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1. Division of General Internal Medicine, Department of Medicine, St. Luke’s International Hospital, 9-1 Akashi-cho, Chuo-ku, Tokyo, 104-8560, Japan 2. St. Luke’s Life Science Institute, Tokyo, Japan 3. Office of Medical Education, University of Hawaii, Honolulu, HI, USA 4. Gastroenterology Center, St. Luke’s International Hospital, Tokyo, Japan