Replisome structure suggests mechanism for continuous fork progression and post-replication repair.

What happens to DNA replication when it encounters a damaged or nicked DNA template has been under investigation for five decades. Initially it was thought that DNA polymerase, and thus the replication-fork progression, would stall at road blocks. After the discovery of replication-fork helicase and replication re-initiation factors by the 1990s, it became clear that the replisome can "skip" impasses and finish replication with single-stranded gaps and double-strand breaks in the product DNA.

[A Rare Cause of Acute Coronary Occlusion with Inferior ST-Elevation Myocardial Infarction and Out of Hospital Cardiac Arrest].

History: The 59-year old female was successfully resuscitated after out of hospital cardiac arrest due to ventricular fibrillation. The ECG after return of spontaneous circulation showed elevated ST-segments in the inferior leads.

Findings And Diagnosis: Acute coronary angiography confirmed a complete occlusion of the right coronary artery without collateral flow.

[Venous Paravasation After Augmentation of Pedicle Screws - An Underestimated Risk].

Cement-augmented pedicle screws can increase the stability of fixators for unstable vertebral fractures in the elderly. Fixators can be inserted quickly and with minimally invasive techniques, reducing surgical risks. From March 2012 until July 2014, we treated 40 patients with percutaneous augmented fixators for unstable vertebral fractures.

[Pay for performance approach and its possible future influence on revenues in German interventional cardiology units].

Pay-for-performance in German health care system is still uncommon but--in view of scheduled legislative projects--could gain more influence in future. Beside others, risc adjusted in-hospital mortality and the door-to-ballon-time inpatients with ST-elevation myocardial infarction could become quality- and performance indicators in interventional cardiology units. As a result, process optimization based on these indicators could have an impact on both patient value (as already today) and revenues (from 2017 onwards).

Early days of DNA repair: discovery of nucleotide excision repair and homology-dependent recombinational repair.

The discovery of nucleotide excision repair in 1964 showed that DNA could be repaired by a mechanism that removed the damaged section of a strand and replaced it accurately by using the remaining intact strand as the template. This result showed that DNA could be actively metabolized in a process that had no precedent. In 1968, experiments describing postreplication repair, a process dependent on homologous recombination, were reported.

Re-engineering the operating room using variability methodology to improve health care value.

Background: Variability in flow of patients through operating rooms has a dramatic impact on a hospital's performance and finances. Natural variation (uncontrollable) and artificial variation (controllable) differ and require different resources and management. The aim of this study was to use variability methodology for a hospital's surgical services to improve operational performance.

Dewatering behavior of sewage screenings.

Screenings from municipal sewage treatment plants have increased in importance in recent years, particularly in Germany, where laws prohibit depositing of screenings in landfill. This paper presents basic investigations of sewage screenings, especially the structure and dewatering behavior. Two standard experiments are conducted.

Chasing zero: the drive to eliminate surgical site infections.

Objectives: It is estimated that healthcare associated infections (HAI) account for 1.7 million infections and 99,000 associated deaths each year, with annual direct medical costs of up to $45 billion. Surgical Site Infections (SSI) account for 17% of HAIs, an estimated annual cost of $3.

Hybrid approach combining off-pump CABG with transapical aortic valve implantation via median sternotomy.

We report the case of a 75-year-old patient diagnosed with severe aortic stenosis and two-vessel coronary artery disease. Due to multiple comorbidities including chronic renal insufficiency, stroke and pulmonary hypertension (EuroSCORE: 34%; STS mortality risk: 14.9%), he was not a candidate for conventional aortic valve surgery.

Stab or throw? Biomechanical studies on the injuring potential of glass fragments.

During a Christmas party, two male guests started fighting. The perpetrator was allegedly pushed onto a glass table by the victim or fell into the table together with that man so that the glass top broke and caused a cut wound on the perpetrator's back. According to his statement he then threw a fragment of the broken glass table in the direction of the other man hitting him accidentally in a way so that the subclavian artery was severed and he died from exsanguination.

[Death in a relaxation tank].

Complete relaxation can be achieved by floating in a darkened, sound-proof relaxation tank filled with salinated water kept at body temperature. Under these conditions, meditation exercises up to self-hypnosis may lead to deep relaxation with physical and mental revitalization. A user manipulated his tank, presumably to completely cut off all optical and acoustic stimuli and accidentally also covered the ventilation hole.

[Domestic accident or child abuse?].

While playing, a 33/4-year-old girl was hiding in a tumble dryer, which had been running before and started the drying process with rotation of the drum again after the girl had climbed into the machine and shut the door. The child suffered multiple haematomas, especially on the back and the lower arms, as well as second-degree burns on body regions not covered by the clothing. The injury pattern was consistent with the properties of the appliance, and the initial suspicion that the child had been physically abused could not be maintained.

[Differential diagnosis of traumatic skull findings in infants: residues after vacuum extraction].

If autopsy findings in an infant show traumatic changes on the skullcap, these are not always the result of a postnatal trauma due to child abuse, a fall or another accidental event. With regard to differential diagnosis a birth trauma should also be kept in mind, so that the history of the delivery is important. The spectrum of possible residues after vacuum extraction (circular fracture and/or elevation of the outer table of skull bones, subperiostal and intraossal haematoma, extradural and subdural haemorrhage) is demonstrated by means of three examples from the forensic autopsy material.

The Ross operation: do native aortic, native pulmonary, and homograft pulmonary valve size and form differences influence results?

Background: The pulmonary autograft approaches the ideal aortic valve substitute but numerous technical modifications are debated. The valves involved often differ in diameter and shape of the recipient annulus. We previously reported simplified surgical rules and early results of 52 patients and here we extend the report to 76 patients and analyze the mid-term results with respect to valve mismatch.

A specific 3' exonuclease activity of UvrABC.

Specific cutting of undamaged DNA by UvrABC nuclease is observed. It occurs seven nucleotides (nt) from the 3' terminus of oligonucleotides annealed to single-stranded M13 DNA circles. Although the location of the UvrABC cut on undamaged DNA is similar to that of the cut on the 5' side of a damaged DNA site during the dual incision reaction, the cut of undamaged DNA is not an intermediate in the dual incision step.

The influence of geometric mismatch between the native aortic, native pulmonary and homograft pulmonary valve on the results of the pulmonary autograft operation.

Background: The pulmonary autograft operation has achieved broad acceptance and may be the ideal aortic valve substitute. Both the pulmonary autograft and the aortic homograft are more complicated procedures than prosthetic valve replacement. The trend to insert the pulmonary autograft as a root replacement rather than in the subcoronary position has achieved greater uniformity in the results, but there is still confusing diversity in opinions on technical details and anatomical dimensions.

Endaortitis of coarctation of the aorta after invasive diagnostics.

We report the case of a young woman in whom endaortitis developed at the site of a coarctation of the aorta after the invasive investigation of right fossa iliac pain. The organism responsible suggests a causal relationship to the investigations without antibiotic prophylaxis, and we emphasize the need for antibiotic prophylaxis in these cases. Invasive investigation of isolated coarctation in a young adult or adolescent is probably superfluous.

The limited strand-separating activity of the UvrAB protein complex and its role in the recognition of DNA damage.

The recognition by Escherichia coli Uvr nucleotide excision repair proteins of a variety of lesions with diverse chemical structures and the presence of helicase activity in the UvrAB complex which can displace short oligonucleotides annealed to single-stranded DNA led to a model in which this activity moves UvrAB along undamaged DNA to damaged sites where the lesion blocks further translocation and the protein-DNA pre-incision complex is formed. To evaluate this mechanism for damage recognition, we constructed substrates with oligonucleotides of different lengths annealed to single-stranded DNA circles and placed a single 2-(acetylamino)fluorene (AAF) lesion either on the oligonucleotide or on the circle. For the substrates with no lesion, the UvrAB complex effectively displaced a 22-mer but not a 27-mer or longer fragments.

UvrAB activity at a damaged DNA site: is unpaired DNA present?

To study the activity of the Escherichia coli UvrA and UvrB nucleotide excision repair proteins during the formation of the pre-incision complex at a damaged DNA site, we used substrates with modifications around a single 2-(acetylamino)fluorene (AAF) lesion. Based on the release of AAF-containing oligonucleotides from a single-stranded DNA circle, we conclude that during interaction with our substrates UvrAB introduces changes in DNA which are localized at the lesion and are limited to 1-3 bp. Since these changes might include a denaturation of DNA at the lesion site and, consequently, a bubble structure might be present in a pre-incision complex, we studied incision activity of UvrABC excinuclease on substrates with 1-4 unpaired bases next to an AAF adduct.