I think everyone is stuck wondering how to make the tooltips from the tooltips paper: http://diyhpl.us/~bryan/papers2/nanotech/Optimal%20tooltip%2...
All of that was motivated by goals of making nanofactories like shown in this eye candy video: http://www.youtube.com/watch?v=vEYN18d7gHg
Because positional, precise molecular manufacturing still doesn't exist, I have been increasingly interested in using DNA synthesis (using phosphoramidite chemistry) to combinatorially build proteins that lock together in pre-defined shape based on ligand-specific binding affinities between the blocks. The Nanosystems book left out a lot of biology that can be hijacked to help out goals like these.
Long-term we might be able to coerce enzymes into creating molecular machines anyway: https://groups.google.com/group/enzymaticsynthesis