The aim to find the perfect biomaterial for spinal implant has been the focus of spinal research since the 1800s. Spinal surgery and the devices used therein have undergone a constant evolution in order to meet the needs of surgeons who have continued to further understand the biomechanical principles of spinal stability and have improved as new technologies and materials are available for production use. The perfect biomaterial would be one that is biologically inert/compatible, has a Young's modulus similar to that of the bone where it is implanted, high tensile strength, stiffness, fatigue strength, and low artifacts on imaging. Today, the materials that have been most commonly used include stainless steel, titanium, cobalt chrome, nitinol (a nickel titanium alloy), tantalum, and polyetheretherketone in rods, screws, cages, and plates. Current advancements such as 3-dimensional printing, the ProDisc-L and ProDisc-C, the ApiFix, and the Mobi-C which all aim to improve range of motion, reduce pain, and improve patient satisfaction. Spine surgeons should remain vigilant regarding the current literature and technological advancements in spinal materials and procedures. The progression of spinal implant materials for cages, rods, screws, and plates with advantages and disadvantages for each material will be discussed.

1 A double-blind, placebo-controlled, cross-over trial of quinine in leg cramps occurring at rest was conducted in 22 elderly cramp sufferers. 2 Despite demonstration of impaired quinine elimination in the elderly, prescription of the traditional dose of 300 mg quinine bisulphate at night failed to produce a significant (P = 0.1) reduction in the number or severity of cramps. 3 There was a significant relationship between serum quinine concentration and attenuation of cramps. However, the simple expedient of increasing the nightly dose of quinine may carry the concomitant risk of cinchonism.

Purpose of review The goal of this review was to compare and contrast the results and implications from several recent transcriptomic studies that analyzed the expression of lncRNAs in breast cancer. How many lncRNAs are dysregulated in breast cancer? Do dysregulated lncRNAs contribute to breast cancer etiology? Are lncRNAs viable biomarkers in breast cancer? Recent findings Transcriptomic profiling of breast cancer tissues, mostly from The Cancer Genome Atlas, identified thousands of long noncoding RNAs that are expressed and dysregulated in breast cancer. The expression of lncRNAs alone can divide patients into molecular subtypes. Subsequent functional studies demonstrated that several of these lncRNAs have important roles in breast cancer cell biology. Summary Thousands of lncRNAs are dysregulated in breast cancer that can be developed as biomarkers for prognostic or therapeutic purposes. The reviewed reports provide a roadmap to guide functional studies to discover lncRNAs with critical biological functions relating to breast cancer development and progression.

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Introduction:Emerging evidence in depression suggests that blood-brain barrier (BBB) breakdown and elevated inflammatory cytokines in states of persistent stress or trauma may contribute to the development of symptoms. Signal-to-noise ratio afforded by ultra-high field MRI may aid in the detection of maladaptations of the glymphatic system related to BBB integrity that may not be visualized at lower field strengths. Methods:We investigated the link between glymphatic neuroanatomy via perivascular spaces (PVS) and trauma experience in patients with major depressive disorder (MDD) and in healthy controls using 7-Tesla MRI and a semi-automated segmentation algorithm.Results: After controlling for age and gender, the number of traumatic events was correlated with total PVS volume in MDD patients (r = 0.50, p = .028) and the overall population (r = 0.34, p = .024). The number of traumatic events eliciting horror was positively correlated with total PVS volume in MDD patients (r = 0.50, p = .030) and the overall population (r = 0.32, p = .023). Age correlated positively with PVS count, PVS total volume, and PVS density in all participants (r > 0.35, p < .01). Conclusions:These results suggest a relationship between glymphatic dysfunction related to BBB integrity and psychological trauma, and that glymphatic impairment may play a role in trauma-related symptomatology.