Basal cell carcinoma histopathologic upgrading and Mohs micrographic surgery: a single institution, retrospective review.

Basal cell carcinoma (BCC) histopathology can differ between original biopsy and wide local excision or Mohs micrographic surgery (MMS). We aimed to analyze the rate of difference in BCC subtypes between the original biopsy and MMS frozen section to determine the rate of histopathological upgrading and also to identify risk factors for upgrading. A single institution, retrospective cohort study of patients with BCC treated with MMS was performed at the University of Texas Southwestern. Screening criteria identified 3235 BCCs. Of these, 1289 tumors were identified as having lower-grade pathology on initial biopsy. 291 (22.6%) of the lower-grade pathology tumors were upgraded to a higher-grade pathology. Tumors with an upgraded pathology had significantly greater number of stages performed [mean of 2.5 vs 2.3, p < 0.001], pre-operative size [median of 1.0 cm vs 0.8 cm, p < 0.001], and post-operative size [median of 2.0 cm vs 1.7 cm, p < 0.001]. These tumors were significantly more likely to require more advanced repairs [36.8% (107/291) vs 29.8% (297/998), p = 0.03] and be referred for post-operative radiation [1.7% (5/291) vs 0.0% (0/998), p < 0.001]. In addition, there were a significantly greater number of tumors considered recurrent (received prior surgical or non-surgical treatment) in the upgraded pathology group [8.6% (25/291) vs 3.9% (39/998), p < 0.01]. Our study highlights that a significant proportion of these patients are under-graded on initial biopsy and would benefit from more definitive intervention, such as MMS.

To breed or not to breed: physiological correlates of reproductive status in a facultatively biennial iguanid.

It is unusual for seasonal breeders to frequently skip opportunities for reproduction. We investigated the relationship between physiological state and reproductive decision-making in Galápagos marine iguanas (Amblyrhynchus cristatus), a species in which females typically reproduce biennially, although the proportion of breeding individuals varies significantly across years. Nearly all adult-sized females initiated follicular development prior to the lekking period, but 38% of females resorbed all developing follicles 5-15 days before the start of copulations. Receptive and non-receptive females differed in reproductive hormones during the mate choice period. Testosterone peaked in receptive females immediately prior to copulation, indicating that testosterone or its derivative estradiol likely mediates female receptivity in Galápagos marine iguanas. Non-receptive females showed significant peaks in both testosterone and progesterone during follicular atresia, suggesting that these hormones may be involved in inhibiting vitellogenesis. Two to three weeks prior to the period of reproductive decision-making (and the onset of follicular atresia in non-receptive females) receptive females were in higher body condition, were developing larger follicles, and had lower levels of both baseline and stress-induced corticosterone. Reproduction is extremely costly in this long-lived species, and increases the likelihood of mortality in the year following breeding; females could therefore gain significant benefits from being attuned to indicators of reproductive success. We suggest that corticosterone may modulate reproductive decisions by altering individual sensitivity to both internal and external cues of the likelihood of successful reproduction.

Exogenous and endogenous corticosterone alter feather quality.

We investigated how exogenous and endogenous glucocorticoids affect feather replacement in European starlings (Sturnus vulgaris) after approximately 56% of flight feathers were removed. We hypothesized that corticosterone would retard feather regrowth and decrease feather quality. After feather regrowth began, birds were treated with exogenous corticosterone or sham implants, or endogenous corticosterone by applying psychological or physical (food restriction) stressors. Exogenous corticosterone had no impact on feather length and vane area, but rectrices were lighter than controls. Exogenous corticosterone also decreased inter-barb distance for all feathers and increased barbule number for secondaries and rectrices. Although exogenous corticosterone had no affect on rachis tensile strength and stiffness, barbicel hooking strength was reduced. Finally, exogenous corticosterone did not alter the ability of Bacillus licheniformis to degrade feathers or affect the number of feathers that failed to regrow. In contrast, endogenous corticosterone via food restriction resulted in greater inter-barb distances in primaries and secondaries, and acute and chronic stress resulted in greater inter-barb distances in rectrices. Food-restricted birds had significantly fewer barbules in primaries than chronic stress birds and weaker feathers compared to controls. We conclude that, although exogenous and endogenous corticosterone had slightly different effects, some flight feathers grown in the presence of high circulating corticosterone are lighter, potentially weaker, and with altered feather micro-structure.