Recent work indicates that both orbitofrontal cortex (OFC) and the basolateral complex of the amygdala (ABL) are involved in processes by which cues are associated with predicted outcomes. To examine the respective roles of these structures in discrimination learning, rats with bilateral sham or neurotoxic lesions of either OFC or ABL were trained on a series of four 2-odor discrimination problems in a thirst-motivated go, no-go task. After acquisition of the series of odor problems, the rats were trained on serial reversals of the final odor problem. Performance on each problem was assessed by monitoring accuracy of choice behavior, and also by measuring latency to respond for fluid outcomes after odor sampling. During discrimination learning, rats in both lesioned groups had similar deficits, failing to show normal changes in response latency during learning, while at the same time exhibiting normal choice behavior relative to controls. Choice behavior was affected only during the reversal phase of training, in which OFC and ABL lesions produced distinctive deficits. Rats with ABL lesions were impaired on the first reversal (S1−/S2+), but were unimpaired at acquiring a reversal back to the original odor-outcome contigencies (S1+/S2−), whereas rats with OFC lesions were impaired on both types of reversals. These findings suggest that OFC and ABL serve partially overlapping roles in the use of incentive information that supports normal discrimination performance.

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Objectives Current knowledge of the pulmonary pathology of coronavirus disease 2019 (COVID-19) is based largely on postmortem studies. In most, the interval between disease onset and death is relatively short (<1 month). Information regarding lung pathology in patients who survive for longer periods is scant. We describe the pathology in three patients with severe COVID-19 who underwent antemortem examination of lung tissue at least 8 weeks after initial diagnosis. Methods We conducted a retrospective case series. Results The first patient developed acute respiratory failure and was started on extracorporeal membrane oxygenation (ECMO) on day 21, with subsequent hemothorax. Debridement (day 38) showed extensive lung infarction with diffuse alveolar damage and Candida overgrowth. The second patient developed acute respiratory failure requiring mechanical ventilation that did not improve despite ECMO. Surgical lung biopsy on day 74 showed diffuse interstitial fibrosis with focal microscopic honeycomb change. The third patient also required ECMO and underwent bilateral lung transplantation on day 126. The explanted lungs showed diffuse interstitial fibrosis with focal microscopic honeycomb change. Conclusions This series provides histologic confirmation that complications of COVID-19 after 8 weeks to 4 months of severe disease include lung infarction and diffuse interstitial fibrosis.

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Background: Mixed (composite) exocrine-neuroendocrine cell carcinomas are defined as an intimate admixture of neoplastic glandular exocrine and neuroendocrine cell types. Although gastric adenocarcinoma containing a small number of neuroendocrine cells is a relatively frequent occurrence, gastric neoplasms containing equal proportions of both cell types are rare.

BACKGROUND: Ultrasound-guided fine-needle aspiration (US-FNA) cytology is a commonly used method in the surveillance of suspicious lymph nodes (LNs) in patients with papillary thyroid carcinoma (PTC). The measurement of thyroglobulin (Tg) levels in LNs during FNA has been suggested to improve the diagnosis. In the current study, the use of US-FNA-Tg in LNs that were suspicious for metastatic PTC was investigated. METHODS: A total of 208 cases from the Johns Hopkins Hospital with both US-guided FNA cytology and US-FNA-Tg measurements were included; 60 cases had follow-up surgeries performed. Tg levels were correlated with cytological and histological diagnoses. RESULTS: Of 35 cases of cytologically diagnosed metastatic PTC, 34 were confirmed by surgery. The median US-FNA-Tg concentration was 4232.7 ng/mL, whereas in 112 benign LNs the median Tg concentration was < 0.2 ng/mL (P <.0001). Receiver operating characteristic analysis (area under the curve, 0.949) demonstrated a sensitivity of 97% and a specificity of 81% at the Tg detection limit (<0.2 ng/mL), whereas cutoff values of 9.6 ng/mL to 100 ng/mL resulted in a sensitivity of 76% and a specificity of 98%. Of 15 cases with a cytological diagnosis of "suspicious for PTC," 9 cases had markedly elevated Tg levels detected on FNA. Seven of these 9 cases had follow-up surgeries confirming the diagnosis of PTC. Of 29 cases with a "nondiagnostic" cytology, 7 had markedly elevated Tg levels on FNA, with a median of 1305.5 ng/mL, and were confirmed to be metastatic PTC at surgery. CONCLUSIONS: US-FNA-Tg demonstrated a strong negative predictive value (93%-99%). It may be particularly useful for difficult cases. However, standardization of the sample collection is still needed to further improve the accuracy of the approach. Cancer (Cancer Cytopathol) 2013;121:440-8. V C 2013 American Cancer Society.

CD3ζ is a subunit of the CD3 molecule that, until recently, appeared restricted to T-cells and natural killer cells. However, experimental studies have demonstrated a role of CD3ζ in dendritic outgrowth in the visual system as well as in synaptic plasticity. Given the increasing evidence for uncharacteristic recapitulation of neurodevelopmental processes in neurodegenerative diseases, in this study, we evaluated brains from subjects with Parkinson's disease and Lewy body dementia for evidence of aberrant CD3 expression. Our data shows marked CD3ζ in association with the α-synuclein containing pathological lesions, i.e., Lewy bodies and Lewy neurites, in the brains of subjects with Parkinson's disease and Lewy body dementia. This finding raises the novel concept of CD3 dysregulation in these disorders as a pathogenic factor and also furthers the increasing evidence that the recall of aberrant neurodevelopmental processes underlies the pathogenesis of neurodegenerative diseases.