Scopus 2024
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Item Metadata only Parental Absence, Family Environment, and Adolescents’ School Performance: Evidence from the Three Southernmost Provinces of Thailand1(2024-12-01) Jampaklay A.; Lucktong A.; Vapattanawong P.; Tangchonlatip K.; Yakoh K.; Chamratrithirong A.; Ford K.; Jampaklay A.; Mahidol UniversityThe impact of parental absence on children remains inconclusive and needs more contextualized research. This analysis examines the impact of parental absence on adolescents’ school performance and whether the impact can be explained by the family environment. The outcome is measured using adolescents’ assessment of their school performance compared with their classmates. The parent-adolescent living arrangement is classified as the adolescents living with both parents, with only the mother, and without the mother. We measure family environment using the family function (APGAR), parental/carer monitoring, and the parent-adolescent relationship. We used data from a household survey conducted in 2021 in Thailand’s three southernmost provinces where migration of young people to Malaysia is common. The sample includes 358 adolescents aged 13–17 years old and currently in school. Findings show significant negative though indirect impacts of maternal absence on the adolescents’ school performance. Also, the significant impact of maternal absence is mediated by the family environment, particularly family function. Significant evidence of the effect of family environment on adolescents’ academic outcome, net of the parent-adolescent living arrangements particularly parent/carer monitoring, is highlighted.Item Metadata only IMPACT OF BASIN AMPLIFICATION FACTORS ON THE PSHA ANALYSIS IN THE CHIANG MAI BASIN (THAILAND)(2024-01-01) Ornthammarath T.; Warnitchai P.; Poovarodom N.; Ornthammarath T.; Mahidol UniversityWe evaluate a probabilistic seismic hazard analysis (PSHA) for the Chiang Mai basin (Thailand), to assess the impact of site response characterization on hazard estimates. The effect of a basin amplification factor introduced in NGA West 2 ground motion models (GMMs) is presented based on the available shear wave velocity profile from microtremor measurement. In addition, 1D amplification related to stratigraphic conditions is considered with the associated uncertainties, and their impact on the hazard is analyzed through a sensitivity analysis. The results provide a good comparison between empirical GMMs and a conventional study, highlighting the importance of ground amplification effects in hazard assessment.Item Metadata only ASSESSING THE INFLUENCE OF EVACUATION SIGNAGE ON TSUNAMI EVACUATION: A CASE STUDY OF KHAO LAK, THAILAND(2024-01-01) Trumikaborworn N.; Latcharote P.; Warnitchai P.; Trumikaborworn N.; Mahidol UniversityTsunamis pose a significant threat to coastal communities worldwide and necessitate effective evacuation strategies. However, the influence of evacuation signage on tsunami evacuation needs further investigation in existing simulation studies. This research fills this gap by examining how evacuation signage influences the efficiency and effectiveness of tsunami evacuation processes. Our focus is on Khao Lak, Thailand, where the current state of evacuation signage is not adequately maintained. In this study, a case study in Khao Lak, Thailand, is conducted using agent-based modelling and simulation developed on the Unity game engine. A dynamic simulation environment is created, incorporating realistic agent behaviour, individual preferences, and physical interaction. Through the exploration of various scenarios, the influence of different signage following ratios on success rates and casualties is evaluated, taking into account the challenges posed by inadequate maintenance of existing evacuation signage. Through the analysis of simulation results, valuable insights into the role of evacuation signage in improving tsunami evacuation are expected to be gained. These insights will assist urban planners, emergency management authorities, and policy makers in the design and placement of signage systems, contributing to the development of more effective evacuation plans that consider the observed maintenance problems in Khao Lak, Thailand. Additionally, this research will make a contribution to the broader field of agent-based modelling and simulation, demonstrating the applicability of Unity as a powerful platform for studying complex real-world phenomena.Item Metadata only SITE AMPLIFICATIONS OF CHIANG MAI BASIN, THAILAND FROM 1D AND 2D SITE RESPONSE ANALYSIS(2024-01-01) Jirasakjamroonsri A.; Poovarodom N.; Warnitchai P.; Ornthammarath T.; Jirasakjamroonsri A.; Mahidol UniversityChiang Mai, the largest city in northern Thailand and the second largest city in the country after Bangkok. The city is located on a flood plain composed of unconsolidated sediments. The city is occasionally threatened by tremors originating from nearby faults in Thailand and neighboring countries. Although ground motion amplifications have been observed, limited research studies have been conducted to comprehensively understand the seismic mitigation measures required for the area, particularly regarding site effects. This study aims to investigate seismic site effects in Chiang Mai basin and analyze site response in central part of Chiang Mai basin using differences 1-dimensional (1D) soil model. An approximately 140 sites distributed across the center of the basin, covering an area of approximately 1,500 sq.km, were investigated by microtremor observations and 50 sites for site response analysis. The first part, microtremor observations using the Centerless Circular Array (CCA) method was conducted to estimate phase velocity dispersion curves and derive shear wave velocities (Vs) profile through inversion analysis. The findings from this part provide information of average Vs from the surface to 30-m depth (Vs30) and estimated Quaternary sediment thickness. The second part, site response analysis using 1D soil model was involved to examine site amplification. Ground motions obtained from Probabilistic Seismic Hazard Assessment were input as rock outcrop acceleration, and their propagation through the 1D soil models was analyzed using an equivalent linear analysis. From the strong motion database, motions with the same mechanism of occurrence were selected and scaled to match response spectra with the conditional mean spectrum (CMS) at periods of 0.2, 0.5, 1.0, 1.5, 2.0, and 3.0 seconds, corresponding to a return period of 2475 years. The average spectral accelerations were then used to evaluate the Maximum Credible Earthquake (MCE) design spectrum for each site. Finally, this study presents a comparison between site amplification from 1D and 2D soil models and provides recommendations for site response analysis in irregular basins. This study is expected to significantly contribute to enhancing our understanding of seismic site effects in the Chiang Mai basin. Furthermore, it would provide invaluable insights that can guide the implementation of appropriate measures to effectively mitigate earthquake hazards in the region.Item Metadata only THE EFFECT OF FAR-FIELD EARTHQUAKES ON THE BEHAVIOUR OF SHALLOW TUNNELS IN STRUCTURED CLAYS(2024-01-01) Cabangon L.T.; Elia G.; Rouainia M.; Keawsawasvong S.; Ornthammarath T.; Cabangon L.T.; Mahidol UniversityFar-field earthquakes are typically characterised by their low peak ground acceleration, peak ground velocity and Arias intensity, having far lower damage potential than near-field signals. In places like Bangkok and Singapore, where known active seismic faults lie at considerable distance, the effects of far-field earthquakes on tunnels are frequently ignored. However, far-field motions have relatively longer duration and a greater probability of containing long-period waves which can result in a higher response in the low-frequency region of the acceleration spectrum. When thick layers of structured clay deposits, such as those found in Bangkok, are subjected to far-field earthquakes, they can significantly amplify a long-period ground motion. This can result in large ground deformations and generate high shear strains, which in turn induce large forces in geotechnical structures such as tunnel linings. In this paper, a set of two-dimensional finite element simulations have been conducted to predict the behaviour of a shallow tunnel built in a thick Bangkok soft clay deposit and subjected to both far-field and near-field earthquake motions. A kinematic hardening model developed for natural clays has been used to capture the essential features of the dynamic soil behaviour. The results clearly demonstrate that, despite having less intensity, a far-field, long-period, long-duration earthquake can induce equally destructive forces in the tunnel lining as those generated by a strong, near-field, short-duration motion. This highlights the importance of considering the effects of far-field earthquakes in designing seismic-resistant shallow tunnels in soft clays and reduce the risk of geotechnical infrastructure systems.Item Metadata only SEISMIC FRAGILITY OF BUILDINGS DAMAGED BY THE 2014 NORTHERN THAILAND EARTHQUAKE(2024-01-01) Ornthammarath T.; Chua C.T.; Foytong P.; Suppasri A.; Ornthammarath T.; Mahidol UniversityOn 5 May 2014, a 6.1-Mw earthquake struck the Mae Lao region in Thailand and resulted in the evacuation of all public structures in the epicentral area due to varying degrees of structural and nonstructural damage. This study reports the damage sustained by public buildings in the epicentral area based on postseismic surveys and data gathered from the local official database. Using these damage observations, fragility functions are then derived for public buildings, that is, temples and community health centers, and compared with fragility functions developed for residential buildings damaged in the same area. This earthquake provided several important lessons related to nonstructural damage to local community health centers and temples within the epicentral region. The failure of nonstructural components could lead to serious injuries and casualties. This study has also shown that poor seismic performance of local temples could be expected with moderate ground shaking. Findings in this study could be useful for developing appropriate strategies to ensure safety of local communities for moderate earthquakes for similar structures within the Indochina region in the future.Item Metadata only RAPID STRUCTURAL IDENTIFICATION OF EXISTING BUILDINGS SUBJECT TO EARTHQUAKE GROUND MOTION: THE CASE STUDY OF CHIANG MAI AND CHIANG RAI(2024-01-01) Warnitchai P.; Poovarodom N.; Ornthammarath T.; Warnitchai P.; Mahidol UniversityIn the current research project, three work packages have been adopted. Firstly, ambient vibration measurements have been performed in a number of buildings in order to obtain the building's dynamic properties. Secondly, Finite Element Models have been created in order to check the inelastic properties of selected buildings for different earthquake hazard levels. Finally, a long-term structural health monitoring system using low-cost sensors will be adopted in order to monitor and validate the response of critical infrastructure as well as inform local staff and building occupants of earthquake impact in real-time warning..Item Metadata only Genomic alteration in sporadic adolescent and young adult-onset colorectal adenocarcinoma.(2024-01-20) Korphaisarn K.; Sakornsakolpat P.; Pongpaibul A.; Roothumnong E.; Thongnoppakhun W.; Akewanlop C.; Pithukpakorn M.; Korphaisarn K.; Mahidol University154Background: Colorectal cancer (CRC) incidence is increasing in adults younger than 50 years. This study evaluated genomic alteration in adolescent and young adult (AYA)-onset sporadic CRC patients who aged between 15 and 39 years. Methods: DNA from 90 archived formalin-fixed, paraffin-embedded (FFPE) tissue samples that histologically confirmed adenocarcinoma with proficient mismatch repair tumors at Siriraj Hospital (Bangkok, Thailand) were extracted. Patients who clinically suspected familial adenomatous polyposis were excluded. Gene mutational analysis was performed by next-generation sequencing (NGS) using an Oncomine Comprehensive Assay Plus kit (Thermo Fisher Scientific, Inc., Waltham, MA, USA) and compared with previous reported molecular data in adult-onset CRC from our group. Results: The top 5 mutations frequency observed were TP53, KRAS, FBXW7, PIK3CA, and SMAD4 mutations which were comparable to what reported in adult-onset CRC. However, FBXW7, PIK3CA, NOTCH1, FGFR3, ERBB2, and PTEN were reported more frequent in AYA group. No difference in number of KRAS, NRAS, and BRAF mutations among 2 groups. Table below shows key cancer genes mutation frequencies. Conclusions: This study is the comprehensive report hotspot mutations using NGS in sporadic AYA-onset sporadic CRC patients. The most commonly identified gene mutation frequencies among AYA-onset were similar to those reported in adult-onset, except for FBXW7, PIK3CA, NOTCH1, FGFR3, ERBB2, and PTEN mutations that had a slightly higher frequency. Further studies on larger sample set for genetic and epigenetic landscape are required. [Table presented]Item Metadata only Revitalizing the state of primary healthcare towards achieving universal health coverage in conflict affected fragile northeastern Nigeria: Challenges, strategies and way forward(2024-12-01) Musa S.S.; Ibrahim A.M.; Ogbodum M.U.; Haruna U.A.; Gololo A.A.; Abdulkadir A.K.; Ukaegbu E.; Agyapong J.; Shallangwa M.M.; Adamu N.A.; Muhammad B.A.; Lucero-Prisno D.E.; Musa S.S.; Mahidol UniversityThe Alma-Ata Declaration of 1978 defined primary healthcare as a critical way to obtain universal health care and 'health for all.' In Nigeria, the National Health Policy (NHP) and the subsequent formation of the Primary Health Care (PHC) system aim to modernize healthcare delivery, at the grassroots level. In recent decades, however, the status of primary healthcare in Nigeria, particularly in the northeastern region, has significantly deteriorated, further posing significant threats to health equity and universal access to healthcare. Armed conflicts, humanitarian crises, insufficient finance, inadequate infrastructure, and labor shortages have negatively impacted the region's PHC facilities. This article discusses the poor state of primary healthcare in northeastern Nigeria and its implications for achieving universal health coverage in the region. In addition, the article elaborates on the historical context, highlights the difficulties and challenges in the development of primary healthcare, and explores potential solutions to improve the system.Item Metadata only Enhancing primary healthcare delivery in Nigeria through the adoption of advanced technologies(2024-12-01) Umar A.B.; Sani S.K.; Aliyu L.J.; Hassan M.; Imam M.; Haruna U.A.; Ibrahim A.M.; Lucero-Prisno D.E.; Umar A.B.; Mahidol UniversityEnhancing primary healthcare delivery in Nigeria by adopting advanced technologies holds substantial promise for improving healthcare accessibility, quality, and efficiency. Primary healthcare focuses on community-based, essential care that is practical, socially acceptable, and affordable. Despite efforts to improve healthcare delivery, challenges persist, particularly in rural and underserved areas. The aim of this study was to explore the transformative potential of technologies such as telemedicine, electronic health records (EHRs), health information systems (HIS), artificial intelligence (AI), and medical drones in addressing these challenges. Telemedicine facilitates access to healthcare in remote areas by overcoming geographical barriers. EHRs streamline administrative and clinical processes, enhancing patient care and safety. HIS improves data management, patient safety, and provider communication. AI revolutionizes diagnostics, treatment personalization, and operational efficiency. Medical drones offer innovative solutions for delivering medical supplies to remote locations. The paper also addresses the challenges associated with these technologies, including infrastructure limitations, regulatory issues, and data privacy concerns. Recommendations include investing in infrastructure, developing regulatory frameworks, building capacity, fostering public-private partnerships, engaging communities, and implementing robust data security measures. By addressing these recommendations, Nigeria can leverage advanced technologies to enhance healthcare delivery and achieve better health outcomes.Item Metadata only Kaempferia noctiflora var.Thepthepae (Zingiberaceae), a New Taxon from Thailand(2024-03-07) Nopporncharoenkul N.; Jenjittikul T.; Somnoo T.; Meewasana J.; Tanming W.; Nopporncharoenkul N.; Mahidol UniversityTaxonomic study of Kaempferia subgen. Protanthium (Zingiberaceae) is difficult due to a high degree of intraspecific morphological variation in several species and the implied morphological overlap among the currently recognized species. Herein, we clarify the taxonomic circumscription of K. noctiflora, a rare species endemic to Chiang Mai Province (N Thailand), by describing K. noctiflora var.Thepthepae Noppornch. & Somnoo, var. nova. It differs from K. noctiflora var. noctiflora especially by the labellum colouration and flowering time. The diagnostic characters of this novel variety are discussed and compared with those of morphologically similar taxa. Images of the plants, habit and dissected flowers, and information on the phenology, distribution and ecology are provided. Kaempferia noctiflora var. noctiflora and var.Thepthepae are considered Vulnerable and Endangered, respectively.Item Metadata only Historical Legends of the Buddha in the Region of Bongabhumi(2024-01-01) Chowdhury S.B.; Chowdhury S.B.; Mahidol UniversityIn the region of Bongabhumi, Buddhism has an extensive tradition of elegance, history, and heritage from over 2,600 years ago. This chapter centers on the Buddha’s footprint in the soil of ancient Bongabhumi, revealing a connection between the Buddha and the people of ancient Bengal from its inception. Additionally, it focuses on two historical Buddhist pilgrimage sites: Chakrashala Phratara Cetiya and Ramu Rangkut Banasram Bouddho Bihar of Bangladesh. To clarify the historical legend of Buddhism in the region of Bongabhumi, this chapter also discusses Buddhist transmissions in the Bengal Delta up to the modern period, as well as illustrates how Buddhist communities and their contemporary practices express lived Buddhism in Bongabhumi.Item Metadata only Burmese American Youth Experiences with Theravada Buddhism in the San Francisco Bay Area(2024-01-01) Saruya R.; Saruya R.; Mahidol UniversityHow do children and young people in the Burmese diaspora learn Buddhism? What strategies do teachers use? And how do the students themselves view their experiences? This chapter attempts to answer these questions through the cases of two young lay females who both had short-term but highly impactful experiences: one as a temporary nun, and the other as a repeat attendee at a Buddhist youth camp. These experiences are contextualized, in the first instance with descriptions of the monastic space and the Burmese-language classes that prompted the subject’s choice of monastery, and in the second, with the history of the camp and exploration of its monastic spaces. In both these cases, Buddhism was not always taught directly by monks; that is, while they physically recalled the Buddha and Buddhism in terms of aesthetics, comportment, and the practice of sīla or “morality,” they were not usually the ones teaching Buddhism in the strictest sense. Thus, this research demonstrates the importance of studying lived Buddhism and how the laity—and especially the female laity—serve as active agents in the maintenance of Burmese Buddhism, and of Burmese culture more generally.Item Metadata only One Health Implementation Cycle, Stakeholder Analysis and Engagement(2024-01-01) Rüegg S.R.; Traore T.; Pettan-Brewer C.; Figueroa D.; Becerra N.C.; Ormea V.; Ratanakorn P.; Plangsangmas T.; Queenan K.; Häsler B.; Maassen C.B.M.; Thys S.; Rüegg S.R.; Mahidol UniversityThe chapter introduces the One Health implementation cycle with all steps that occur during the implementation of a project or policy. We start with an introduction to the implementation of activities in socio-ecological systems (SES), which are, by definition, complex and dynamic. We then explore the kind of challenges we encounter in SES and how these determine the importance of engaging stakeholders in the problem statement, in the understanding of the SES itself and in the co-production of solutions. The cycle starts with stating the problem in an inclusive way and exploring the stakeholders systematically, to leave no one behind. Then, we start a community of practice by co-producing a common understanding of the SES and the challenge. We then reach out and will discover what conflicting perspectives and interests we may encounter and how to deal with them to align behind a common theory of change. This forms the basis for other parts in the implementation cycle, which are covered in Chapters 11, 12 and 13.Item Metadata only Racial disparities in the immunotherapeutic outcomes of patients with non-small cell lung cancer (NSCLC): An in-depth systematic review and meta-analysis(2024-01-01) Wannaphut C.; Saowapa S.; Polpichai N.; Wattanachayakul P.; Lalitnithi P.; Tanariyakul M.; Siladech P.; Wannaphut C.; Mahidol UniversityBackground: The utilization of immunotherapy has become prevalent in the therapeutic approach to non-small cell lung cancer (NSCLC), owing to its association with enhanced survival outcomes. Nevertheless, a notable gap exists in the available information regarding potential variations in the survival benefits of immunotherapy based on the racial demographics of NSCLC patients. Methods: A systematic search for articles published until January 2023 was performed on PubMed, EMBASE, and Google Scholar databases. Articles that aligned with the research objective were included, while non-English articles, case reports, conference abstracts, studies combining immunotherapy with other cancer therapies, and studies on small-cell lung cancer were excluded. Data required for review and analysis was independently abstracted into separate Excel files by two reviewers. Furthermore, Statistical analyses were performed using the Review Manager software, and the methodological quality evaluation was done using the Newcastle Ottawa Scale. Results: Seven cohort studies were used for review and analysis. A subgroup analysis of data from these studies showed that Black/African American and Asian NSCLC patients receiving immunotherapy had improved overall survival (OS) than White patients (HR: 0.84; 95% CI: 0.75 – 0.95; p = 0.006 and HR: 0.53; 95% CI: 0.30 – 0.93; p = 0.03, respectively). However, the difference in OS is statistically insignificant when Hispanic patients are compared with white patients (HR: 0.68; 95% CI: 0.46 – 1.00; p = 0.05). On the other hand, the subgroup analyses did not demonstrate any significant difference in progression-free survival (PFS) when comparing Black/African American, Asian or Hispanic patients to White patients (HR: 0.93; 95% CI: 0.79 – 1.09; p = 0.35, HR: 0.89; 95% CI: 0.51 – 1.55; p = 0.69, and HR: 1.01; 95% CI: 0.82 – 1.23; p = 0.96, respectively). Conclusions: Among non-small cell lung cancer (NSCLC) patients undergoing immunotherapeutic interventions, it is discerned that Black/African American and Asian individuals exhibit superior overall survival (OS) outcomes compared to their White counterparts. However, it is noteworthy that the observed racial disparity does not appear to exert a discernible influence on the progression-free survival (PFS) of NSCLC patients subjected to immunotherapy. Research Sponsor: None.Item Metadata only Child sexual abuse/exploitation and LGBTQI+ children: Context, links, vulnerabilities, gaps, challenges and priorities(2024-04-01) Capaldi M.; Schatz J.; Kavenagh M.; Capaldi M.; Mahidol UniversityChild sexual exploitation and abuse (CSEA) is a pervasive issue affecting children globally, cutting across socio-economic, ethnic, and cultural lines. While much research has historically emphasized the victimization of girls, emerging studies highlight the vulnerability of boys and underscore the neglected intersections of CSEA with LGBTQI+ statuses. LGBTQI+ youth are particularly susceptible to CSEA due to societal discrimination, stigmatization, and biases stemming from socio-cultural, religious, and family contexts. Notably, transgender children and youth face exacerbated risks, marked by alarming rates of stigma, violence, and discrimination, often termed transphobia. From an examination of the academic, evidence-based literature, this discussion paper sheds light on harmful cultural practices (such as the ‘dancing boys’ of South Asia who may exhibit feminine characteristics and are frequently exposed to the risk of sexual violence); myths (surrounding homosexuality); religious doctrines (which generally approach these issues within a discourse of morality and sin); and socio-ecological factors that collectively increase the risk of CSEA for LGBTQI+ children - with a focus on the developing world. Furthermore, while the socio-ecological and resilience frameworks offer promising avenues for understanding and addressing these vulnerabilities, glaring data gaps persist, especially beyond developed countries. The paper concludes with identifying the compelling need for robust research and a comprehensive understanding of how CSEA impacts LGBTQI+ children worldwide, which can guide targeted interventions and support.Item Metadata only Resolution of optic neuritis and probable multiple sclerosis after long-term ingestion of very high doses of vitamin D3: A case report(2024-12-01) Charoenngam N.; Holick M.F.; Charoenngam N.; Mahidol UniversityA 36-year-old male presented with 2 months of left-eye visual disturbance and was diagnosed with optic neuritis due to probable multiple sclerosis (MS). He was advised to undergo periodic ophthalmology follow-up without immunosuppressive treatment. Due to persistent symptoms, he expressed interest in very high-dose vitamin D3 therapy of 54,000 IUs/day (1,000 IUs/kg/day) along with a zero-calcium diet. After starting the therapy, he experienced sustained symptomatic improvement of visual symptoms over 4 years, along with radiological stability of the optic neuritis lesion without developing hypercalcemia. This case supports the potential therapeutic efficacy of very high-dose vitamin D for MS.Item Metadata only General Characteristics of Eastern Indonesian Household Dietary Diversity Score(2024-08-01) Maretalinia; Suryani D.; Angriani Y.; Maretalinia; Mahidol UniversityHousehold dietary diversity score (HDDS) is a crucial indicator of food security and nutritional outcomes. The data collection was done from 2017 to 2018 in Eastern Indonesia. This study aimed to capture the characteristics of HDDS based on district, province, religion, and head of household age. This study used secondary data from the Coastal Community Development Project (CCDP), IFAD Impact Assessment Survey 2018. The total sample of this study was 2,884 households. The HDDS was calculated based on the score of 12 food groups and presented in a bar graph using STATA version 17. The result revealed that the lowest HDDS was found in the Kupang district, East Nusa Tenggara Province, Confucianism or Konghucu Religion, and 15 to 25 years of head of household age. Household dietary diversity score is a critical measure of food security and nutritional status, reflecting a household's access to a variety of foods. Understanding and addressing these determinants are essential for improving household dietary diversity and ultimately enhancing nutrition outcomes.Item Metadata only Undifferentiated Pleomorphic Sarcoma with Reactive Eccrine Syringofibroadenoma: A Case Report(2024-12-01) Donsakul N.; Jerasutus S.; Tubtieng I.; Assavanatenapa R.; Vejjabhinanta V.; Donsakul N.; Mahidol UniversityUndifferentiated pleomorphic sarcoma (UPS) is an aggressive soft tissue sarcoma with a poor prognosis. The patients are usually found to have metastasis when the primary tumor is diagnosed. Eccrine syringofibroadenoma (ESFA) is a rare cutaneous adnexal lesion of eccrine duct origin. There are five subtypes, one of which is reactive ESFA, known to occur in reaction to an inflammatory or neoplastic process. In this article, we report a case of the co-existence of both UPS and ESFA in a 70-year-old male patient, presenting with a painless, erythematous, irregular surface nodule with a peripherally extended brownish hyperkeratotic plaque on the right palm. The histologic findings revealed an ill-defined dermal tumor of atypical epithelioid and spindle-shaped cells with large pleomorphic hyperchromatic nuclei and abundant eosinophilic cytoplasm. Some of those cells were multinucleated giant cells in the stroma with vascular proliferation and mixed inflammatory cell infiltrate. The tumor cells, which were only positive for vimentin, supported the diagnosis of undifferentiated pleomorphic sarcoma (UPS). Meanwhile, the overlying epidermis demonstrated hyperkeratosis, papillated epidermal hyperplasia, and proliferation of anastomosing slender cords and strands of cuboid cells within loose fibrovascular stroma. These findings are the characteristics of eccrine syringofibroadenoma (ESFA). We describe here a patient in whom reactive ESFA occurred on and surrounded the UPS tumor.Item Metadata only Ectopic Cervical Thymic Tissue Mimicking Parathyroid Hyperplasia: A Rare Occurrence Linked to Graves Disease(2024-11-01) Chatchomchuan W.; Thewjitcharoen Y.; Nakasatien S.; Suvikapakornkul R.; Keerawat S.; Himathongkam T.; Chatchomchuan W.; Mahidol UniversityThymic hyperplasia has occasionally been reported in patients with Graves disease (GD). However, ectopic cervical thymic hyperplasia in the setting of hyperthyroid GD is exceptionally rare. We describe a case of a 54-year-old Thai woman who presented with hyperthyroidism, diplopia, and pretibial myxedema. She underwent a total thyroidectomy because of diplopia caused by Graves ophthalmopathy. During the surgery, 3 macroscopically abnormal enlargements of parathyroid gland-like tissue were identified and removed. Histopathology revealed hyperplastic thymic tissue mixed with 1 normal-sized parathyroid gland at the location of the left upper parathyroid gland, and thymic tissue was found in the sample labeled as the right upper parathyroid gland. Notably, the sample labeled as the right lower parathyroid gland was actually determined to be a lymph node. Preoperative blood samples showed normal serum calcium and parathyroid hormone levels. Postoperatively, computed tomography of the chest showed thymic hyperplasia in the anterior mediastinum, which slightly regressed at the 9-month follow-up. The patient had transient hypoparathyroidism requiring oral calcium and active vitamin D supplements for 6 months postoperatively. Ectopic cervical thymic hyperplasia can be found in GD and might be indistinguishable from parathyroid hyperplasia. Biochemical evaluations are required to exclude concomitant hyperparathyroidism, and a conservative approach should be considered.