Thirty-six percent of patients experienced an infectious event du

Thirty-six percent of patients experienced an infectious event during hospitalization, which resulted in more exacerbation of TTP (p = 0.02). Infections were not overrepresented during treatment in patients who received steroids and/or rituximab. Further genetic analysis of toll-like receptor (TLR)-9 functionally relevant polymorphisms revealed that TLR-9 + 2848 G and TLR-9 + 1174 A genotypes were more frequent in TTP patients than in controls (p = 0.04 and p = 0.026, respectively) and more particularly in patients negative for the Class II human leukocyte see more antigen system susceptibility allele DRB1*11 (p = 0.001 and p = 0.002, respectively). Haplotypes

estimation showed that 1174A-2848G haplotype was significantly more frequent in TTP (p = 0.004), suggesting a primary role for this haplotype variation in conferring a predisposition for acquired TTP.\n\nCONCLUSION: Infections should be considered as an aggravating factor during the course of TTP. Particular polymorphisms in TLR-9 gene may represent risk factors for TTP.”
“We have evaluated the clinical, radiological and metabolic features of infantile urolithiasis (UL).\n\nWe have reviewed the medical records of 93 children who were diagnosed as having UL before 1 year of age. We recorded patient

demographics, the age at diagnosis, presenting symptoms, family history, the localizations and dimensions of stones, urinary metabolic examinations, ZD1839 clinical trial as well as physical, laboratory, and radiologic findings. Our secondary objective was to

compare some features of this group with those of older children with UL followed-up in the same clinic which were previously reported.\n\nWe evaluated 93 children referred to our pediatric nephrology clinics. A family history of UL was 56.2 % in the study group. Resolution of stones was observed in 30.1 % of the cases. Urinary DMH1 tract infections (UTIs) were detected in 65.9 % of females and 46.2 % of males. At least one urinary metabolic abnormality was found in 79.5 % of all the children. Most commonly seen metabolic abnormality was hypercalciuria. In all patients stones were located in kidneys except one infant who had an ureteral stone together with a kidney stone. Fifteen (16.1 %) children had an accompanying systemic disorder.\n\nAmong pediatric urinary stone diseases infantile UL can be regarded as a separate clinical entity. Coexistence of systemic disorders and anatomic anomalies at high frequencies may indicate a role of distinct pathogenetic mechanisms. In addition, high rates of UTIs and metabolic abnormalities in this age group justify screening for these parameters during follow-up of these children.”
“In conservation biology, increasing numbers of studies have focused on reproductive interference (RI) between a native species and related aliens. However, few studies have examined the frequency dependence of RI, despite of its key importance to invasiveness.

The R34W and K48R mutations were particularly intriguing mutation

The R34W and K48R mutations were particularly intriguing mutations that apparently either destabilize tetramers Bafilomycin A1 through mechanisms not probed by the univalent tetramer binding assay or represent polymorphisms rather than the pathogenic mutations responsible for observed clinical symptoms. All alpha 0 HE/HPP mutations studied here appear to exert their destabilizing effects through molecular recognition rather than structural mechanisms.”
“Objective: The aim of the study was to provide criteria that can help to distinguish between GBS-TRF

and A-CIDP in the early phase of disease.\n\nBackground: The distinction between Guillain-Barre syndrome (GBS) with fluctuations shortly after start of treatment

(treatment-related fluctuations, or GBS-TRF) and chronic inflammatory demyelinating polyneuropathy with acute onset (A-CIDP) is difficult but important because prognosis and treatment strategy largely differ.\n\nMethods: Patients with GBS(n = 170) were included in a prospective longitudinal study. Patients with GBS-TRF (n = 16) and patients with A-CIDP (n = 8) were analyzed and compared. Extended clinical Selleck IPI 145 data, biologic material, and electrophysiologic data were collected during 1 year follow-up.\n\nResults: The first TRF in the GBS-TRF group always occurred within 8 weeks (median 18 days; range 10-54 days) from onset of weakness. In the GBS-TRF group, 5 (31%) patients had a second TRF and none had more TRFs. At all timepoints, patients in the A-CIDP group were less severely affected than patients with GBS-TRF, did not need artificial ventilation, rarely had cranial nerve dysfunction, and tended to have more CIDP-like electrophysiologic abnormalities. More GBS-TRF patients were severely affected and more patients had sensory disturbances when compared Batimastat ic50 to the GBS group without fluctuations.\n\nConclusions: The diagnosis of acute-onset chronic inflammatory demyelinating polyneuropathy (CIDP) should be considered when a patient thought to have Guillain-Barre syndrome deteriorates again after 8 weeks from onset or when deterioration occurs

3 times or more. Especially when the patient remains able to walk independently and has no cranial nerve dysfunction or electrophysiologic features likely to be compatible with CIDP, maintenance treatment for CIDP should be considered. Neurology (R) 2010; 74: 1680-1686″
“The schizophrenia brain is differentiated from the normal brain by subtle changes, with significant overlap in measures between normal and disease states. For the past 25 years, schizophrenia has increasingly been considered a neurodevelopmental disorder. This frame of reference challenges biological researchers to consider how pathological changes identified in adult brain tissue can be accounted for by aberrant developmental processes occurring during fetal, childhood, or adolescent periods.

As predicted, grey mouse lemurs foraged risk-sensitively

As predicted, grey mouse lemurs foraged risk-sensitively CDK assay indicated by longer latencies to enter a feeding platform and to start feeding as well as by relatively longer feeding time compared to nonfeeding in high-risk situations. Individual differences in risk taking were repeatable and repeatability increased with increasing risk. Individual plasticity was higher for low-risk individuals providing field evidence for coping styles. There was no relationship between individual body condition and risk-taking behaviour. Finally, boldness measured in a novel object test was correlated with risk taking in a foraging task, providing a rare ecological validation for this personality

trait. These results suggest that intrinsic individual differences JNK-IN-8 in boldness need to be considered as an important source of variation when testing predictions of risk-sensitive foraging using optimality approaches. (C) 2012 The Association for the Study of Animal Behaviour. Published by Elsevier Ltd. All rights reserved.”
“Constructed wetlands (CWs) are widely used natural-like systems for wastewater treatment where organic matter is removed through carbon dioxide (CO2) emissions. Several studies have been conducted regarding emissions

and the sequestration of CO2 in CWs in the Northern Hemisphere; however, to the best of our knowledge, no studies have been performed in the Mediterranean Basin. This work quantified daily and cumulative CO2 emissions click here from a full-scale CW horizontal subsurface flow (HSSF) bed during semiarid Mediterranean spring climate conditions. The average daily CO2-C that was released in the atmosphere during the first 50 days ranged from approximately 17.5% to 32.6% of the C that was removed from wastewater. Considering both the Phragmites australis aerial part dry matter production (0.83 kg m(-2)) and the average CO2-C emissions, after 50 days of vegetative regrowth, the HSSF bed was demonstrated

to act as a CO2 sink. The cumulative CO2 efflux was 452.15 +/- 50.40 CO2 gm(-2) and 276.02 +/- 12.07 CO2 gm(-2) for vegetated and unvegetated sites, respectively. (C) 2014 Elsevier B.V. All rights reserved.”
“1. The absorption, metabolism and excretion of teneligliptin were investigated in healthy male subjects after a single oral dose of 20 mg [C-14]teneligliptin. 2. Total plasma radioactivity reached the peak concentration at 1.33 h after administration and thereafter disappeared in a biphasic manner. By 216 h after administration, bigger than = 90% of the administered radioactivity was excreted, and the cumulative excretion in the urine and faeces was 45.4% and 46.5%, respectively. 3. The most abundant metabolite in plasma was a thiazolidine-1-oxide derivative (designated as M1), which accounted for 14.7% of the plasma AUC (area under the plasma concentration versus time curve) of the total radioactivity.

Binding of these Fabs to covalently stabilized chimeric trimers o

Binding of these Fabs to covalently stabilized chimeric trimers of N-peptides of HIV1 gp41 (named (CCIZN36)(3) or 3-H) has now been investigated using X-ray crystallography, cryo-electron microscopy, and a variety of biophysical methods. Crystal structures of the complexes between 3-H

and Fab 8066 and Fab 8062 check details were determined at 2.8 and 3.0 angstrom resolution, respectively. Although the structures of the complexes with the neutralizing Fab 8066 and its non-neutralizing counterpart Fab 8062 were generally similar, small differences between them could be correlated with the biological properties of these antibodies. The conformations of the corresponding CDRs of each antibody in the complexes with 3-H and 5-Helix are very similar. The adaptation to a different target upon complex formation is predominantly achieved by changes in the structure of the trimer of N-HR helices, as well as by adjustment of the orientation of the Fab molecule relative to the N-HR in the complex, via rigid-body movement. The structural data presented here indicate that binding of three Fabs 8062 with high affinity requires more significant changes in the Rapamycin structure of the N-HR trimer compared to

binding of Fab 8066. A comparative analysis of the structures of Fabs complexed to different gp41 intermediate mimetics allows further evaluation of biological relevance for generation of neutralizing antibodies, as well as provides novel structural insights into immunogen design.”
“Background: Domperidone treatment for gastroparesis is associated with variable efficacy as well as the potential for side effects. DNA microarray single nucleotide polymorphism (SNP) analysis may help to elucidate the role of genetic variability on the therapeutic effectiveness and toxicity see more of domperidone.\n\nAim:

The aim of this study was to identify SNPs that are associated with clinical efficacy and side effects of domperidone treatment for gastroparesis from DNA microarray experiments. This will help develop a strategy for rational selection of patients for domperidone therapy.\n\nMethods: DNA samples extracted from the saliva of 46 patients treated with domperidone were analyzed using Affymetrix 6.0 SNP microarrays. Then least angle regression (LARS) was used to select SNPs that are related to domperidone efficacy and side effects. Decision tree based prediction models were constructed with the most correlated features selected by LARS.\n\nResults: Using the most stable SNP selected by LARS a prediction model for side effects of domperidone achieved (95 +/- 0)% true negative rate (TN) and (78 +/- 11)% true positive rate (IF) in nested leave-one-out tests.

Results: The postoperative decrease of AT III and the platele

\n\nResults: The postoperative decrease of AT III and the platelet count on admission to the intensive care unit (ICU) and 3 hours later were significantly less in group I. The leukocyte count and the values of CRP, PT, APTT, and PT-INR did not differ significantly

between the groups. The duration of mechanical ventilation after surgery tended to be shorter in group I.\n\nConclusions: Sivelestat significantly reduced the postoperative decreases in AT III and platelet count in patients undergoing emergency surgery for AAD.”
“Purpose: Although epinephrine is one of the most commonly used vasoconstrictor in association with local anesthesia in dentistry, systemic effects of topical admission of epinephrine for sinus augmentation have not been investigated yet. The purpose of this study was to reveal Z-IETD-FMK Apoptosis inhibitor the safety of epinephrine as a topical vasoconstrictor in sinus augmentation procedures.\n\nPatients and Methods: Forty-three healthy patients who require sinus floor augmentation for dental implant placement were included in this study. Patients were divided into 2 groups according to the application of either epinephrine-soaked selleck chemicals cottonoid or saline-soaked cottonoid for sinus

floor augmentation, and heart rate, systolic, and diastolic pressures were evaluated and compared before, during, and after the procedure.\n\nResults: Although there were changes in heart rate, systolic, and diastolic blood pressures, no statistical significance was observed for neither heart rate nor systolic and diastolic blood pressures (P > 0.05).\n\nConclusions: This study showed that the topical use of 1/100,000 epinephrine ensures efficacy by helping the clinician to elevate the sinus membrane and keeps the changes in systemic hemodynamics within safe limitations.”
“Multilayer films consisting of bovine submaxillary

mucin (BSM) and poly(allylamine hydrochloride) (PAH) were prepared on various substrates using layer-by-layer assembly. The effects of both the assembly pH and ionic strength on multilayer characteristics were investigated LY2090314 by assessing film thicknesses (10-80 nm), surface wetting characteristics, and cell repulsion. Also, the dynamic assembly behavior was monitored using quartz crystal microbalance with dissipation monitoring (QCM-D) to further understand the effect of assembly pH on film characteristics. Assembly studies revealed that substantial amounts of BSM adhere to the outermost surface only at low pH conditions. The resulting multilayer films assembled at low pH conditions were found to exhibit hydrophilic and cell repellent behavior. In addition, it was found that batch-to-batch variations of the biopolymer BSM could dramatically alter properties.


“Monoclonal antibodies (MAbs) against Vibrio vulnificus (i


“Monoclonal antibodies (MAbs) against Vibrio vulnificus (isolate I, VVC and isolate II, VVB) were raised using heat-killed and heat-killed plus SDS-mercaptoethanol treated forms of VVC and VVB for immunizing Swiss mice. Twenty three hybridomas producing MAbs against V vulnificus were selected and divided into five groups according to their specificities to different V vulnificus isolates and apparent protein antigens which ranged from similar to 3-50 kDa. Four groups were specific to V vulnificus without cross reactivity to either other Vibrio spp. or other bacterial species. In dot blot based assays, one group of MAbs were specific to VVC, with a sensitivity

of similar to 1.6 x 10(7) CFU ml(-1) (similar to 1.6 x 10(4) cells spot(-1)), and bound to proteins of similar to 50 and similar to 39 kDa. Other MAbs, binding to proteins ranging this website from similar to 3-14 and similar to 40 kDa, detected VVB (but not VVC) with high sensitivity at similar to 1.6 x 10(5) and 4 x 10(6) CFU ml(-1) (similar to 1.6 x 10(2) and 4 x 10(3) cells spot(-1)), respectively. In addition, certain MAbs were able to recognize V. vulnificus in tissues by means of immunohistochemistry. The remaining groups demonstrated cross reactivity to Vibrio fluvialis. MAbs from this study can, therefore, detect the difference between some isolates of V. vulnificus and in addition to pathogen detection may, with further antibodies, form

the basis of serovar typing isolates in the future. (C) 2008 Elsevier BTSA1 B.V.

All rights reserved.”
“Tick-borne encephalitis (TBE) virus causes severe encephalitis with serious sequelae in humans. An epizootiological survey of wild rodents is SBC-115076 mw effective to detect TBE virus-endemic areas; however, limited serological diagnostic methods are available to detect anti-TBE virus antibodies in wild rodents. In this study, ELISAs for the detection of rodent antibodies against the TBE virus were developed using two recombinant proteins, domain III of the E protein (EdIII) and subviral particles (SPs), as the antigens. As compared with the neutralization test, the ELISA using EdIII had 77.1% sensitivity and 80.0% specificity, and the ELISA using SPs had 91.4% sensitivity and 100% specificity. Furthermore, when the ELISAs were applied to the epizootiological survey in the TBE virus-endemic area, both of the ELISAs was able to detect wild rodents with TBE virus-specific antibodies. This is the first study to show that ELISAs using recombinant antigens can be safe and useful in the detection of TBE virus-infected wild rodents in epizootiological research.”
“Background: The occipitocervicopectoral flap has a local skin pedicle in the occipital region, with the distal portion of the flap in the pectoral region. One disadvantage of the occipitocervicopectoral flap is its limited flap length. To overcome this disadvantage, a perforator supercharging technique was applied to enlarge the original flap length.

Recent studies

Recent studies www.selleckchem.com/products/BMS-777607.html using better indices of obesity such as waist circumference (WC) and waist to hip ratio (WHR) have shown that high WC and WHR were directly and positively associated with higher event rate and total mortality in these patients. Because the OP could convey the wrong message in obese patients, the validity and true nature of the OP will be examined in this concise review. A Medline search of the English literature

was performed between 2000 and September 2012, and 46 pertinent articles were selected for this review. The majority of these studies do not support an OP and those that do have used almost exclusively BMI as an index of obesity. Therefore, based on recent studies using other indices of body fat distribution, such as WC and WHIR, besides BMI, the true existence of OP has been questioned and needs to be confirmed by future studies. J Am Soc Hypertens 2013;7(1):85-94.

(C) 2013 American Society of Hypertension. All rights reserved.”
“Using numerical simulations, we study the effect of disorder on the optical properties of cylindrical aggregates of molecules with strong excitation transfer interactions. The exciton states and the energy transport properties of such molecular nanotubes attract considerable interest for application in artificial light-harvesting systems and energy transport wires. In the absence of disorder, such nanotubes exhibit two optical absorption

peaks, resulting from three super-radiant exciton states, one polarized along the axis of the cylinder, the other AZD1208 manufacturer two (degenerate) polarized perpendicular to this axis. These selection rules, imposed by the cylindrical symmetry, break down in the presence of disorder in the molecular transition energies, due to the fact that the exciton states localize and no longer wrap completely around the tube. We show that the important parameter is the ratio of the exciton localization length and the tube’s circumference. When this ratio decreases, the distribution of polarization angles of the exciton states changes from a two-peak structure (at zero and ninety degrees) to a single peak determined by the orientation of individual molecules within the tube. This is also reflected FG-4592 in vivo in a qualitative change of the absorption spectrum. The latter agrees with recent experimental findings. (C) 2011 American Institute of Physics. [doi: 10.1063/1.3528993]“
“Background: Low birth weight is considered as a risk factor for increased mortality in patients for early corrective surgery in cardiac defects. Arterial switch operation is the optimal operation for neonates with transposition of the great arteries.\n\nAim: A retrospective study was undertaken to evaluate early and mid-term results of surgeries of infants with transposition of the great arteries with body weight less than 2500 g.

This rare site for AEF was diagnosed on computed tomography, and

This rare site for AEF was diagnosed on computed tomography, and we present the first case of endovascular treatment of this uncommon complication.”
“Objective: Moderate alcohol consumption appears protective against cardiovascular events and mortality in community-based

epidemiologic studies, but whether its consumption affects perioperative outcomes remains unknown. Therefore, the authors tested the hypothesis that alcohol consumption of 3 or more drinks per week improves postoperative outcomes in patients undergoing coronary artery bypass graft (CABG) surgery.\n\nDesign: A propensity-matched retrospective cohort study.\n\nSetting: Cytoskeletal Signaling inhibitor A major cardiovascular surgical institute, tertiary care teaching hospital.\n\nParticipants: Data from 13,065 patients undergoing elective CABG surgery at the Cleveland Clinic were analyzed.\n\nInterventions:

None.\n\nMeasurements and Main Results: Propensity scores were used to match alcohol users with infrequent/nonusers. From the matched subset, the relationship between alcohol use and the composite outcome (any major cardiac, renal, respiratory, infectious, or neurologic morbidity and mortality) was determined univariably with the Pearson chi-square test and multivariably using stepwise logistic regression. Estimation VX-661 inhibitor of the relationship between such alcohol use and hospital length of stay was of secondary interest. Patients who reported consuming at least 3 drinks per week experienced similar odds of the composite outcome (adjusted odds ratio [95% confidence interval] of 1.13 [0.96-1.34], p = 0.14) to infrequent or nonusers. In a secondary analysis, the hospital length

of stay was unrelated to alcohol use (adjusted hazard ratio [95% Cl] of 1.03 [0.97-1.09], p = 0.28).\n\nConclusion: The present results showed that alcohol consumption was not associated with the risk for postoperative complications in patients undergoing CABG surgery. Alcohol abusers could not be separated in this study, and, based on find more previous literature, this result might not be applied to them. (C) 2010 Elsevier Inc. All rights reserved.”
“Investigations of individual variability have allowed us to reveal the crucial (=nodal) stages in embryogenesis of the moor frog (Rana arvalis Nills.). These crucial stages are: the late gastrula stage (stages 1820), the hatching stages (stages 32-33) and, apparently, early metamorphosis (stage 39). Moreover, we have found that each embryonic structure passes through its specific crucial stages. For example, stage 34 is crucial for the trait “tail width” but is internodal for all other embryonic traits. At this stage, larva passes from an attached to a free-swimming life style. We also found considerable differences between the different frog populations in the the level of developmental variability. These differences were associated with internodal developmental stages.

A total of 18 mtTFA SNPs specific to patients with AC with freque

A total of 18 mtTFA SNPs specific to patients with AC with frequencies >10% were identified. Two were located in the coding region and 16 were identified in non-coding regions. Conversely, there were five SNPs that were only BIX 01294 in vivo present in patients with AC and normal subjects and had a frequency >10%. In

the AC group, the hepatic mtTFA mRNA and protein levels were significantly lower than those in the other two groups. Moreover, the hepatic mtDNA copy number was significantly lower in the AC group than in the controls and alcoholics without AC. Based on these data, we conclude that AC-specific mtTFA SNPs may be responsible for the observed reductions in mtTFA mRNA, protein levels and mtDNA copy number and they may also increase the susceptibility to AC.”
“Almost all small animal SPECT is performed with pinhole collimators (PH), including single-PH (SPH) and multi-PH (MPH). In the clinical study, not only PH but also parallel-hole collimator (PAH) is often used in planar

and SPECT imaging. However, there have been no comparative studies on image quality with various collimators on the small animal imaging. This study compared the basic characteristics of PH and PAH in small animal imaging.\n\nPerformance of planar and SPECT images was evaluated using (TcO4)-Tc-99m (-) and SPH, MPH and PAH with low energy and high resolution on the SPECT/CT scanner FX3200. We measured sensitivity, resolution, concentration linearity and uniformity. Planar imaging of mice with Tc-99m-labeled mercaptoacetyltriglycine (Tc-99m-MAG(3)) was performed using SPH and PAH. SPECT imaging with Tc-99m-methylene diphosphonate 4EGI-1 (Tc-99m-MDP) was performed using all collimators.\n\nWith SPH, MPH and PAH, sensitivity was 43.5, 211.2 and 926.5 cps/MBq, respectively, 5-Fluoracil mouse and spatial resolution was 0.60/0.56, non/0.96, 5.20/5.34 mm full-width half maximum

(planar/SPECT), respectively. There were marked correlations between the radioactivity counts on images and radioactivity with all collimators. Values of % standard deviation on planar imaging showed small differences between the SPH and PAH, while the values were the smallest on SPECT imaging with MPH. On imaging of mice, SPH yielded high-quality Tc-99m-MAG(3)-planar images when compared with PAH. MPH yielded sharper Tc-99m-MDP-SPECT images than SPH and PAH.\n\nThe characteristics of PH and PAH differed on small animal imaging. Although sensitivity was higher with PAH, PH showed higher resolution. Among the PH collimators, SPH was more appropriate for planar imaging, and MPH was more suitable for SPECT imaging in a small animal imaging scanner with CZT detector.”
“Background: Depression has been found to be a predictor of rehospitalization and mortality in heart failure (HF). Parathyroid hormone (PTH) is a novel promising biomarker that can predict hospitalization, functional status and mortality in HF.

e , laccases, were immobilized onto silica nanoparticles The res

e., laccases, were immobilized onto silica nanoparticles. The resulting nanobiocatalyst produced at kilogram scale was demonstrated to possess a broad substrate spectrum regarding the degradation of recalcitrant pollutants. This nanobiocatalyst was applied in a membrane reactor at technical scale for tertiary wastewater treatment. The system efficiently removed BPA and the results of long-term

field tests illustrated the potential of fumed silica nanoparticles/laccase composites for advanced biological wastewater treatment.”
“Aims: The aim of this study was to evaluate the potential role of laparoscopic appendicectomy in reducing morbidity and length of stay in children compared to open procedures in a UK District General Hospital setting. Methods: A three-year retrospective review of children smaller than = 15 years with histologically confirmed appendicitis AZD6738 who underwent laparoscopic (LA) and/or open (OA) appendicectomy was performed. Choice of operation

was based on individual surgeon’s preference and on patient’s body size. Data collected included rate of histologically complicated appendicitis, post-operative length of stay (LOS), and collective and differential morbidity rates, i.e., Lapatinib wound infection, intra-abdominal collection, and ileus. Chi-square and Mann-Whitney tests were used for statistical analysis. P smaller than 0.05 was regarded as significant. Results: Eighty children (70% male) were identified at median age 11 (3-15) years. They could be divided into complicated (n = 18, 22%) and simple appendicitis (n = 62, 78%). Appendicectomy was performed in all as an OPEN (n = 53, 66%) or LAPAROSCOPIC (n = 27, 34%) procedure. Both groups were comparable in gender distribution (P = 0.11)

and rate of complicated appendicitis (30% vs. 19%, respectively; P = 0.27). Median age was significantly lower in the OPEN group [10 (3-15) vs. 12 (7-15) years; P smaller than 0.004]. Laparoscopic appendicectomy had a significantly lower rate of collective morbidity (3.8% vs. 25.9%; P smaller than 0.003), including lower rate of intra-abdominal collection (1.9% vs. 14.8%; P smaller than 0.01). Median LOS was not significantly different (1 day vs. 2 days; selleck chemical P = 0.14). Conclusion: Laparoscopic appendicectomy in children in a UK District General Hospital is safe and was associated with significantly less post-operative morbidity than the open technique. (C) 2014 Published by Elsevier Inc.”
“Flagella, the helical propellers that extend from the bacterial surface, are a paradigm for how complex molecular machines can be built outside the living cell. Their assembly requires ordered export of thousands of structural subunits across the cell membrane and this is achieved by a type Ill export machinery located at the flagellum base, after which subunits transit through a narrow channel at the core of the flagellum to reach the assembly site at the tip of the nascent structure, up to 20 mu m from the cell surface.