Yuto Unoki¹, Koutarou Kunimoto², Takuma Hata³, Fumitaka Yoshimura², Kousuke Ishizuka⁴, *Toshihiko Oshita⁵ (1. Department of General Internal Medicine, Iizuka Hospital, 2. Department of General Medicine, National Hospital Organization Kumamoto Medical Center, 3. Department of Internal Medicine, Mito Kyodo General Hospital, University of Tsukuba, Japan , 4. Department of General Medicine,St.Marianna University School of Medicine Hospital, 5. Department of General Internal Medicine, Kobe City Nishi-Kobe Medical Center)