Purpose: This qualitative study examined the inner response of medical students who participated in a transgender healthcare education program. The factors that effected the inner response were investigated in order to suggest strategies for improving the effectiveness of the transgender healthcare education program.Methods: The transgender healthcare education program consisted of 2 hours of lectures and 2 hours of clinical role-play over 3 weeks. Eight 4-year medical students in Seoul, South Korea, were selected considering gender, the route of admission to medical school, and religion. Each student was interviewed individually for approximately 30 minutes 3 times before, during, and after the educational program, and interviews were analyzed using thematic analysis.Results: By attending the transgender healthcare education program, students have shown three types of inner response—confusion, acceptance, and negotiation. The students’ personal identities and professional identities influenced these responses. In particular, students’ existing professional identities motivated them to learn about transgender healthcare and played a key role in resolving the discomfort that occurred during the educational program. Through the transgender healthcare education, students were able to reduce prejudice against transgender people, understand the unique medical needs of the transgender population and increase their self-efficacy related to transgender health care.Conclusion: The transgender healthcare education program allowed medical school students to acquire medical knowledge related to transgender patients and increase their cultural competence as future medical professionals. In addition, as the professional identity is critical in educating transgender healthcare, it should be considered thoroughly in order to effectively educate the medical students.

Objectives: This study was performed to evaluate the difference of the cervical vestibular evoked myogenic potentials (cVEMP) stimulated by bone-conduction (BC) and air-conduction (AC) in patients with nonspecific dizziness.Methods: Twenty-eight dizzy patients (56 ears) and 15 subjects (30 ears) as normal control was enrolled. Responses of BC- and AC-cVEMP were recorded sequentially in both groups. cVEMP parameters including latencies, inter-latencies intervals, amplitudes, and interaural amplitude asymmetry were analyzed and compared.Results: Among the patients with nonspecific dizziness, AC-cVEMP responses were clearly detected in all 56 ears while BC-cVEMP responses were detected in 32 ears (57.1%). Amplitudes of BC-cVEMP were significantly smaller than those of AC-cVEMP in all patients with BC-cVEMP response. There was no difference in latencies, inter-latencies intervals, and interaural amplitude asymmetry ratios between BC- and AC-cVEMP. There was no significant difference in BCand AC-cVEMP between the dizzy and control groups.Conclusions: BC-cVEMP is not clinically useful in comparison to AC-cVEMP for the evaluation of nonspecific dizziness. An effective stimulation tool for BC is necessary to provoke more reliable responses of BC-cVEMP.

Basal cell adenomas (BCA) arising from the nasal cavity or paranasal sinuses are very rare. A 64-year-old male patient was suspected of having a malignant tumor after undergoing preoperative computed tomography scans and magnetic resonance imaging. The intraoperative frozen section showed a malignant tumor; however, the final diagnosis revealed BCA with atypia, tubular pattern.

Background and Objectives Despite the usually favorable prognosis of well-differentiated thyroid cancer (WDTC) following appropriate treatment, advanced T-staged WDTCs are associated with poor prognosis. This study focused on identifying genes associated with the prognosis of locally advanced WDTC by analyzing a The Cancer Genome Atlas cohort.Subjects and Method We analyzed the data of 501 patients with WDTC and classified them into two subgroups: pathological T4 stage (Cluster 1) or T1-3 stage (Cluster 2). We compared the mRNA expressions of thyroid cancer-related genes, and the somatic mutation frequencies of various cancer genes between the two subgroups.Results Cluster 1 included 23 patients (papillary=21/follicular-variant papillary thyroid cancer [FVPTC]=2) and Cluster 2 478 patients (papillary=371/FVPTC=100/others=7). Cluster 1 showed worse overall and disease-free survival than Cluster 2 (<i>p</i><0.05 and <i>p</i>=0.12, respectively). Patients with pT4 stage had about a 1.8-fold increased risk of overall recurrence or death. <i>MET, SERPINA1, TIMP1, PROS1, FN1, CDKN2A</i>, and <i>CDKN2B</i> were significantly elevated while <i>TG, DNAH9, TFF3, CRABP1, TPO, JAK2, KIT, KDR</i>, and <i>NFE2L2</i> were significantly lower in Cluster 1 (all, <i>p</i><0.05 and adjusted <i>p</i><0.05). A <i>TERT, EIF1AX</i>, and <i>ATM</i> showed significantly frequent somatic mutations in Cluster 1 when compared to Cluster 2. We also identified seven pathways related to 16 genetic markers.Conclusion Locally advanced WDTC presented 16 genetic alterations. We identified somatic mutations associated with local invasion transformation. Relevant pathways related to the 16 genetic markers could be therapeutic targets. Genetic analysis of locally advanced WDTC may be used to predict clinical applications in patient survival.

Background: Although chemotherapy-induced vocal-fold motion impairment was first reported in 1971, there are few reports. Herein, we describe a case in which life-threatening side effects occurred after injection laryngoplasty for the treatment of chemotherapy-induced vocal-fold motion impairment accompanied by dysphonia and aspiration in a patient with lymphoma.Case presentation: An 86-year-old woman with diffuse large B-cell lymphoma developed left vocal fold immobility with dysphonia and aspiration after six cycles of rituximab, cyclophosphamide, doxorubicin, vincristine, and prednisone (R-CHOP) therapy. The patient underwent injection laryngoplasty to prevent aspiration pneumonia approximately 5 h after the 7th cycle of chemotherapy. On the 3rd day after the procedure, she visited the emergency room with swelling of the anterior neck and dyspnea with stridor, which had gradually worsened since the previous day, and emergency hematoma removal was performed. On the 14th day after injection laryngoplasty, laryngeal examination performed to observe the vocal cord bruises revealed improvement of edema. Dyspnea and dysphonia observed before emergency surgery resolved completely one month after the operation.Conclusions: It is important to promptly evaluate patients with symptoms such as dyspnea and stridor after injection laryngoplasty and select a safe procedure time for patients receiving chemotherapy to avoid serious complications, such as hematomas.