Background
The relationship between clinical as well as subclinical thyroid disease and cardiovascular disease has been reported. Epidemiological evidence is accumulating that vascular risk factors increase the risk of AD. We sought to investigate the relationship between thyroid function and dementia. Methods: We examined patients who were admitted to geriatric ward of one psychiatric hospital in Kyong-Gi. The control group was individuals who underwent check up at a health promotion center of one university hospital in Daejeon. Results: The number of patients with dementia was 110. In the dementia group, there were 12 people with subclinical hyperthyroidism, 6 with subclinical hypothyroidism, and 2 with apparent hypothyroidism. After controlling for education, hypertension, diabetes and total cholesterol, multiple logistic regression yielded the odds ratio for dementia to be significantly higher in the group with low levels of thyroid stimulating hormone compared to the normal group (OR 4.00, 95% confidence interval 1.04∼15.39). Conclusion: We found a significant relationship between dementia and subclinical hyperthyroidism. (J Korean Acad Fam Med 2007;28:173-178)

Background
The purpose of this study was to find the weight-related factors related to active attitude towards weight loss in children who are overweight or obese and their parents. Methods: A total of 252 elementary school children who were overweight or obese and their parents were surveyed on weight-related attitudes for one month in May 2003 in Kimhae. The definition of overweight and obesity was based on age and sex-specific Korean children's BMI references established in 1998. Results: Among the total, 64.5% of children and 76.4% of parents thought frequently about losing weight in children. Among the total, 52.8% of children and 47.6% of parents tried losing weight in children more than three times. In children, the factors related to frequent thoughts of losing weight were gender, body mass index (BMI), body dissatisfaction index, and the score of eating attitude (P＜0.05). Parents' thought about their children's losing weight and the efforts to persuade their children to lose weight were related to children's frequent thought about losing weight. The children's factors related to trying to lose weight by themselves were age, BMI, and the score of eating attitude. The parent's factors related to children trying to lose weight were body dissatisfaction index of their children by parents, parent's eating attitude score, parent's thought about children's losing weight and making efforts to persuade children to lose weight by parents. The children's eating attitude was related to frequent thoughts about losing weight (odds ratio 1.05, 95% CI 1.03∼1.07) and trying to lose weight more than 3 times (odds ratio 1.02, 95% CI 1.003∼1.04) after adjusting for other factors. Likewise, parents' effort to persuade their childrento lose weight was related to children's effort to lose weight (odds ratio 2.62, 95% CI 1.34∼5.1). Conclusion: Active attitude towards losing weight in overweight or obese children was related to parent's attitude to wards losing weight. (J Korean Acad Fam Med 2007;28:179-186)

Background
There are incoherent studies about the effect of night shift work on circadian diurnal rhythms of cardiovascular parameters. Our study aimed to assess the alteration of circadian diurnal rhythms of cardiovascular parameters by night shift work. Methods: We studied 26 healthy nurse volunteers engaged in 3 shift work. From March 16 to April 30, 2006, ABPM (ambulatory blood pressure monitoring) was performed to each nurse two times during the day and night shift. Three nurses were excluded due to pain omdiced by ABPM. Blood pressure and heart rate was monitored every 30 minutes. Paired T-test was used for statistical analysis. Results: The mean arterial pressure, the mean systolic pressure, the mean heart rate and the mean pulse pressure during the overall period were significantly higher in the night shift than the day shift (P-value: ＜0.05, ＜0.001, ＜0.05, and ＜0.001, respectively). The mean arterial pressure, the mean diastolic pressure and the mean heart rate during in-hospital working period were significantly higher in the day shift (P-value: ＜0.05, ＜0.001, and ＜0.05, respectively). All parameters during the daytime sleep period after the night shift were significantly higher than during the nighttime sleep period after the day shift (P-values: ＜0.001). Proportional percentile falls of 3 parameters (systolic pressure, diastolic pressure, and heart rate) during the daytime sleep period after the night shift were significantly less than during the nighttime sleep period after the day shift (P-values: ＜0.001). Conclusion: The night shift work caused significant alteration in homeostasis of autonomic nervous system associated with circadian diurnal rhythms of cardiovascular parameters. (J Korean Acad Fam Med 2007;28: 187-194)

Background
Recently, the prevalence of childhood obesity has increased dramatically, but the cause still remains incompletely understood. The goal of this study was to present a direction for treatment and prevention of childhood obesity on the basis of the data of physical activity energy expenditure, inactive time and dietary habits of Korean children. Methods: A total of 56 children were selected from 8 elementary schools in Seoul and Gwacheon-city. Children's physical activity pattern and dietary habits were obtained by questionnaire. The children wore accelerometer on their wrists from Friday to Tuesday over the whole weekend. Then, we calculated the activity energy expenditure using the activity counts recorded on the accelerometer. Results: Neither the physical activity energy expenditure (kcal/kg) nor the activity pattern showed a significant difference between the normal weight group and the overweight group. The overweight children spent more time watching TV and using the computer. The overweight group did not have breakfast and ate much more and faster in terms of dietary habit. Conclusion: This study suggests that bad habituations in diet and increase of inactivity time can play more important role than physical activity in causing overweight in 7-year-old children. (J Korean Acad Fam Med 2007;28: 195-203)

Background
The purpose of this study was to evaluate the effectiveness of telephone call reminder on retention rate in obese patients. Methods: A total of 118 patients (85 first-time visitors, 33 re-visitors), who visited an obesity management clinic from May 2003 to May 2004, were divided into the intervention group (n=64) and the comparison group (n=54). The intervention was a telephone call reminder before the appointment date. The retention rate up to 7th visit and body mass index were compared between the two groups. Results: The retention rate was 64.4% at 4th visit (after 66.5⁑29.2 days from the first visit) and 36.4% at 7th visit (after 142.1⁑57.8 days from the first visit). For the first- time visitors, the retention rate at 3rd visit was significantly higher (85.1%) in the intervention group than those in the comparison group (67.6%, P=0.049). Otherwise, there were no significant differences in retention rate and body mass index at each visit between the two groups regardless of the visiting status. However, the body mass index at 4th and 7th visit was significantly lower in the intervention group than in the comparison group among the first-time visitors who completely attended 7 times (P=0.031). Conclusion: We could not find the telephone call reminder to be an effective method to improve retention rate in obesity management clinic. Further intensive approach is needed to promote attendance. (J Korean Acad Fam Med 2007;28:204-209)

Adult onset Still's disease (AOSD) is an uncommon acute systemic inflammatory disease of unknown origin. The clinical features include high spiking fever, arthralgia or arthritis, transient maculopapular rash, lymphadenopathy, hepatosplenomegaly, and serositis. The laboratory findings include leukocytosis(neutrophilia), elevation of AST, ALT, ESR, CRP and serum ferritin, and negative rheumatic factor and anti-nuclear antibody. We report a case of a 52-year old woman whom symptom is subsided after steroid use. (J Korean Acad Fam Med 2007;28: 210-213)