Elderly kidney transplant recipients have favorable outcomes but increased infection-related mortality

임정훈,Lee Ga Young,Jeon Yena,Jung Hee-Yeon,Choi Ji Young,CHO, JANG-HEE,Park Sun Hee,김용림,Kim Hyung-Kee,Huh Seung,유은상,Won Dong Il,Kim Chan-Duck 대한신장학회 2022 Kidney Research and Clinical Practice Vol.41 No.3

Background: The number of elderly patients with end-stage kidney disease has been increasing, but the outcomes of kidney transplants (KT) remain poorly understood in elderly patients. Therefore, we evaluated the clinical outcomes of elderly KT recipients and analyzed the impact of elderly donors. Methods: This retrospective cohort study included patients who underwent KT between 2000 and 2019. KT recipients were divided into four groups according to a combination of recipient and donor age (≥60 or <60 years); elderly recipients: old-to-old (n = 46) and young-to-old (n = 83); young recipients: old-to-young (n = 98) and young-to-young (n = 796). We compared the risks of mortality, graft failure, and acute rejection between groups using Cox regression analysis. Results: The incidence of delayed graft function, graft failure, and acute rejection was not different among groups. Annual mean tacrolimus trough level was not lower in elderly recipients than young recipients during 10-year follow-up. Mortality was significantly higher in elderly recipients (p = 0.001), particularly infection-related mortality (p < 0.001). In multivariable Cox regression analysis, old-toold and young-to-old groups had increased risk of mortality (adjusted hazard ratio [aHR], 2.89; 95% confidence interval [CI], 1.14– 7.32; p = 0.03; aHR, 3.06; 95% CI, 1.51–6.20; p = 0.002). However, graft failure and acute rejection risks were not increased in elderly recipients. Conclusion: In elderly recipients, graft survival and acute rejection-free survival were not inferior to those of young recipients. However, mortality, especially risk of infection-related death, was increased in elderly recipients. Thus, low immunosuppression intensity might help decrease mortality in elderly recipients.

Comparison of trophic factors changes in the hippocampal CA1 region between the young and adult gerbil induced by transient cerebral ischemia.

Yan, Bing Chun,Park, Joon Ha,Kim, Sung Koo,Choi, Jung Hoon,Lee, Choong Hyun,Yoo, Ki-Yeon,Kwon, Young-Geun,Kim, Young-Myeong,Kim, Jong-Dai,Won, Moo-Ho Kluwer Academic/Plenum Publishers 2012 Cellular and molecular neurobiology Vol.32 No.8

<P>In the present study, we investigated neuronal death/damage in the gerbil hippocampal CA1 region (CA1) and compared changes in some trophic factors, such as brain-derived neurotrophic factor (BDNF), glial cell line-derived neurotrophic factor (GDNF) and vascular endothelial growth factor (VEGF), in the CA1 between the adult and young gerbils after 5 min of transient cerebral ischemia. Most of pyramidal neurons (89%) were damaged 4 days after ischemia-reperfusion (I-R) in the adult; however, in the young, about 59% of pyramidal neurons were damaged 7 days after I-R. The immunoreactivity and levels of BDNF and VEGF, not GDNF, in the CA1 of the normal young were lower than those in the normal adult. Four days after I-R in the adult group, the immunoreactivity and levels of BDNF and VEGF were distinctively decreased, and the immunoreactivity and level of GDNF were increased. However, in the young group, all of their immunoreactivities and levels were much higher than those in the normal young group. From 7 days after I-R, all the immunoreactivities and levels were apparently decreased compared to those of the normal adult and young. In brief, we confirmed our recent finding: more delayed and less neuronal death occurred in the young following I-R, and we newly found that the immunoreactivities of trophic factors, such as BDNF, GDNF, and VEGF, in the stratum pyramidale of the CA1 in the young gerbil were much higher than those in the adult gerbil 4 days after transient cerebral ischemia.</P>

Bovine botulism outbreak associated with incidental consumption of presumably contaminated leftover food

( Jae Won Byun ),( Kyung Hyun Lee ),( Ha Young Kim ),( Soon Seek Yoon ),( Ji Youl Jung1 ),( Woo Seog Jeong1 ),( Jae Ku Oem ),( Jong Soo Lim ),( Myoung Heon Lee ),( You Chan Bae ) 한국예방수의학회(구 한국수의공중보건학회) 2013 예방수의학회지 Vol.37 No.1

Nine cattle among 18 in a native Korean herd died or were euthanized within 3 days. The affected cattle showed cowshed. The pigs and dogs had been fed leftover food originating from nearby restaurants, and the cattle could presumably reach the contaminated food in the pig troughs. Necropsy revealed a few chicken bones and red pepper pieces as well as large amounts of grain and rice straw hay mixed in the rumen. Botulism type D was isolated in the ruminal contents of one of the cattle. We speculated that the outbreak was associated with the cattle incidentally eating presumably contaminated leftover food from the pig trough.

여성 연소노인의 지각연령에 따른 사회무용 지도자 선호에 대한 연구

정문미(Jung, Moon Mi),원영신(Won, Young Shin),고대선(Ko, Dae Sun) 한국노년학회 2010 한국노년학 Vol.30 No.2

본 연구는 여성 연소노인의 사회 인구학적 특성에 따른 지각연령의 차이를 알아보고 지각연령이 사회무용 지도자 선호에 미치는 영향을 규명하는 데 목적이 있다. 이와 같은 연구목적을 달성하기 위하여 서울지역 소재 노인교육기관(노인교실, 노인대학, 노인학교, 노인복지회관, 사회복지회관, 대학부설 평생교육원 및 사회교육원, 종교기관 등)에서 사회무용 프로그램에 참여한 경험이 있는 여성 연소노인을 모집단으로 설정한 다음, 유의표본표집법을 이용하여 450명의 연구대상을 표집하였으며, 불성실하게 응답한 자료를 제외하고 총 428명의 자료를 최종분석에 사용하였다. 자료처리는 SPSS Windows 15.0 version을 이용하여 빈도분석, 탐색적 요인분석, 신뢰도분석, 카이검정, 독립표본 t-test, 일원분산분석, 이항 로지스틱 회귀분석을 실시하였으며, 다음과 같은 결론을 도출하였다. 첫째, 사회 인구학적 특성에 따른 지각연령은 역연령, 교육수준에 있어서 지각연령 하위요인(보이는 연령, 느끼는 연령, 관심사 연령, 활동 연령) 모두에 유의한 차이가 나타났다. 또한 결혼유지 상태는 관심사 연령과 느끼는 연령, 경제수준은 보이는 연령, 관심사 연령, 느끼는 연령에 있어서만 유의한 차이가 나타났다. 둘째, 사회 인구학적 특성에 따른 사회무용 지도자 선호는 교육수준에 있어서 사회무용 지도자 선호 하위특성(성별, 연령, 교육수준, 전공경력) 모두에 유의한 차이가 나타났다. 또한 역연령은 지도자의 전공경력을 제외, 경제수준은 지도자의 성별을 제외한 모든 사회무용 지도자 선호 하위특성에 유의한 차이가 나타났으며, 결혼유지 상태는 지도자의 교육수준에 있어서만 유의한 차이가 나타났다. 셋째, 지각연령이 사회무용 지도자 선호에 미치는 영향을 분석한 결과, 지각연령의 하위 요소 중 보이는 연령만이, 사회무용 지도자 선호하위특성 중 전공경력을 제외한 성별(B=.458), 연령(B=.483), 교육수준(B=.76) 모두에 유의한 정적(+) 영향을 미치는 것으로 나타났다. The purpose of this study was to examine the demographic characteristics of the female young-old to their self-perceived age and the impact of their self-perceived age on preference for a social dance instructor. The subjects in this study were 450 women who were selected by purposive sampling from a population of the female young-old who had ever participated in social dance programs in senior education institutions senior class, senior college, senior shool, Senior welfare center, social welfare center, university, school of lifelong education, religion community) in Seoul. After a survey was conducted, the answer sheets from 428 respondents were analyzed except some incomplete ones. As for data handling, a SPSS Windows Ver. 15.0 program was employed, and a frequency analysis, exploratory factor analysis, reliability analysis, pearson chi-square, independent-samples t-test, one-way ANOVA and binary-logistic regression were utilized. The findings of the study were as follows: First, self-perceived age by social population characteristics shows significant difference in all lower factors of self-perceived age(Look age, Feel age, Interest age, Do age) as chronological age, education level. Also, the marriage status shows significant difference only in interest age and feel age, the economic level shows only in look age, interest age and feel age. Second, the social dance instructor preference by social population characteristics shows significant difference in the all lower facts of social dance coaches preference(gender, age, education level, instructor career) up to educational level. Also, chronological age without the instructor career, economic level without instructor gender show the significant difference in the lower facts of all social dance instructor preference. Also, marriage status shows the significant difference in the educational level of the instructor. Third, the analysis of the influence of self-perceived age on the instructor preference shows all gender(B=.458), age(B=.483) and educational lever(B=.76) without career were influenced in significant (+) way.

Implementation of UPT Service in WIN-Based Mobile Communication Networks

Yun Won Chung(정윤원),Min Young Chung(정민영),Dan Keun Sung(성단근),In Jeong Kim(김인정),Jung Keun Shin(신정근),Sung Kim(김성) 한국통신학회 1999 한국통신학회 학술대회 및 강연회 Vol.1999 No.4

여성 연소노인의 지각연령과 사회무용지도자 실제에 따른 지도효율성

정문미(Jung Moon Mi),원영신(Won Young Shin) 글로벌시니어건강증진개발원 2011 글로벌시니어건강증진개발원 논문집 Vol.1 No.1

본 연구는 여성 연소노인의 사회 인구학적 특성에 따른 사회무용 지도자 실제, 사회무용 지도자 실제에 따른 지도 효율성의 차이, 그리고 지각연령이 지도 효율성에 미치는 영향을 규명하는 데 목적이 있다. 이와 같은 연구목적을 달성하기 위하여 서울지역 소재 노인교육기관(노인교실, 노인대학, 노인학교, 노인복지회관, 사회복지회관, 대학부설 평생교육원 및 사회교육원, 종교기관 등)에서 사회무용 프로그램에 참여한 경험이 있는 여성 연소노인을 모집단으로 설정한 다음, 유의표본표집법을 이용하여 450명의 연구대상을 표집하였으며, 불성실하게 응답한 자료를 제외하고 총 428명의 자료를 최종분석에 사용하였다. 자료처리는 SPSS Windows 15.0 version을 이용하여 빈도분석, 탐색적 요인분석, 신뢰도분석, 카이검정, 상관관계, 다중 회귀분석, 공분산분석을 실시하였으며, 다음과 같은 결론을 도출하였다. 첫째, 사회 인구학적 특성에 따른 사회무용 지도자 실제는 참여기관 유형에 있어서만 사회무용 지도자 실제 하위특성 모두에 한 차이가 나타났다. 또한 결혼유지 상태는 지도자의 성별, 연령을 제외, 교육수준과 경제수준은 성별을 제외, 직업상태(현재)는 성별과 전공경력을 제외한 모든 사회무용 지도자 실제 하위특성에 유의한 차이가 나타났다. 역연령은 지도자의 전공경력에서만 유의한 차이가 나타났다. 둘째, 지각연령이 지도 효율성에 미치는 영향을 분석한 결과, 지각연령의 하위요소 중, 보이는 연령이 지도 효율성의 하위 요소 중, 인지된 지도만족(B=-.106)에 부적(-), 활동 연령이 인지된 기능향상(B=.109)과 인지된 지도만족(B=.178)에 있어 모두 정적(+) 영향을 미치는 것으로 나타났다. 셋째, 사회 인구학적 특성과 지각연령이 일정한(통제된) 경우, 실제 사회무용 지도자의 하위특성인 성별, 연령, 교육수준, 전공경력 모두에 따라 지도 효율성의 하위요인 모두에 유의한 차이가 있었다. The purpose of this study is to find the between the young-old woman the demographic characteristics and practice of social dance instructor, the difference of between practice of social dance instructor and coaching effectiveness, and tne effect of between the self-perceived age and oaching effectiveness. The subjects in this study were 450 women who were selected by purposive sampling from a population of the young-old woman who had ever participated in social dance programs in senior education institutions senior class, senior college, senior school, Senior welfare center, social welfare center, university, school of lifelong education, religion community) in Seoul. After a survey was conducted, the answer sheets from 428 respondents were analyzed except some incomplete ones. As for data handling, a SPSS Windows Ver. 15.0 program was employed, and a frequency analysis, exploratory factor analysis, reliability analysis, pearson chi-square, binary-logistic regression, ANCOVA and were utilized. The findings of the study were as follows: First, practice of the coaches according to social population characteristics shows the significant difference for all practical lower facts of the coaches only in types of participation institute. Also, marriage status without the coaches’ gender and age, educational and economic level without gender, and current job status without the gender and career show the significant difference in practical lower facts of all the coaches. Chronological age shows the significant difference only in the career of the coaches. Second, the analysis of the influence of elf-perceived age on the coaching effectiveness shows all recognized coaching satisfaction(B=-.106) of (-), function improvement(B=.109) with the recognition of activity age and recognized coaching satisfaction(B=.178) were influenced in (+) way. Third, in case of social population characteristics and self-perceived age are controled, all lower factors of coaching effectiveness shows significant difference according to the actual coaches’ gender, age, educational level and career.

윈도우 기반 응용프로그램 제공 서비스를 위한 Win32 API 메시지 인가 시스템의 개발

김영호,정민아,원용관,Kim, Young-Ho,Jung, Mi-Na,Won, Yong-Gwan 한국정보처리학회 2004 정보처리학회논문지 C : 정보통신,정보보안 Vol.11 No.1

컴퓨터 자원의 대용량화 및 네트워크 속도의 증가로 인하여 사용자가 네트워크를 통해 원격지의 서버에 접속하여 컴퓨터론 사용하는 요구가 증가되었다. 이에 따라 중앙집중형 컴퓨팅을 통한 응용프로그램 제공 서비스도 활성화되었다. 중앙집중형 컴퓨팅 시스템은 중앙의 대용량컴퓨터 시스템에 설치된 응용프로그램을 공유 프로토콜을 통하여 원격 사용자에게 제공하는 응용프로그램 공유 서비스(ASP: Application Service Provision) 시스템 모델이다. 중앙집중형 컴퓨팅 시스템을 통한 응용프로그램 공유 서비스는 기밀성, 가용성 무결성 등의 보안 사항이 반드시 유지되어야 한다. 기존 원격 컴퓨팅인 Telnet, FTP 접속은 단순히 파일 및 데이터의 접근 권한을 제어함으로 보안이 유지된다. 그러나 윈도우 기반 시스템의 경우 다수의 사용자가 통일한 권한을 통해 통일한 응용프로그램을 제공받기 때문에 사용자들 사이에 기밀성 및 무결성을 저해 할 수 있다. 또한 다수의 사용자가 하나의 응용프로그램에 파일열기, 복사, 서식 수정 등의 여러 기능 명령어를 전송하기 때문에 파일 및 데이터 접근 제어만을 통해서는 시스템의 기밀성 유지한 수 없다. 또한 기밀성의 문제는 곧 가용성 및 무결성의 문제로 이어질 수 있다. 본 논문에서는 윈도우 기반 중앙집중형 컴퓨팅 시스템의 응용프로그램 공유 서비스를 지원함에 있어 사용자가 실행하는 Win32 API 메시지 명령어 접근제어 시스템을 제안한다. 제안하는 시스템은 GUI(Graphical User Interface) 기반의 서버에서 사용자가 서버에 접속하여 발생하는 모든 메시지(마우스, 키보드, I/O, etc....)들을 감시한다. 감시된 메시지 기반의 명령어는 미리 설정된 사용자별 보안 정책에 기반 하여 해당 응용프로그램에게 전달 여부가 결정된다. 이러한 메시지 기반 상세 보안을 통해 기밀성 침해의 우려가 있는 메시지 명령어를 차단하고, 기능 명령어 차단에 의한 자원의 기밀성을 해결하였다. The growth of computer resource and network speed has increased requests for the use of remotely located computer systems by connecting through computer networks. This phenomenon has hoisted research activities for application service provision that uses server-based remote computing paradigm. The server-based remote computing paradigm has been developed as the ASP (Application Service Provision) model, which provides remote users through application sharing protocol to application programs. Security requirement such as confidentiality, availability, integrity should be satisfied to provide ASP service using centralized computing system. Existing Telnet or FTP service for a remote computing systems have satisfied security requirement by a simple access control to files and/or data. But windows-based centralized computing system is vulnerable to confidentiality, availability, integrity where many users use the same application program installed in the same computer. In other words, the computing system needs detailed security level for each user different from others, such that only authorized user or group of users can run some specific functional commands for the program. In this paper, we propose windows based centralized computing system that sets security policies for each user for the use of instructions of the application programs, and performs access control to the instructions based on the security policies. The system monitors all user messages which are executed through graphical user interface by the users connecting to the system. Ail Instructions, i.e. messages, for the application program are now passed to authorization process that decides if an Instruction is delivered to the application program based on the pre-defined security polices. This system can be used as security clearance for each user for the shared computing resource as well as shared application programs.

고령자 남녀와 20대 남녀에 있어서 다양한 등속수축중 최대 모멘트의 비교

金智源(Ji-Won Kim),金相佑(Sang-Woo Kim),文基旭(Ki-Wook Moon),嚴光文(Gwang-Moon Eom),李泳揆(Young-Gyu Lee),南貞淑(Jung-Sook Nam),朴寬龍(Kwan-Yong Park),金耀翰(Yo-Han Kim),洪廷和(Jeong-Hwa Hong),朴炳奎(Bung-Kyu Park) 대한전기학회 2008 전기학회논문지 Vol.57 No.10

In this paper, we investigated the maximum ankle joint plantarflexion moment (MPM) of young and elderly subjects during various modes of isokinetic contractions with special interest in the elderly females who were reported to have higher fall rate than the elderly males. Subjects include the young subjects (14 males: 22.7±2.5yrs, 13 females: 20.5±1.3yrs) and the elderly subjects (17 males: 65.8±10.5yrs, 26 females: 71.4±5.2yrs). The MPM was normalized by each subject's body weight. The MPM of elderly females was the weakest among the groups, particularly, at the eccentric contractions. The male-to-female ratio of MPM was greater in the elderly than in the young and the young-to-elderly ratio of MPM was greater in female than in male, both during the eccentric contractions. The result suggests that the decreased muscle force per body weight, especially at the eccentric contraction, may be one reason for the more frequent fall of the elderly female than the elderly male.

알레르기 ; 알레르기 환자에서 한방 이외의 대체 요법의 사용 현황에 대한 다기관 조사

이현정 ( Hyun Jung Lee ),이재현 ( Jae Hyun Lee ),이용원 ( Yong Won Lee ),김철우 ( Cheol Woo Kim ),동헌종 ( Hun Jong Dhong ),박해심 ( Hae Sim Park ),조영주 ( Young Joo Cho ),조진희 ( Jin Hee Cho ),조상헌 ( Sang Heon Cho ),편복양 ( 대한내과학회 2011 대한내과학회지 Vol.80 No.1

목적: 한국에서 알레르기 질환 치료를 위한 한방 치료뿐만 아니라 대체 요법이 많이 이용되고 있으며, 그 현황에 대하여 다기관 조사를 시행하였다. 방법: 10개의 대학병원 외래로 내원한 647명의 알레르기 환자를 대상으로 설문조사를 시행하였으며, 이 중 510명이 한방 이외의 대체 요법에 응답하였다. 이환되어 있는 알레르기 질환은 천식(50.0%), 알레르기 비염(36.0%), 아토피 피부염(36.0%), 그리고 두드러기(9.3%)였다. 각각 환자들에게 12 문항의 설문조사를 시행하였으며, 한방 이외의 대체 요법의 사용 빈도 및 종류, 대체 요법에 의지하게 된 이유, 비용, 그리고 치료효과에 대한 의견을 물어 보았다. 결과: 16.7%의 알레르기 환자에서 한방 이외의 다른 대체 요법을 받았으며, 평균 1.6종의 한방 이외의 대체 요법을 받았다. 가장 많이 의지하는 대체 요법은 민간 식이요법 (48.6%)이었고, 그 다음이 아로마 요법(23.8%), 지압(14.3%), 건강 호흡법(7.6%), 마인드 컨트롤(5.7%), 목욕요법(5.7%) 순이었다. 대체 요법을 받은 환자 중 마인드 컨트롤(50%), 식이요법(50%), 그리고 건강 호흡법(75%)의 경우 치료 효과가 만족스럽다는 응답이 높았으며, 목욕요법, 아로마 요법, 그리고 지압은 만족도가 각각 33.3%, 28.0%, 26.7%로 저조하였다. 대체 요법 사용자의 63.6%가 5회 미만의 대체 요법을 받았고, 91.8%가 1년 이내로 치료받았으며, 1인당 평균 연 37 만원을 지출하였다. 대체 요법을 선택한 가장 큰 이유는 체질이 개선될 수 있을까 해서(44.2%)였으며, 대체 요법이 몸에 부담이 없어서(31.4%), 면역기능이 강화되어서(22.9%) 순으로 나타났고, 15.7%는 양약치료가 도움이 되지 않아서 대체 요법을 선택하였다고 응답하였다. 결론: 한국에서 알레르기 환자의 상당수가 한방뿐만 아니라 여러 가지의 대체 요법을 사용하고 있음을 알 수 있었다. 대체 요법의 사용 빈도가 증가하고 그 종류가 다양함을 고려할 때, 의료진은 대체 요법의 현황에 대하여 정확히 인지하고 이에 대해 관심을 가지고 환자를 대하여야 하며 올바른 알레르기 질환 치료법에 대해 환자뿐만 아니라 의료인에게 교육하는 것이 필요하다. Background/Aims: The use of unproven complementary/alternative medicine (CAM) to treat allergies is popular in Korea. We conducted a multicenter survey of the current use of CAM other than herbal medication in Korean allergy patients. Methods: This study enrolled 510 adults with allergic diseases, including asthma, allergic rhinitis, atopic dermatitis, and chronic urticaria, from ten hospitals. They underwent a structured questionnaire interview and clinical assessment of the prevalence, motivation, costs, and subjective assessment of CAM. Results: Of the patients, 16.7% used at least one type of CAM to treat their allergic diseases. Common types of CAM were diet (48.6%), aroma therapy (23.8%), massage (14.3%), breathing exercises (7.6%), baths (5.7%), and mind control (5.7%). The therapeutic effects of CAM included improved in patients using mind control (50%), diet (50%), breathing exercises (75%), and baths (33.3%), but worse in patients using aroma therapy (28%), and massage (26.7%). About 36.4% of the patients used CAM more than four times per year, and the average cost per CAM user was 370,000 won/year. The main reason for trying CAM was `hope to improve my constitution`. Conclusions: CAM is used widely for treating allergic diseases in Korea. Detailed knowledge of CAM and patient education are important. Further studies of the clinical efficacy of CAM are needed. (Korean J Med 2011;80:68-77)

Productivity Loss of Rheumatoid Arthritis Patients according to the Their Stages of the Disease Activity Score

( Sang-Cheol Bae ),( Jin-Hye Cha ),( Jung-Yoon Choe ),( Sung Jae Choi ),( Soo-Kyung Cho ),( Won-Tae Chung ),( Chung-Il Joung ),( Young-Ok Jung ),( Young Mo Kang ),( Dong-Wook Kim ),( Jinseok Kim ),( Y 대한류마티스학회 2018 대한류마티스학회지 Vol.25 No.2

Objective. Productivity loss was compared by 3-stage of disease activity and associations between higher disease activity and high productivity loss were identified. Methods. Data were extracted from Rheumatoid Arthritis (RA) Patient-reported Outcomes Research, which enrolled 2,000 RA patients (>20-year) on disease-modifying-antirheumatic-drugs (DMARDs) (≥ 6-month) from December 2012 to June 2013. This included 1,457 RA patients with the disease activity score (DAS-28-ESR) in their medical charts. Productivity loss in time and indirect cost was estimated using The World Health Organization Health and Work Performance Questionnaire (HPQ). Baseline characteristics and productivity loss outcomes were compared according to DAS-28-ESR groups. Results. 84.4% were females, 54.2% had low DAS-28-ESR (<3.2), and 38.2% and 7.6% had moderate (3.2∼5.1) and high DAS-28-ESR (>5.1). Patients with moderate to high DAS-28-ESR had higher lost productivity time (LPT) and monthly costs of LPT than those with low DAS-28-ESR (time in hours: 110.0±58.4 vs. 132.4±57.2 vs. 71.5±52.0, p<0.0001; monthly costs of LPT in 1,000 Korean won: 1,097±607 vs. 1,302±554 vs. 741±531, p<0.0001). Multiple regression analyses revealed significant associations with high LPT in high (adjusted odds ratio [OR]=3.87, 95% confidence interval [CI]: 2.18∼6.87) and moderate DAS-28-ESR (adjusted OR=1.88, 95% CI: 1.41∼2.52) compared to low DAS-28-ESR. In addition, positive associations with high monthly costs of LPT were observed in high (adjusted OR=3.45, 95% CI: 1.98∼5.99) and moderate DAS-28-ESR (adjusted OR=1.93, 95% CI: 1.43∼2.54) compared to low DAS-28-ESR. Conclusion. Timely therapeutic strategies should be taken into consideration given that the RA patients with moderate to high DAS-28-ESR showed strong associations with high productivity loss for effective management of RA. (J Rheum Dis 2018;25:122-130)