1.Influence of Incidental Pulmonary Nodules on Surgical Decision-Making in Thyroid Cancer: a Nationwide Survey
Ja Kyung LEE ; Sukmin YUN ; Eunji KIM ; Yoon KONG ; Hyeong Won YU ; Min Joo KIM ; Jae Hoon MOON ; June Young CHOI
International Journal of Thyroidology 2026;19(1):68-77
Background and Objectives:
The clinical significance of incidental pulmonary nodules detected during thyroid cancer evaluation remains unclear. This study aimed to investigate how such findings affect surgical decisionmaking and whether management differs by physician characteristics.
Materials and Methods:
A web-based survey was distributed to 722 active members of the Korean Thyroid Association in March 2025. Eligible participants included board-certified endocrinologists, endocrine surgeons, and otolaryngologists actively treating thyroid cancer. The questionnaire included clinical scenarios featuring incidental lung nodules found during thyroid cancer work-up, with respondents asked to choose preferred surgical extent (thyroid lobectomy vs. total thyroidectomy) and management approaches.
Results:
Out of 72 physicians who completed the survey, half (n=36, 50.0%) of the respondents answered that the presence of incidental lung nodules could influence their decision on thyroidectomy extent. Among those influenced by lung nodules, 86.1% recommended total thyroidectomy in patients with high- or intermediate-risk thyroid cancer, while 11.1% would do so for all thyroid cancer patients.Endocrinologists, compared to surgeons, were more likely to choose total thyroidectomy in patients with preoperative incidental lung nodules (78.3% vs. 36.7%, p=0.001).
Conclusion
Incidental lung nodules may influence surgical planning in clinicians due to the risk of micrometastasis from thyroid cancer. Endocrinologists tend to favor a more extensive surgical approach compared to surgeons, reflecting greater concern for potential metastatic disease. These findings underscore the need for multidisciplinary consensus guidelines for the management of incidental pulmonary nodules in thyroid cancer patients.
2.Analysis of the distribution and association of periodontal disease-causing bacteria in saliva according to the severity of periodontitis in the elderly in some communities
Sukmin LEE ; Yun-Sook JUNG ; Keun-Bae SONG ; Youn-Hee CHOI
Journal of Korean Academy of Oral Health 2020;44(4):240-245
Objectives:
Periodontitis-causing microorganisms and their virulence factors can provoke periodontal destruction in the host. This study was aimed at evaluating the distribution of periodontal disease and its relationship with 11 periodontal disease-causing bacteria in the elderly.
Methods:
Individuals aged 60 years or above were recruited after obtaining informed consent. The clinical attachment loss was measured at studied sites to determine the severity of periodontitis. Further, the stimulated salivary samples were collected and analyzed with real-time polymerase chain reaction to detect 11 strains of periodontitis-causing bacteria.
Results:
The severity of periodontal disease was proportional to the amount of periodontal diseasecausing bacteria. Porphyromonas gingivalis in the red complex increased from 6.60±5.50 in stage 1 to 5.36±5.39 in stage 2 and 7.19±5.56 in stage 3 (P=0.003). Tannerella forsythia increased from 6.54±4.60 in stage 1 to 7.44±4.56 in stage 2 and 8.49±4.70 in stage 3 (P=0.007).
Conclusions
The presence of complex bacterial groups and their number of strains were high in participants with severe periodontitis. Controlling periodontitis-related bacteria is important for periodontal health in the elderly.

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