1. Department of Rheumatology, Aino Memorial Hospital, Unzen, Japan;
2. Department of Orthopedic Surgery, Aino Memorial Hospital, Unzen, Japan;
3. Department of Neurology, JCHO Isahaya General Hospital, Isahaya, Japan;
4. Department of Neurology, University Graduate School of Medical Science, Kumamoto, Japan;
5. Nagasaki Diagnostic Pathology Clinic, Nagasaki, Japan