[1] Owani Hosp, Dept Internal Med, Aomori, Japan
[2] Hirosaki Univ, Grad Sch Med, Dept Gastroenterol, 5 Zaifu Cho, Hirosaki, Aomori 0368562, Japan
[3] Hirosaki Univ, Grad Sch Med, Dept Cardiol, Aomori, Japan
[4] Hirosaki Univ, Grad Sch Med, Dept Social Med, Aomori, Japan
[5] Hirosaki Univ Hosp, Clin Res Support Ctr, Aomori, Japan
[6] Stanford Univ, Sch Med, Div Gastroenterol & Hepatol, Stanford, CA USA