The cellular signaling pathways of the prostate play a central role in the induction, maintenance, and progression of prostate cancer (CaP). Neuroendocrine (NE) cells demonstrate attributes that suggest they are an integral part of these signaling cascades. We summarize what is known regarding NE cells in CaP focusing on NE cellular transdifferentiation. This significant event in CaP progression appears to be accelerated by androgen deprivation (AD) treatment. We examine biochemical pathways that may impact NE differentiation in a chronological manner focusing on AD therapy (ADT) as a central event in inducing androgen-independent CaP. Our analysis is limited to the common adenocarcinoma pattern of CaP and excludes small-cell and carcinoid prostatic variants. In conclusion, we speculate on the future of treatment and research in this area.

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Akt is a serine/threonine kinase mediating multiple intracellular pathways involved in prostate cancer (CaP) biology. Increased understanding of the molecular mechanisms of Akt activation and signaling have led to the development of an increasing number of Akt inhibitors. These biologic agents demonstrate activity against a wide range of cancers in preclinical studies. Clinical studies of Akt inhibition in CaP are in progress, including agents such as celecoxib, perifosine and genistein. How best to integrate Akt inhibitors with standard CaP therapy or select patients most likely to benefit is the subject of ongoing research.

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Based on our long-term clinical and angiographic results, we advocate that the presented method be a valid treatment option for selected cases.

Ventral hernia repair is frequently performed with one of a number of mesh products, usually with good results. The current emphasis on laparoscopic repair has resulted in multiple composite mesh products for use in the peritoneal cavity. The addition of a second layer of more inert material to the mesh is intended to prevent adhesions with the underlying viscera, and multiple studies demonstrate effectiveness in doing this. Despite this, occasional complications may still present. We present the case of a 65-year-old man coming to our clinic 5 years after a third ventral hernia repair/revision with composite mesh.

RC is an effective model for teaching residents. Significant and reproducible improvement can be realized with low risk of adverse outcomes.