study was designed to treat and monitor these youngest PD patients, which are relatively many due to the high prevalence of congenital nephrotic syndrome of the Finnish type (CNF, NPHS1) in Finland, with a strict protocol, to evaluate the results and to improve metabolic balance, growth, and development. A retrospective analysis of 23 children under two years of age at onset of PD, treated between 1995 and 2000, was performed to obtain a control population for our prospective PD study. Respectively, 21 patients less than two years of age at the beginning of PD were enrolled in prospective studies between 2001 and 2005. Medication for uremia and nutrition were care-fully adjusted during PD. Laboratory parameters and intravascular volume status were regu-larly analyzed. Growth was analyzed and compared with midparental height. In a prospective neurological study, the risk factors for development and the neurological development was determined. Brain images were surveyed. Hearing was tested. In a retrospective neurological study, the data of six NPHS1 patients with a congruent neurological syndrome was analyzed. All these patients had a serious dyskinetic cerebral palsy-like syndrome with muscular dysto-nia and athetosis (MDA). They also had a hearing defect. Metabolic control was mainly good in both PD patient groups. Hospitalization time shortened clearly. The peritonitis rate diminished. Hypertension was a common problem. Left ventricular hypertrophy decreased during the prospective study period. None of the patients in either PD group had pulmonary edema or dialysis-related seizures. Growth was good and catch-up growth was documented in most patients in both patient groups during PD. Mortality was low (5% in prospective and 9% in retrospective PD patients). In the prospective PD patient group 11 patients (52%) had some risk factor for their neuro-development originating from the predialysis period. The neurological problems, detected be-fore PD, did not worsen during PD and none of the patients developed new neurological com-plications during PD. Brain infarcts were detected in four (19%) and other ischemic lesions in three patients (14%). At the end of this study, 29% of the prospectively followed patients had a major impairment of their neurodevelopment and 43% only minor impairment. In the NPHS1+MDA patients, no clear explanation for the neurological syndrome was found. The brain MRI showed increased signal intensity in the globus pallidus area. Kernic-terus was contemplated to be causative in the hypoproteinemic newborns but it could not be proven. Mortality was as high as 67%. Our results for young PD patients were promising. Metabolic control was acceptable and growth was good. However, the children were significantly smaller when compared to their midparental height. Although many patients were found to have neurological impairment at the end of our follow-up period, PD was a safe treatment whereby the neurodevelopment did not worsen during PD.