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Hintergrund: Laparoskopische Kolonresektionen haben bei traditioneller perioperativer Therapie im Gegensatz zu offenen Operationen kurzfristige Vorteile im klinischen Verlauf. Es ist fraglich, ob sich die guten Ergebnisse der laparoskopischen Operationstechnik weiter verbessern lassen, wenn die Patienten nach «Fast-track»-Konzepten behandelt werden. Patienten und Methoden: In einer prospektiven, nicht randomisierten Beobachtungsstudie sollte der klinische Verlauf von Patienten mit elektiven laparoskopischen Sigma- und anterioren Rektumresektionen unter traditioneller oder «Fast-track»-Therapie untersucht werden. Essentielle «Fast-track»-Bestandteile waren unter anderem: Patientenschulung, Periduralanalgesie, forcierte Mobilisation und oraler Kostaufbau. Zielkriterien waren allgemeine und chirurgische Komplikationen und die forcierte Vitalkapazität (FVC). Ergebnisse: Von 116 Fällen wurden 33 Patienten traditionell und 83 Patienten nach «Fast-track» behandelt. Der orale Kostaufbau (p <> [ABSTRACT FROM AUTHOR]

Partially degradable, nonionic AB and ABA type di- and triblock copolymers based on poly(propylene carbonate) and poly(ethylene glycol) blocks were synthesized via immortal copolymerization of carbon dioxide and propylene oxide, using mPEG or PEG as a macroinitiator, and ( R , R )-(salcy)-CoOBzF₅ as a catalyst in a solvent-free one-pot procedure. The amphiphilic surfactants were prepared with molecular weights ( M n ) between 2800 and 10,000 g·mol - ¹ with narrow molecular weight distributions (1.03⁻1.09). The copolymers were characterized using ¹H-, 13 C- and DOSY-NMR spectroscopy and size exclusion chromatography (SEC). Surface-active properties were determined by surface tension measurements (critical micelle concentration, CMC; CMC range: 1⁻14 mg·mL - ¹). Degradation of the acid-labile polycarbonate blocks was investigated in aqueous solution using online ¹H-NMR spectroscopy and SEC. The amphiphilic polymers were used as surfactants in a direct miniemulsion polymerization for poly(styrene) (PS) nanoparticles with mean diameter of 270 to 940 nm. The usage of an acid-triggered precipitation of the emulsion simplified the separation of the particles from the surfactant and purification of the nanoparticles., Competing Interests: The authors declare no conflict of interest.

The enzyme ferrochelatase catalyses the formation of protoheme by inserting Fe(2+) into protoporphyrin IX. Although most organisms express only one ferrochelatase, all land plants analysed so far possess at least two ferrochelatase proteins. Analysis of publicly available expression data suggests that the two Arabidopsis thaliana ferrochelatases, FC1 and FC2, serve different functions, corroborating previous assumptions. Co-expression analysis of FC1 and FC2, together with microarray analyses, implies that fc1 and fc2 trigger different modes of plastid signalling in roots and leaves, respectively, and indicates that FC2 might be involved in stress responses. Thus, loss of FC2 increases resistance to salt and flagellin treatment. Whereas fc1 plants showed no obvious mutant phenotype, fc2 mutants formed abnormally small, pale green rosette leaves; were low in chlorophylls, carotenoids and several photosynthetic proteins; and their photosynthetic performance was impaired. These phenotypes are attenuated by growth in continuous light, in agreement with the finding that fc2 plants accumulate protochlorophyllide and display a fluorescent (flu) phenotype in the dark. In consequence we show that, contrary to earlier suggestions, FC2 produces heme not only for photosynthetic cytochromes, but also for proteins involved in stress responses, whereas the impairment of FC1 apparently interferes only marginally with stress responses., (© 2013 John Wiley & Sons Ltd.)

Well-defined poly((furfuryl glycidyl ether)-co-(glycidyl methyl ether) carbonate) (P((FGE-co-GME)C)) copolymers with varying furfuryl glycidyl ether (FGE) content in the range of 26% to 100% are prepared directly from CO2 and the respective epoxides in a solvent-free synthesis. All materials are characterized by size-exclusion chromatography (SEC), (1)H NMR spectroscopy, and differential scanning calorimetry (DSC). The furfuryl-functional samples exhibit monomodal molecular weight distributions with Mw/Mn in the range of 1.16 to 1.43 and molecular weights (Mn) between 2300 and 4300 g mol(-1). Thermal properties reflect the amorphous structure of the polymers. Both post-functionalization and cross-linking are performed via Diels-Alder chemistry using maleimide derivatives, leading to reversible network formation. This transformation is shown to be thermally reversible at 110 °C., (© 2014 WILEY-VCH Verlag GmbH & Co. KGaA, Weinheim.)

Most chloroplast proteins (cp proteins) are nucleus-encoded, synthesized on cytosolic ribosomes as precursor proteins containing a presequence (cTP), and post-translationally imported via the Tic/Toc complex into the organelle, where the cTP is removed. Only a few unambiguous instances of cp proteins that do not require cTPs (non-canonical cp proteins) have been reported so far. However, the survey of data from large-scale proteomic studies presented here suggests that the fraction of such proteins in the total cp proteome might be as large as approximately 30%. To explore this discrepancy, we chose a representative set of 28 putative non-canonical cp proteins, and used in vitro import and Red Fluorescent Protein (RFP)-fusion assays to determine their sub-cellular destinations. Four proteins, including embryo defective 1211, glycolate oxidase 2, protein disulfide isomerase-like protein (PDII), and a putative glutathione S-transferase, could be unambiguously assigned to the chloroplast. Several others ('potential cp proteins') were found to be imported into chloroplasts in vitro, but failed to localize to the organelle when RFP was fused to their C-terminal ends. Extrapolations suggest that the fraction of cp proteins that enter the inner compartments of the organelle, although they lack a cTP, might be as large as 11.4% of the total cp proteome. Our data also support the idea that cytosolic proteins that associate with the cp outer membrane might account for false positive cp proteins obtained in earlier studies.

Flowering plants control energy allocation to their photosystems in response to light quality changes. This includes the phosphorylation and migration of light-harvesting complex II (LHCII) proteins (state transitions or short-term response) as well as long-term alterations in thylakoid composition (long-term response or LTR). Both responses require the thylakoid protein kinase STN7. Here, we show that the signaling pathways triggering state transitions and LTR diverge at, or immediately downstream from, STN7. Both responses require STN7 activity that can be regulated according to the plastoquinone pool redox state. However, LTR signaling does not involve LHCII phosphorylation or any other state transition step. State transitions appear to play a prominent role in flowering plants, and the ability to perform state transitions becomes critical for photosynthesis in Arabidopsis thaliana mutants that are impaired in thylakoid electron transport but retain a functional LTR. Our data imply that STN7-dependent phosphorylation of an as yet unknown thylakoid protein triggers LTR signaling events, whereby an involvement of the TSP9 protein in the signaling pathway could be excluded. The LTR signaling events then ultimately regulate in chloroplasts the expression of photosynthesis-related genes on the transcript level, whereas expression of nuclear-encoded proteins is regulated at multiple levels, as indicated by transcript and protein profiling in LTR mutants.

Two homologous plastocyanin isoforms are encoded by the genes PETE1 and PETE2 in the nuclear genome of Arabidopsis thaliana. The PETE2 transcript is expressed at considerably higher levels and the PETE2 protein is the more abundant isoform. Null mutations in the PETE genes resulted in plants, designated pete1 and pete2, with decreased plastocyanin contents. However, despite reducing plastocyanin levels by over approximately 90%, a pete2 null mutation on its own affects rates of photosynthesis and growth only slightly, whereas pete1 knockout plants, with about 60-80% of the wild-type plastocyanin level, did not show any alteration. Hence, plastocyanin concentration is not limiting for photosynthetic electron flow under optimal growth conditions, perhaps implying other possible physiological roles for the protein. Indeed, plastocyanin has been proposed previously to cooperate with cytochrome c(6A) (Cyt c(6A)) in thylakoid redox reactions, but we find no evidence for a physical interaction between the two proteins, using interaction assays in yeast. We observed homodimerization of Cyt c(6A) in yeast interaction assays, but also Cyt c(6A) homodimers failed to interact with plastocyanin. Moreover, phenotypic analysis of atc6-1 pete1 and atc6-1 pete2 double mutants, each lacking Cyt c(6A) and one of the two plastocyanin-encoding genes, failed to reveal any genetic interaction. Overexpression of either PETE1 or PETE2 in the pete1 pete2 double knockout mutant background results in essentially wild-type photosynthetic performance, excluding the possibility that the two plastocyanin isoforms could have distinct functions in thylakoid electron flow.

Objective: To determine the specific effects of working long hours in surgery and potential cardiac stress in the individual surgeon by measuring heart rate variability (HRV)., Design, Setting, and Participants: This prospective study measured HRV before, during, and after a 24-hour shift in a standardized resting period of 10 minutes. Measurements were repeated over 10 shifts for each participant. Eight surgeons from a high-volume inner-city surgery department took part in the study., Main Outcome Measures: Time and frequency domain parameters of HRV as parameters of cardiac stress and correlations with perceived stress and fatigue on a visual analog scale., Results: Perceived fatigue increased over 24 hours (P < .001), whereas stress levels decreased slightly (P = .06). Time domain parameters of HRV increased from before the shift to after the shift (standard deviation of normal to normal intervals, square root of the mean normal to normal interval, and percentage of adjacent pairs of normal to normal intervals differing by more than 50 milliseconds: all P < .01), denoting more cardiac relaxation. Both the low- and high-frequency components increased (P = .04 and P < .001, respectively), showing a heightened activity of the autonomic nervous system., Conclusions: Measurements of HRV during a 24-hour surgical shift did not show an increase in cardiac stress concerning time domain parameters despite intense workloads for a median of 20 hours. Frequency components increased in parallel, though, suggesting alterations in sympathovagal balance. Perceived stress levels correlated with HRV, whereas fatigue did not. Further studies on occupational stress and its cardiac effects in surgeons are needed.

Ectopic thyroid glands are generally a rare entity appearing mostly in the cervical midline (90% of the cases) and even more rarely in other anatomical sites (10%). We present the case of an ectopic submandibular thyroid gland. An 81-year-old woman was referred to our department with a history of right-sided submandibular swelling. Preoperative FNA revealed benign ectopic thyroid tissue. The patient was submitted to resection of the mass. Histological examination of the specimen confirmed the diagnosis. A substitution treatment with thyroxin was initiated postoperatively, as this was the only functional thyroid tissue. Review of the literature revealed 18 similar cases. Physicians should be aware of the possibility that a submandibular swelling could be an ectopic thyroid gland. This entity poses specific diagnostic and therapeutic difficulties. Thorough preoperative diagnostics and resection of the ectopic tissue guarantee a good outcome.

The laparoscopic adjustable gastric band (LAGB) has become a common, usually successful treatment for morbid obesity. Complications occur in 10-20%, most commonly band slippage and port system problems, especially infection of the port area. A rare complication is penetration of the band into the stomach. We report the penetration of the tube connecting the port system with the gastric band, into the colon 1 year after treatment of a port infection.

The main use of ultraviolet light radiation in hospitals is for the disinfection of the air. A study was made of the disinfecting efficiency of indirect ultraviolet radiation (lifts, cleaning of bedding), direct irradiation of rooms overnight or after use, ultraviolet curtains (irradiation of the whole width of passages, doorways and entrances) and ultraviolet irradiation of the filter of air-conditioners. The results are analysed. With the exception of the barrier technique ultraviolet light irradiation did not substantially reduce the number of micro-organisms in the air. Knowledge of the limitations and side-effects of this technique, control of the intensity of ultraviolet irradiation and bacterial counts are regular intervals are some of the factors that determine the success of this mode of disinfection. Detailed studies of the acceptable upper limits of the number of micro-organisms in the air of hospital wards and operating theatres is of prime importance for evaluating the effectiveness of air-disinfection by ultraviolet light irradiation.