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Nakashima Y, Tamai M, Kita J, Michitsuji T, Shimizu T, Fukui S, Umeda M, Nishino A, Suzuki T, Horai Y, Okada A, Nishimura T, Koga T, Kawashiri SY, Iwamoto N, Ichinose K, Hirai Y, Arima K, Yamasaki S, Nakamura H, Origuchi T, Takao S, Uetani M, Aoyagi K, Eguchi K, Kawakami A. Magnetic Resonance Imaging Bone Edema at Enrollment Predicts Rapid Radiographic Progression in Patients with Early RA: Results from the Nagasaki University Early Arthritis Cohort. J Rheumatol 2016; 43:1278-84. [PMID: 27134251 DOI: 10.3899/jrheum.150988] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/31/2016] [Indexed: 12/16/2022]
Abstract
OBJECTIVE To clarify whether magnetic resonance imaging (MRI) bone edema predicts the development of rapid radiographic progression (RRP) in the Nagasaki University Early Arthritis Cohort of patients with early-stage rheumatoid arthritis (RA). METHODS Patients with early-stage RA (n = 76) were enrolled and underwent 1.5-T MRI of both wrists and finger joints. Synovitis, bone edema, and bone erosion were evaluated using the Rheumatoid Arthritis Magnetic Resonance Imaging Scoring (RAMRIS). RRP was defined as an annual increment > 3 at 1 year by the Genant-modified Sharp score of plain radiographs. A multivariate logistic regression analysis was performed to establish the risk factors for RRP. RESULTS Median disease duration at enrollment was 3 months. RRP was found in 12 of the 76 patients at 1 year. A univariate analysis revealed that matrix metalloprotease-3, RAMRIS bone edema score, and RAMRIS bone erosion score were associated with RRP. Multivariate logistic regression analyses demonstrated that the RAMRIS bone edema score at enrollment (5-point increase, OR 2.18, 95% CI 1.32-3.59, p = 0.002) was the only independent predictor of the development of RRP at 1 year. A receiver-operating characteristic analysis identified the best cutoff value for RAMRIS bone edema score as 5. RRP was significantly rare among the patients with a RAMRIS bone edema score < 5 at enrollment (2 from 50 patients). CONCLUSION Our findings suggest that MRI bone edema is closely associated with the development of RRP in patients with early-stage RA. Physicians should carefully control the disease activity when MRI bone edema is observed in patients with early RA.
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Affiliation(s)
- Yoshikazu Nakashima
- From the Department of Immunology and Rheumatology, and Department of Public Health, and Department of Health Sciences, Nagasaki University Graduate School of Biomedical Sciences; Japanese Red Cross Nagasaki Genbaku Hospital; Department of Radiology and Radiation Research, Nagasaki University Hospital, Nagasaki; Department of Clinical Immunology and Rheumatology, Hiroshima University, Hiroshima; Department of Radiology, Institute of Biomedical Sciences, Tokushima University Graduate School, Tokushima; Sasebo Chuo Hospital, Sasebo, Japan.Y. Nakashima, MD, Department of Immunology and Rheumatology, Nagasaki University Graduate School of Biomedical Sciences; M. Tamai, MD, PhD, Department of Immunology and Rheumatology, Nagasaki University Graduate School of Biomedical Sciences; J. Kita, MD, PhD, Department of Immunology and Rheumatology, Nagasaki University Graduate School of Biomedical Sciences; T. Michitsuji, MD, Department of Immunology and Rheumatology, Nagasaki University Graduate School of Biomedical Sciences; T. Shimizu, MD, Department of Immunology and Rheumatology, Nagasaki University Graduate School of Biomedical Sciences; S. Fukui, MD, Department of Immunology and Rheumatology, Nagasaki University Graduate School of Biomedical Sciences; M. Umeda, MD, Department of Immunology and Rheumatology, Nagasaki University Graduate School of Biomedical Sciences; A. Nishino, MD, Department of Immunology and Rheumatology, Nagasaki University Graduate School of Biomedical Sciences; T. Suzuki, MD, PhD, Japanese Red Cross Nagasaki Genbaku Hospital; Y. Horai, MD, PhD, Department of Immunology and Rheumatology, Nagasaki University Graduate School of Biomedical Sciences; A. Okada, MD, PhD, Japanese Red Cross Nagasaki Genbaku Hospital; T. Nishimura, PhD, Department of Public Health, Nagasaki University Graduate School of Biomedical Sciences; T. Koga, MD, PhD, Department of Immunology and Rheumatology, Nagasaki University Graduate School of Biomedical Sciences; S. Kawashiri, MD
| | - Mami Tamai
- From the Department of Immunology and Rheumatology, and Department of Public Health, and Department of Health Sciences, Nagasaki University Graduate School of Biomedical Sciences; Japanese Red Cross Nagasaki Genbaku Hospital; Department of Radiology and Radiation Research, Nagasaki University Hospital, Nagasaki; Department of Clinical Immunology and Rheumatology, Hiroshima University, Hiroshima; Department of Radiology, Institute of Biomedical Sciences, Tokushima University Graduate School, Tokushima; Sasebo Chuo Hospital, Sasebo, Japan.Y. Nakashima, MD, Department of Immunology and Rheumatology, Nagasaki University Graduate School of Biomedical Sciences; M. Tamai, MD, PhD, Department of Immunology and Rheumatology, Nagasaki University Graduate School of Biomedical Sciences; J. Kita, MD, PhD, Department of Immunology and Rheumatology, Nagasaki University Graduate School of Biomedical Sciences; T. Michitsuji, MD, Department of Immunology and Rheumatology, Nagasaki University Graduate School of Biomedical Sciences; T. Shimizu, MD, Department of Immunology and Rheumatology, Nagasaki University Graduate School of Biomedical Sciences; S. Fukui, MD, Department of Immunology and Rheumatology, Nagasaki University Graduate School of Biomedical Sciences; M. Umeda, MD, Department of Immunology and Rheumatology, Nagasaki University Graduate School of Biomedical Sciences; A. Nishino, MD, Department of Immunology and Rheumatology, Nagasaki University Graduate School of Biomedical Sciences; T. Suzuki, MD, PhD, Japanese Red Cross Nagasaki Genbaku Hospital; Y. Horai, MD, PhD, Department of Immunology and Rheumatology, Nagasaki University Graduate School of Biomedical Sciences; A. Okada, MD, PhD, Japanese Red Cross Nagasaki Genbaku Hospital; T. Nishimura, PhD, Department of Public Health, Nagasaki University Graduate School of Biomedical Sciences; T. Koga, MD, PhD, Department of Immunology and Rheumatology, Nagasaki University Graduate School of Biomedical Sciences; S. Kawashiri, MD
| | - Junko Kita
- From the Department of Immunology and Rheumatology, and Department of Public Health, and Department of Health Sciences, Nagasaki University Graduate School of Biomedical Sciences; Japanese Red Cross Nagasaki Genbaku Hospital; Department of Radiology and Radiation Research, Nagasaki University Hospital, Nagasaki; Department of Clinical Immunology and Rheumatology, Hiroshima University, Hiroshima; Department of Radiology, Institute of Biomedical Sciences, Tokushima University Graduate School, Tokushima; Sasebo Chuo Hospital, Sasebo, Japan.Y. Nakashima, MD, Department of Immunology and Rheumatology, Nagasaki University Graduate School of Biomedical Sciences; M. Tamai, MD, PhD, Department of Immunology and Rheumatology, Nagasaki University Graduate School of Biomedical Sciences; J. Kita, MD, PhD, Department of Immunology and Rheumatology, Nagasaki University Graduate School of Biomedical Sciences; T. Michitsuji, MD, Department of Immunology and Rheumatology, Nagasaki University Graduate School of Biomedical Sciences; T. Shimizu, MD, Department of Immunology and Rheumatology, Nagasaki University Graduate School of Biomedical Sciences; S. Fukui, MD, Department of Immunology and Rheumatology, Nagasaki University Graduate School of Biomedical Sciences; M. Umeda, MD, Department of Immunology and Rheumatology, Nagasaki University Graduate School of Biomedical Sciences; A. Nishino, MD, Department of Immunology and Rheumatology, Nagasaki University Graduate School of Biomedical Sciences; T. Suzuki, MD, PhD, Japanese Red Cross Nagasaki Genbaku Hospital; Y. Horai, MD, PhD, Department of Immunology and Rheumatology, Nagasaki University Graduate School of Biomedical Sciences; A. Okada, MD, PhD, Japanese Red Cross Nagasaki Genbaku Hospital; T. Nishimura, PhD, Department of Public Health, Nagasaki University Graduate School of Biomedical Sciences; T. Koga, MD, PhD, Department of Immunology and Rheumatology, Nagasaki University Graduate School of Biomedical Sciences; S. Kawashiri, MD
| | - Toru Michitsuji
- From the Department of Immunology and Rheumatology, and Department of Public Health, and Department of Health Sciences, Nagasaki University Graduate School of Biomedical Sciences; Japanese Red Cross Nagasaki Genbaku Hospital; Department of Radiology and Radiation Research, Nagasaki University Hospital, Nagasaki; Department of Clinical Immunology and Rheumatology, Hiroshima University, Hiroshima; Department of Radiology, Institute of Biomedical Sciences, Tokushima University Graduate School, Tokushima; Sasebo Chuo Hospital, Sasebo, Japan.Y. Nakashima, MD, Department of Immunology and Rheumatology, Nagasaki University Graduate School of Biomedical Sciences; M. Tamai, MD, PhD, Department of Immunology and Rheumatology, Nagasaki University Graduate School of Biomedical Sciences; J. Kita, MD, PhD, Department of Immunology and Rheumatology, Nagasaki University Graduate School of Biomedical Sciences; T. Michitsuji, MD, Department of Immunology and Rheumatology, Nagasaki University Graduate School of Biomedical Sciences; T. Shimizu, MD, Department of Immunology and Rheumatology, Nagasaki University Graduate School of Biomedical Sciences; S. Fukui, MD, Department of Immunology and Rheumatology, Nagasaki University Graduate School of Biomedical Sciences; M. Umeda, MD, Department of Immunology and Rheumatology, Nagasaki University Graduate School of Biomedical Sciences; A. Nishino, MD, Department of Immunology and Rheumatology, Nagasaki University Graduate School of Biomedical Sciences; T. Suzuki, MD, PhD, Japanese Red Cross Nagasaki Genbaku Hospital; Y. Horai, MD, PhD, Department of Immunology and Rheumatology, Nagasaki University Graduate School of Biomedical Sciences; A. Okada, MD, PhD, Japanese Red Cross Nagasaki Genbaku Hospital; T. Nishimura, PhD, Department of Public Health, Nagasaki University Graduate School of Biomedical Sciences; T. Koga, MD, PhD, Department of Immunology and Rheumatology, Nagasaki University Graduate School of Biomedical Sciences; S. Kawashiri, MD
| | - Toshimasa Shimizu
- From the Department of Immunology and Rheumatology, and Department of Public Health, and Department of Health Sciences, Nagasaki University Graduate School of Biomedical Sciences; Japanese Red Cross Nagasaki Genbaku Hospital; Department of Radiology and Radiation Research, Nagasaki University Hospital, Nagasaki; Department of Clinical Immunology and Rheumatology, Hiroshima University, Hiroshima; Department of Radiology, Institute of Biomedical Sciences, Tokushima University Graduate School, Tokushima; Sasebo Chuo Hospital, Sasebo, Japan.Y. Nakashima, MD, Department of Immunology and Rheumatology, Nagasaki University Graduate School of Biomedical Sciences; M. Tamai, MD, PhD, Department of Immunology and Rheumatology, Nagasaki University Graduate School of Biomedical Sciences; J. Kita, MD, PhD, Department of Immunology and Rheumatology, Nagasaki University Graduate School of Biomedical Sciences; T. Michitsuji, MD, Department of Immunology and Rheumatology, Nagasaki University Graduate School of Biomedical Sciences; T. Shimizu, MD, Department of Immunology and Rheumatology, Nagasaki University Graduate School of Biomedical Sciences; S. Fukui, MD, Department of Immunology and Rheumatology, Nagasaki University Graduate School of Biomedical Sciences; M. Umeda, MD, Department of Immunology and Rheumatology, Nagasaki University Graduate School of Biomedical Sciences; A. Nishino, MD, Department of Immunology and Rheumatology, Nagasaki University Graduate School of Biomedical Sciences; T. Suzuki, MD, PhD, Japanese Red Cross Nagasaki Genbaku Hospital; Y. Horai, MD, PhD, Department of Immunology and Rheumatology, Nagasaki University Graduate School of Biomedical Sciences; A. Okada, MD, PhD, Japanese Red Cross Nagasaki Genbaku Hospital; T. Nishimura, PhD, Department of Public Health, Nagasaki University Graduate School of Biomedical Sciences; T. Koga, MD, PhD, Department of Immunology and Rheumatology, Nagasaki University Graduate School of Biomedical Sciences; S. Kawashiri, MD
| | - Shoichi Fukui
- From the Department of Immunology and Rheumatology, and Department of Public Health, and Department of Health Sciences, Nagasaki University Graduate School of Biomedical Sciences; Japanese Red Cross Nagasaki Genbaku Hospital; Department of Radiology and Radiation Research, Nagasaki University Hospital, Nagasaki; Department of Clinical Immunology and Rheumatology, Hiroshima University, Hiroshima; Department of Radiology, Institute of Biomedical Sciences, Tokushima University Graduate School, Tokushima; Sasebo Chuo Hospital, Sasebo, Japan.Y. Nakashima, MD, Department of Immunology and Rheumatology, Nagasaki University Graduate School of Biomedical Sciences; M. Tamai, MD, PhD, Department of Immunology and Rheumatology, Nagasaki University Graduate School of Biomedical Sciences; J. Kita, MD, PhD, Department of Immunology and Rheumatology, Nagasaki University Graduate School of Biomedical Sciences; T. Michitsuji, MD, Department of Immunology and Rheumatology, Nagasaki University Graduate School of Biomedical Sciences; T. Shimizu, MD, Department of Immunology and Rheumatology, Nagasaki University Graduate School of Biomedical Sciences; S. Fukui, MD, Department of Immunology and Rheumatology, Nagasaki University Graduate School of Biomedical Sciences; M. Umeda, MD, Department of Immunology and Rheumatology, Nagasaki University Graduate School of Biomedical Sciences; A. Nishino, MD, Department of Immunology and Rheumatology, Nagasaki University Graduate School of Biomedical Sciences; T. Suzuki, MD, PhD, Japanese Red Cross Nagasaki Genbaku Hospital; Y. Horai, MD, PhD, Department of Immunology and Rheumatology, Nagasaki University Graduate School of Biomedical Sciences; A. Okada, MD, PhD, Japanese Red Cross Nagasaki Genbaku Hospital; T. Nishimura, PhD, Department of Public Health, Nagasaki University Graduate School of Biomedical Sciences; T. Koga, MD, PhD, Department of Immunology and Rheumatology, Nagasaki University Graduate School of Biomedical Sciences; S. Kawashiri, MD
| | - Masataka Umeda
- From the Department of Immunology and Rheumatology, and Department of Public Health, and Department of Health Sciences, Nagasaki University Graduate School of Biomedical Sciences; Japanese Red Cross Nagasaki Genbaku Hospital; Department of Radiology and Radiation Research, Nagasaki University Hospital, Nagasaki; Department of Clinical Immunology and Rheumatology, Hiroshima University, Hiroshima; Department of Radiology, Institute of Biomedical Sciences, Tokushima University Graduate School, Tokushima; Sasebo Chuo Hospital, Sasebo, Japan.Y. Nakashima, MD, Department of Immunology and Rheumatology, Nagasaki University Graduate School of Biomedical Sciences; M. Tamai, MD, PhD, Department of Immunology and Rheumatology, Nagasaki University Graduate School of Biomedical Sciences; J. Kita, MD, PhD, Department of Immunology and Rheumatology, Nagasaki University Graduate School of Biomedical Sciences; T. Michitsuji, MD, Department of Immunology and Rheumatology, Nagasaki University Graduate School of Biomedical Sciences; T. Shimizu, MD, Department of Immunology and Rheumatology, Nagasaki University Graduate School of Biomedical Sciences; S. Fukui, MD, Department of Immunology and Rheumatology, Nagasaki University Graduate School of Biomedical Sciences; M. Umeda, MD, Department of Immunology and Rheumatology, Nagasaki University Graduate School of Biomedical Sciences; A. Nishino, MD, Department of Immunology and Rheumatology, Nagasaki University Graduate School of Biomedical Sciences; T. Suzuki, MD, PhD, Japanese Red Cross Nagasaki Genbaku Hospital; Y. Horai, MD, PhD, Department of Immunology and Rheumatology, Nagasaki University Graduate School of Biomedical Sciences; A. Okada, MD, PhD, Japanese Red Cross Nagasaki Genbaku Hospital; T. Nishimura, PhD, Department of Public Health, Nagasaki University Graduate School of Biomedical Sciences; T. Koga, MD, PhD, Department of Immunology and Rheumatology, Nagasaki University Graduate School of Biomedical Sciences; S. Kawashiri, MD
| | - Ayako Nishino
- From the Department of Immunology and Rheumatology, and Department of Public Health, and Department of Health Sciences, Nagasaki University Graduate School of Biomedical Sciences; Japanese Red Cross Nagasaki Genbaku Hospital; Department of Radiology and Radiation Research, Nagasaki University Hospital, Nagasaki; Department of Clinical Immunology and Rheumatology, Hiroshima University, Hiroshima; Department of Radiology, Institute of Biomedical Sciences, Tokushima University Graduate School, Tokushima; Sasebo Chuo Hospital, Sasebo, Japan.Y. Nakashima, MD, Department of Immunology and Rheumatology, Nagasaki University Graduate School of Biomedical Sciences; M. Tamai, MD, PhD, Department of Immunology and Rheumatology, Nagasaki University Graduate School of Biomedical Sciences; J. Kita, MD, PhD, Department of Immunology and Rheumatology, Nagasaki University Graduate School of Biomedical Sciences; T. Michitsuji, MD, Department of Immunology and Rheumatology, Nagasaki University Graduate School of Biomedical Sciences; T. Shimizu, MD, Department of Immunology and Rheumatology, Nagasaki University Graduate School of Biomedical Sciences; S. Fukui, MD, Department of Immunology and Rheumatology, Nagasaki University Graduate School of Biomedical Sciences; M. Umeda, MD, Department of Immunology and Rheumatology, Nagasaki University Graduate School of Biomedical Sciences; A. Nishino, MD, Department of Immunology and Rheumatology, Nagasaki University Graduate School of Biomedical Sciences; T. Suzuki, MD, PhD, Japanese Red Cross Nagasaki Genbaku Hospital; Y. Horai, MD, PhD, Department of Immunology and Rheumatology, Nagasaki University Graduate School of Biomedical Sciences; A. Okada, MD, PhD, Japanese Red Cross Nagasaki Genbaku Hospital; T. Nishimura, PhD, Department of Public Health, Nagasaki University Graduate School of Biomedical Sciences; T. Koga, MD, PhD, Department of Immunology and Rheumatology, Nagasaki University Graduate School of Biomedical Sciences; S. Kawashiri, MD
| | - Takahisa Suzuki
- From the Department of Immunology and Rheumatology, and Department of Public Health, and Department of Health Sciences, Nagasaki University Graduate School of Biomedical Sciences; Japanese Red Cross Nagasaki Genbaku Hospital; Department of Radiology and Radiation Research, Nagasaki University Hospital, Nagasaki; Department of Clinical Immunology and Rheumatology, Hiroshima University, Hiroshima; Department of Radiology, Institute of Biomedical Sciences, Tokushima University Graduate School, Tokushima; Sasebo Chuo Hospital, Sasebo, Japan.Y. Nakashima, MD, Department of Immunology and Rheumatology, Nagasaki University Graduate School of Biomedical Sciences; M. Tamai, MD, PhD, Department of Immunology and Rheumatology, Nagasaki University Graduate School of Biomedical Sciences; J. Kita, MD, PhD, Department of Immunology and Rheumatology, Nagasaki University Graduate School of Biomedical Sciences; T. Michitsuji, MD, Department of Immunology and Rheumatology, Nagasaki University Graduate School of Biomedical Sciences; T. Shimizu, MD, Department of Immunology and Rheumatology, Nagasaki University Graduate School of Biomedical Sciences; S. Fukui, MD, Department of Immunology and Rheumatology, Nagasaki University Graduate School of Biomedical Sciences; M. Umeda, MD, Department of Immunology and Rheumatology, Nagasaki University Graduate School of Biomedical Sciences; A. Nishino, MD, Department of Immunology and Rheumatology, Nagasaki University Graduate School of Biomedical Sciences; T. Suzuki, MD, PhD, Japanese Red Cross Nagasaki Genbaku Hospital; Y. Horai, MD, PhD, Department of Immunology and Rheumatology, Nagasaki University Graduate School of Biomedical Sciences; A. Okada, MD, PhD, Japanese Red Cross Nagasaki Genbaku Hospital; T. Nishimura, PhD, Department of Public Health, Nagasaki University Graduate School of Biomedical Sciences; T. Koga, MD, PhD, Department of Immunology and Rheumatology, Nagasaki University Graduate School of Biomedical Sciences; S. Kawashiri, MD
| | - Yoshiro Horai
- From the Department of Immunology and Rheumatology, and Department of Public Health, and Department of Health Sciences, Nagasaki University Graduate School of Biomedical Sciences; Japanese Red Cross Nagasaki Genbaku Hospital; Department of Radiology and Radiation Research, Nagasaki University Hospital, Nagasaki; Department of Clinical Immunology and Rheumatology, Hiroshima University, Hiroshima; Department of Radiology, Institute of Biomedical Sciences, Tokushima University Graduate School, Tokushima; Sasebo Chuo Hospital, Sasebo, Japan.Y. Nakashima, MD, Department of Immunology and Rheumatology, Nagasaki University Graduate School of Biomedical Sciences; M. Tamai, MD, PhD, Department of Immunology and Rheumatology, Nagasaki University Graduate School of Biomedical Sciences; J. Kita, MD, PhD, Department of Immunology and Rheumatology, Nagasaki University Graduate School of Biomedical Sciences; T. Michitsuji, MD, Department of Immunology and Rheumatology, Nagasaki University Graduate School of Biomedical Sciences; T. Shimizu, MD, Department of Immunology and Rheumatology, Nagasaki University Graduate School of Biomedical Sciences; S. Fukui, MD, Department of Immunology and Rheumatology, Nagasaki University Graduate School of Biomedical Sciences; M. Umeda, MD, Department of Immunology and Rheumatology, Nagasaki University Graduate School of Biomedical Sciences; A. Nishino, MD, Department of Immunology and Rheumatology, Nagasaki University Graduate School of Biomedical Sciences; T. Suzuki, MD, PhD, Japanese Red Cross Nagasaki Genbaku Hospital; Y. Horai, MD, PhD, Department of Immunology and Rheumatology, Nagasaki University Graduate School of Biomedical Sciences; A. Okada, MD, PhD, Japanese Red Cross Nagasaki Genbaku Hospital; T. Nishimura, PhD, Department of Public Health, Nagasaki University Graduate School of Biomedical Sciences; T. Koga, MD, PhD, Department of Immunology and Rheumatology, Nagasaki University Graduate School of Biomedical Sciences; S. Kawashiri, MD
| | - Akitomo Okada
- From the Department of Immunology and Rheumatology, and Department of Public Health, and Department of Health Sciences, Nagasaki University Graduate School of Biomedical Sciences; Japanese Red Cross Nagasaki Genbaku Hospital; Department of Radiology and Radiation Research, Nagasaki University Hospital, Nagasaki; Department of Clinical Immunology and Rheumatology, Hiroshima University, Hiroshima; Department of Radiology, Institute of Biomedical Sciences, Tokushima University Graduate School, Tokushima; Sasebo Chuo Hospital, Sasebo, Japan.Y. Nakashima, MD, Department of Immunology and Rheumatology, Nagasaki University Graduate School of Biomedical Sciences; M. Tamai, MD, PhD, Department of Immunology and Rheumatology, Nagasaki University Graduate School of Biomedical Sciences; J. Kita, MD, PhD, Department of Immunology and Rheumatology, Nagasaki University Graduate School of Biomedical Sciences; T. Michitsuji, MD, Department of Immunology and Rheumatology, Nagasaki University Graduate School of Biomedical Sciences; T. Shimizu, MD, Department of Immunology and Rheumatology, Nagasaki University Graduate School of Biomedical Sciences; S. Fukui, MD, Department of Immunology and Rheumatology, Nagasaki University Graduate School of Biomedical Sciences; M. Umeda, MD, Department of Immunology and Rheumatology, Nagasaki University Graduate School of Biomedical Sciences; A. Nishino, MD, Department of Immunology and Rheumatology, Nagasaki University Graduate School of Biomedical Sciences; T. Suzuki, MD, PhD, Japanese Red Cross Nagasaki Genbaku Hospital; Y. Horai, MD, PhD, Department of Immunology and Rheumatology, Nagasaki University Graduate School of Biomedical Sciences; A. Okada, MD, PhD, Japanese Red Cross Nagasaki Genbaku Hospital; T. Nishimura, PhD, Department of Public Health, Nagasaki University Graduate School of Biomedical Sciences; T. Koga, MD, PhD, Department of Immunology and Rheumatology, Nagasaki University Graduate School of Biomedical Sciences; S. Kawashiri, MD
| | - Takayuki Nishimura
- From the Department of Immunology and Rheumatology, and Department of Public Health, and Department of Health Sciences, Nagasaki University Graduate School of Biomedical Sciences; Japanese Red Cross Nagasaki Genbaku Hospital; Department of Radiology and Radiation Research, Nagasaki University Hospital, Nagasaki; Department of Clinical Immunology and Rheumatology, Hiroshima University, Hiroshima; Department of Radiology, Institute of Biomedical Sciences, Tokushima University Graduate School, Tokushima; Sasebo Chuo Hospital, Sasebo, Japan.Y. Nakashima, MD, Department of Immunology and Rheumatology, Nagasaki University Graduate School of Biomedical Sciences; M. Tamai, MD, PhD, Department of Immunology and Rheumatology, Nagasaki University Graduate School of Biomedical Sciences; J. Kita, MD, PhD, Department of Immunology and Rheumatology, Nagasaki University Graduate School of Biomedical Sciences; T. Michitsuji, MD, Department of Immunology and Rheumatology, Nagasaki University Graduate School of Biomedical Sciences; T. Shimizu, MD, Department of Immunology and Rheumatology, Nagasaki University Graduate School of Biomedical Sciences; S. Fukui, MD, Department of Immunology and Rheumatology, Nagasaki University Graduate School of Biomedical Sciences; M. Umeda, MD, Department of Immunology and Rheumatology, Nagasaki University Graduate School of Biomedical Sciences; A. Nishino, MD, Department of Immunology and Rheumatology, Nagasaki University Graduate School of Biomedical Sciences; T. Suzuki, MD, PhD, Japanese Red Cross Nagasaki Genbaku Hospital; Y. Horai, MD, PhD, Department of Immunology and Rheumatology, Nagasaki University Graduate School of Biomedical Sciences; A. Okada, MD, PhD, Japanese Red Cross Nagasaki Genbaku Hospital; T. Nishimura, PhD, Department of Public Health, Nagasaki University Graduate School of Biomedical Sciences; T. Koga, MD, PhD, Department of Immunology and Rheumatology, Nagasaki University Graduate School of Biomedical Sciences; S. Kawashiri, MD
| | - Tomohiro Koga
- From the Department of Immunology and Rheumatology, and Department of Public Health, and Department of Health Sciences, Nagasaki University Graduate School of Biomedical Sciences; Japanese Red Cross Nagasaki Genbaku Hospital; Department of Radiology and Radiation Research, Nagasaki University Hospital, Nagasaki; Department of Clinical Immunology and Rheumatology, Hiroshima University, Hiroshima; Department of Radiology, Institute of Biomedical Sciences, Tokushima University Graduate School, Tokushima; Sasebo Chuo Hospital, Sasebo, Japan.Y. Nakashima, MD, Department of Immunology and Rheumatology, Nagasaki University Graduate School of Biomedical Sciences; M. Tamai, MD, PhD, Department of Immunology and Rheumatology, Nagasaki University Graduate School of Biomedical Sciences; J. Kita, MD, PhD, Department of Immunology and Rheumatology, Nagasaki University Graduate School of Biomedical Sciences; T. Michitsuji, MD, Department of Immunology and Rheumatology, Nagasaki University Graduate School of Biomedical Sciences; T. Shimizu, MD, Department of Immunology and Rheumatology, Nagasaki University Graduate School of Biomedical Sciences; S. Fukui, MD, Department of Immunology and Rheumatology, Nagasaki University Graduate School of Biomedical Sciences; M. Umeda, MD, Department of Immunology and Rheumatology, Nagasaki University Graduate School of Biomedical Sciences; A. Nishino, MD, Department of Immunology and Rheumatology, Nagasaki University Graduate School of Biomedical Sciences; T. Suzuki, MD, PhD, Japanese Red Cross Nagasaki Genbaku Hospital; Y. Horai, MD, PhD, Department of Immunology and Rheumatology, Nagasaki University Graduate School of Biomedical Sciences; A. Okada, MD, PhD, Japanese Red Cross Nagasaki Genbaku Hospital; T. Nishimura, PhD, Department of Public Health, Nagasaki University Graduate School of Biomedical Sciences; T. Koga, MD, PhD, Department of Immunology and Rheumatology, Nagasaki University Graduate School of Biomedical Sciences; S. Kawashiri, MD
| | - Shin-Ya Kawashiri
- From the Department of Immunology and Rheumatology, and Department of Public Health, and Department of Health Sciences, Nagasaki University Graduate School of Biomedical Sciences; Japanese Red Cross Nagasaki Genbaku Hospital; Department of Radiology and Radiation Research, Nagasaki University Hospital, Nagasaki; Department of Clinical Immunology and Rheumatology, Hiroshima University, Hiroshima; Department of Radiology, Institute of Biomedical Sciences, Tokushima University Graduate School, Tokushima; Sasebo Chuo Hospital, Sasebo, Japan.Y. Nakashima, MD, Department of Immunology and Rheumatology, Nagasaki University Graduate School of Biomedical Sciences; M. Tamai, MD, PhD, Department of Immunology and Rheumatology, Nagasaki University Graduate School of Biomedical Sciences; J. Kita, MD, PhD, Department of Immunology and Rheumatology, Nagasaki University Graduate School of Biomedical Sciences; T. Michitsuji, MD, Department of Immunology and Rheumatology, Nagasaki University Graduate School of Biomedical Sciences; T. Shimizu, MD, Department of Immunology and Rheumatology, Nagasaki University Graduate School of Biomedical Sciences; S. Fukui, MD, Department of Immunology and Rheumatology, Nagasaki University Graduate School of Biomedical Sciences; M. Umeda, MD, Department of Immunology and Rheumatology, Nagasaki University Graduate School of Biomedical Sciences; A. Nishino, MD, Department of Immunology and Rheumatology, Nagasaki University Graduate School of Biomedical Sciences; T. Suzuki, MD, PhD, Japanese Red Cross Nagasaki Genbaku Hospital; Y. Horai, MD, PhD, Department of Immunology and Rheumatology, Nagasaki University Graduate School of Biomedical Sciences; A. Okada, MD, PhD, Japanese Red Cross Nagasaki Genbaku Hospital; T. Nishimura, PhD, Department of Public Health, Nagasaki University Graduate School of Biomedical Sciences; T. Koga, MD, PhD, Department of Immunology and Rheumatology, Nagasaki University Graduate School of Biomedical Sciences; S. Kawashiri, MD
| | - Naoki Iwamoto
- From the Department of Immunology and Rheumatology, and Department of Public Health, and Department of Health Sciences, Nagasaki University Graduate School of Biomedical Sciences; Japanese Red Cross Nagasaki Genbaku Hospital; Department of Radiology and Radiation Research, Nagasaki University Hospital, Nagasaki; Department of Clinical Immunology and Rheumatology, Hiroshima University, Hiroshima; Department of Radiology, Institute of Biomedical Sciences, Tokushima University Graduate School, Tokushima; Sasebo Chuo Hospital, Sasebo, Japan.Y. Nakashima, MD, Department of Immunology and Rheumatology, Nagasaki University Graduate School of Biomedical Sciences; M. Tamai, MD, PhD, Department of Immunology and Rheumatology, Nagasaki University Graduate School of Biomedical Sciences; J. Kita, MD, PhD, Department of Immunology and Rheumatology, Nagasaki University Graduate School of Biomedical Sciences; T. Michitsuji, MD, Department of Immunology and Rheumatology, Nagasaki University Graduate School of Biomedical Sciences; T. Shimizu, MD, Department of Immunology and Rheumatology, Nagasaki University Graduate School of Biomedical Sciences; S. Fukui, MD, Department of Immunology and Rheumatology, Nagasaki University Graduate School of Biomedical Sciences; M. Umeda, MD, Department of Immunology and Rheumatology, Nagasaki University Graduate School of Biomedical Sciences; A. Nishino, MD, Department of Immunology and Rheumatology, Nagasaki University Graduate School of Biomedical Sciences; T. Suzuki, MD, PhD, Japanese Red Cross Nagasaki Genbaku Hospital; Y. Horai, MD, PhD, Department of Immunology and Rheumatology, Nagasaki University Graduate School of Biomedical Sciences; A. Okada, MD, PhD, Japanese Red Cross Nagasaki Genbaku Hospital; T. Nishimura, PhD, Department of Public Health, Nagasaki University Graduate School of Biomedical Sciences; T. Koga, MD, PhD, Department of Immunology and Rheumatology, Nagasaki University Graduate School of Biomedical Sciences; S. Kawashiri, MD
| | - Kunihiro Ichinose
- From the Department of Immunology and Rheumatology, and Department of Public Health, and Department of Health Sciences, Nagasaki University Graduate School of Biomedical Sciences; Japanese Red Cross Nagasaki Genbaku Hospital; Department of Radiology and Radiation Research, Nagasaki University Hospital, Nagasaki; Department of Clinical Immunology and Rheumatology, Hiroshima University, Hiroshima; Department of Radiology, Institute of Biomedical Sciences, Tokushima University Graduate School, Tokushima; Sasebo Chuo Hospital, Sasebo, Japan.Y. Nakashima, MD, Department of Immunology and Rheumatology, Nagasaki University Graduate School of Biomedical Sciences; M. Tamai, MD, PhD, Department of Immunology and Rheumatology, Nagasaki University Graduate School of Biomedical Sciences; J. Kita, MD, PhD, Department of Immunology and Rheumatology, Nagasaki University Graduate School of Biomedical Sciences; T. Michitsuji, MD, Department of Immunology and Rheumatology, Nagasaki University Graduate School of Biomedical Sciences; T. Shimizu, MD, Department of Immunology and Rheumatology, Nagasaki University Graduate School of Biomedical Sciences; S. Fukui, MD, Department of Immunology and Rheumatology, Nagasaki University Graduate School of Biomedical Sciences; M. Umeda, MD, Department of Immunology and Rheumatology, Nagasaki University Graduate School of Biomedical Sciences; A. Nishino, MD, Department of Immunology and Rheumatology, Nagasaki University Graduate School of Biomedical Sciences; T. Suzuki, MD, PhD, Japanese Red Cross Nagasaki Genbaku Hospital; Y. Horai, MD, PhD, Department of Immunology and Rheumatology, Nagasaki University Graduate School of Biomedical Sciences; A. Okada, MD, PhD, Japanese Red Cross Nagasaki Genbaku Hospital; T. Nishimura, PhD, Department of Public Health, Nagasaki University Graduate School of Biomedical Sciences; T. Koga, MD, PhD, Department of Immunology and Rheumatology, Nagasaki University Graduate School of Biomedical Sciences; S. Kawashiri, MD
| | - Yasuko Hirai
- From the Department of Immunology and Rheumatology, and Department of Public Health, and Department of Health Sciences, Nagasaki University Graduate School of Biomedical Sciences; Japanese Red Cross Nagasaki Genbaku Hospital; Department of Radiology and Radiation Research, Nagasaki University Hospital, Nagasaki; Department of Clinical Immunology and Rheumatology, Hiroshima University, Hiroshima; Department of Radiology, Institute of Biomedical Sciences, Tokushima University Graduate School, Tokushima; Sasebo Chuo Hospital, Sasebo, Japan.Y. Nakashima, MD, Department of Immunology and Rheumatology, Nagasaki University Graduate School of Biomedical Sciences; M. Tamai, MD, PhD, Department of Immunology and Rheumatology, Nagasaki University Graduate School of Biomedical Sciences; J. Kita, MD, PhD, Department of Immunology and Rheumatology, Nagasaki University Graduate School of Biomedical Sciences; T. Michitsuji, MD, Department of Immunology and Rheumatology, Nagasaki University Graduate School of Biomedical Sciences; T. Shimizu, MD, Department of Immunology and Rheumatology, Nagasaki University Graduate School of Biomedical Sciences; S. Fukui, MD, Department of Immunology and Rheumatology, Nagasaki University Graduate School of Biomedical Sciences; M. Umeda, MD, Department of Immunology and Rheumatology, Nagasaki University Graduate School of Biomedical Sciences; A. Nishino, MD, Department of Immunology and Rheumatology, Nagasaki University Graduate School of Biomedical Sciences; T. Suzuki, MD, PhD, Japanese Red Cross Nagasaki Genbaku Hospital; Y. Horai, MD, PhD, Department of Immunology and Rheumatology, Nagasaki University Graduate School of Biomedical Sciences; A. Okada, MD, PhD, Japanese Red Cross Nagasaki Genbaku Hospital; T. Nishimura, PhD, Department of Public Health, Nagasaki University Graduate School of Biomedical Sciences; T. Koga, MD, PhD, Department of Immunology and Rheumatology, Nagasaki University Graduate School of Biomedical Sciences; S. Kawashiri, MD
| | - Kazuhiko Arima
- From the Department of Immunology and Rheumatology, and Department of Public Health, and Department of Health Sciences, Nagasaki University Graduate School of Biomedical Sciences; Japanese Red Cross Nagasaki Genbaku Hospital; Department of Radiology and Radiation Research, Nagasaki University Hospital, Nagasaki; Department of Clinical Immunology and Rheumatology, Hiroshima University, Hiroshima; Department of Radiology, Institute of Biomedical Sciences, Tokushima University Graduate School, Tokushima; Sasebo Chuo Hospital, Sasebo, Japan.Y. Nakashima, MD, Department of Immunology and Rheumatology, Nagasaki University Graduate School of Biomedical Sciences; M. Tamai, MD, PhD, Department of Immunology and Rheumatology, Nagasaki University Graduate School of Biomedical Sciences; J. Kita, MD, PhD, Department of Immunology and Rheumatology, Nagasaki University Graduate School of Biomedical Sciences; T. Michitsuji, MD, Department of Immunology and Rheumatology, Nagasaki University Graduate School of Biomedical Sciences; T. Shimizu, MD, Department of Immunology and Rheumatology, Nagasaki University Graduate School of Biomedical Sciences; S. Fukui, MD, Department of Immunology and Rheumatology, Nagasaki University Graduate School of Biomedical Sciences; M. Umeda, MD, Department of Immunology and Rheumatology, Nagasaki University Graduate School of Biomedical Sciences; A. Nishino, MD, Department of Immunology and Rheumatology, Nagasaki University Graduate School of Biomedical Sciences; T. Suzuki, MD, PhD, Japanese Red Cross Nagasaki Genbaku Hospital; Y. Horai, MD, PhD, Department of Immunology and Rheumatology, Nagasaki University Graduate School of Biomedical Sciences; A. Okada, MD, PhD, Japanese Red Cross Nagasaki Genbaku Hospital; T. Nishimura, PhD, Department of Public Health, Nagasaki University Graduate School of Biomedical Sciences; T. Koga, MD, PhD, Department of Immunology and Rheumatology, Nagasaki University Graduate School of Biomedical Sciences; S. Kawashiri, MD
| | - Satoshi Yamasaki
- From the Department of Immunology and Rheumatology, and Department of Public Health, and Department of Health Sciences, Nagasaki University Graduate School of Biomedical Sciences; Japanese Red Cross Nagasaki Genbaku Hospital; Department of Radiology and Radiation Research, Nagasaki University Hospital, Nagasaki; Department of Clinical Immunology and Rheumatology, Hiroshima University, Hiroshima; Department of Radiology, Institute of Biomedical Sciences, Tokushima University Graduate School, Tokushima; Sasebo Chuo Hospital, Sasebo, Japan.Y. Nakashima, MD, Department of Immunology and Rheumatology, Nagasaki University Graduate School of Biomedical Sciences; M. Tamai, MD, PhD, Department of Immunology and Rheumatology, Nagasaki University Graduate School of Biomedical Sciences; J. Kita, MD, PhD, Department of Immunology and Rheumatology, Nagasaki University Graduate School of Biomedical Sciences; T. Michitsuji, MD, Department of Immunology and Rheumatology, Nagasaki University Graduate School of Biomedical Sciences; T. Shimizu, MD, Department of Immunology and Rheumatology, Nagasaki University Graduate School of Biomedical Sciences; S. Fukui, MD, Department of Immunology and Rheumatology, Nagasaki University Graduate School of Biomedical Sciences; M. Umeda, MD, Department of Immunology and Rheumatology, Nagasaki University Graduate School of Biomedical Sciences; A. Nishino, MD, Department of Immunology and Rheumatology, Nagasaki University Graduate School of Biomedical Sciences; T. Suzuki, MD, PhD, Japanese Red Cross Nagasaki Genbaku Hospital; Y. Horai, MD, PhD, Department of Immunology and Rheumatology, Nagasaki University Graduate School of Biomedical Sciences; A. Okada, MD, PhD, Japanese Red Cross Nagasaki Genbaku Hospital; T. Nishimura, PhD, Department of Public Health, Nagasaki University Graduate School of Biomedical Sciences; T. Koga, MD, PhD, Department of Immunology and Rheumatology, Nagasaki University Graduate School of Biomedical Sciences; S. Kawashiri, MD
| | - Hideki Nakamura
- From the Department of Immunology and Rheumatology, and Department of Public Health, and Department of Health Sciences, Nagasaki University Graduate School of Biomedical Sciences; Japanese Red Cross Nagasaki Genbaku Hospital; Department of Radiology and Radiation Research, Nagasaki University Hospital, Nagasaki; Department of Clinical Immunology and Rheumatology, Hiroshima University, Hiroshima; Department of Radiology, Institute of Biomedical Sciences, Tokushima University Graduate School, Tokushima; Sasebo Chuo Hospital, Sasebo, Japan.Y. Nakashima, MD, Department of Immunology and Rheumatology, Nagasaki University Graduate School of Biomedical Sciences; M. Tamai, MD, PhD, Department of Immunology and Rheumatology, Nagasaki University Graduate School of Biomedical Sciences; J. Kita, MD, PhD, Department of Immunology and Rheumatology, Nagasaki University Graduate School of Biomedical Sciences; T. Michitsuji, MD, Department of Immunology and Rheumatology, Nagasaki University Graduate School of Biomedical Sciences; T. Shimizu, MD, Department of Immunology and Rheumatology, Nagasaki University Graduate School of Biomedical Sciences; S. Fukui, MD, Department of Immunology and Rheumatology, Nagasaki University Graduate School of Biomedical Sciences; M. Umeda, MD, Department of Immunology and Rheumatology, Nagasaki University Graduate School of Biomedical Sciences; A. Nishino, MD, Department of Immunology and Rheumatology, Nagasaki University Graduate School of Biomedical Sciences; T. Suzuki, MD, PhD, Japanese Red Cross Nagasaki Genbaku Hospital; Y. Horai, MD, PhD, Department of Immunology and Rheumatology, Nagasaki University Graduate School of Biomedical Sciences; A. Okada, MD, PhD, Japanese Red Cross Nagasaki Genbaku Hospital; T. Nishimura, PhD, Department of Public Health, Nagasaki University Graduate School of Biomedical Sciences; T. Koga, MD, PhD, Department of Immunology and Rheumatology, Nagasaki University Graduate School of Biomedical Sciences; S. Kawashiri, MD
| | - Tomoki Origuchi
- From the Department of Immunology and Rheumatology, and Department of Public Health, and Department of Health Sciences, Nagasaki University Graduate School of Biomedical Sciences; Japanese Red Cross Nagasaki Genbaku Hospital; Department of Radiology and Radiation Research, Nagasaki University Hospital, Nagasaki; Department of Clinical Immunology and Rheumatology, Hiroshima University, Hiroshima; Department of Radiology, Institute of Biomedical Sciences, Tokushima University Graduate School, Tokushima; Sasebo Chuo Hospital, Sasebo, Japan.Y. Nakashima, MD, Department of Immunology and Rheumatology, Nagasaki University Graduate School of Biomedical Sciences; M. Tamai, MD, PhD, Department of Immunology and Rheumatology, Nagasaki University Graduate School of Biomedical Sciences; J. Kita, MD, PhD, Department of Immunology and Rheumatology, Nagasaki University Graduate School of Biomedical Sciences; T. Michitsuji, MD, Department of Immunology and Rheumatology, Nagasaki University Graduate School of Biomedical Sciences; T. Shimizu, MD, Department of Immunology and Rheumatology, Nagasaki University Graduate School of Biomedical Sciences; S. Fukui, MD, Department of Immunology and Rheumatology, Nagasaki University Graduate School of Biomedical Sciences; M. Umeda, MD, Department of Immunology and Rheumatology, Nagasaki University Graduate School of Biomedical Sciences; A. Nishino, MD, Department of Immunology and Rheumatology, Nagasaki University Graduate School of Biomedical Sciences; T. Suzuki, MD, PhD, Japanese Red Cross Nagasaki Genbaku Hospital; Y. Horai, MD, PhD, Department of Immunology and Rheumatology, Nagasaki University Graduate School of Biomedical Sciences; A. Okada, MD, PhD, Japanese Red Cross Nagasaki Genbaku Hospital; T. Nishimura, PhD, Department of Public Health, Nagasaki University Graduate School of Biomedical Sciences; T. Koga, MD, PhD, Department of Immunology and Rheumatology, Nagasaki University Graduate School of Biomedical Sciences; S. Kawashiri, MD
| | - Shoichiro Takao
- From the Department of Immunology and Rheumatology, and Department of Public Health, and Department of Health Sciences, Nagasaki University Graduate School of Biomedical Sciences; Japanese Red Cross Nagasaki Genbaku Hospital; Department of Radiology and Radiation Research, Nagasaki University Hospital, Nagasaki; Department of Clinical Immunology and Rheumatology, Hiroshima University, Hiroshima; Department of Radiology, Institute of Biomedical Sciences, Tokushima University Graduate School, Tokushima; Sasebo Chuo Hospital, Sasebo, Japan.Y. Nakashima, MD, Department of Immunology and Rheumatology, Nagasaki University Graduate School of Biomedical Sciences; M. Tamai, MD, PhD, Department of Immunology and Rheumatology, Nagasaki University Graduate School of Biomedical Sciences; J. Kita, MD, PhD, Department of Immunology and Rheumatology, Nagasaki University Graduate School of Biomedical Sciences; T. Michitsuji, MD, Department of Immunology and Rheumatology, Nagasaki University Graduate School of Biomedical Sciences; T. Shimizu, MD, Department of Immunology and Rheumatology, Nagasaki University Graduate School of Biomedical Sciences; S. Fukui, MD, Department of Immunology and Rheumatology, Nagasaki University Graduate School of Biomedical Sciences; M. Umeda, MD, Department of Immunology and Rheumatology, Nagasaki University Graduate School of Biomedical Sciences; A. Nishino, MD, Department of Immunology and Rheumatology, Nagasaki University Graduate School of Biomedical Sciences; T. Suzuki, MD, PhD, Japanese Red Cross Nagasaki Genbaku Hospital; Y. Horai, MD, PhD, Department of Immunology and Rheumatology, Nagasaki University Graduate School of Biomedical Sciences; A. Okada, MD, PhD, Japanese Red Cross Nagasaki Genbaku Hospital; T. Nishimura, PhD, Department of Public Health, Nagasaki University Graduate School of Biomedical Sciences; T. Koga, MD, PhD, Department of Immunology and Rheumatology, Nagasaki University Graduate School of Biomedical Sciences; S. Kawashiri, MD
| | - Masataka Uetani
- From the Department of Immunology and Rheumatology, and Department of Public Health, and Department of Health Sciences, Nagasaki University Graduate School of Biomedical Sciences; Japanese Red Cross Nagasaki Genbaku Hospital; Department of Radiology and Radiation Research, Nagasaki University Hospital, Nagasaki; Department of Clinical Immunology and Rheumatology, Hiroshima University, Hiroshima; Department of Radiology, Institute of Biomedical Sciences, Tokushima University Graduate School, Tokushima; Sasebo Chuo Hospital, Sasebo, Japan.Y. Nakashima, MD, Department of Immunology and Rheumatology, Nagasaki University Graduate School of Biomedical Sciences; M. Tamai, MD, PhD, Department of Immunology and Rheumatology, Nagasaki University Graduate School of Biomedical Sciences; J. Kita, MD, PhD, Department of Immunology and Rheumatology, Nagasaki University Graduate School of Biomedical Sciences; T. Michitsuji, MD, Department of Immunology and Rheumatology, Nagasaki University Graduate School of Biomedical Sciences; T. Shimizu, MD, Department of Immunology and Rheumatology, Nagasaki University Graduate School of Biomedical Sciences; S. Fukui, MD, Department of Immunology and Rheumatology, Nagasaki University Graduate School of Biomedical Sciences; M. Umeda, MD, Department of Immunology and Rheumatology, Nagasaki University Graduate School of Biomedical Sciences; A. Nishino, MD, Department of Immunology and Rheumatology, Nagasaki University Graduate School of Biomedical Sciences; T. Suzuki, MD, PhD, Japanese Red Cross Nagasaki Genbaku Hospital; Y. Horai, MD, PhD, Department of Immunology and Rheumatology, Nagasaki University Graduate School of Biomedical Sciences; A. Okada, MD, PhD, Japanese Red Cross Nagasaki Genbaku Hospital; T. Nishimura, PhD, Department of Public Health, Nagasaki University Graduate School of Biomedical Sciences; T. Koga, MD, PhD, Department of Immunology and Rheumatology, Nagasaki University Graduate School of Biomedical Sciences; S. Kawashiri, MD
| | - Kiyoshi Aoyagi
- From the Department of Immunology and Rheumatology, and Department of Public Health, and Department of Health Sciences, Nagasaki University Graduate School of Biomedical Sciences; Japanese Red Cross Nagasaki Genbaku Hospital; Department of Radiology and Radiation Research, Nagasaki University Hospital, Nagasaki; Department of Clinical Immunology and Rheumatology, Hiroshima University, Hiroshima; Department of Radiology, Institute of Biomedical Sciences, Tokushima University Graduate School, Tokushima; Sasebo Chuo Hospital, Sasebo, Japan.Y. Nakashima, MD, Department of Immunology and Rheumatology, Nagasaki University Graduate School of Biomedical Sciences; M. Tamai, MD, PhD, Department of Immunology and Rheumatology, Nagasaki University Graduate School of Biomedical Sciences; J. Kita, MD, PhD, Department of Immunology and Rheumatology, Nagasaki University Graduate School of Biomedical Sciences; T. Michitsuji, MD, Department of Immunology and Rheumatology, Nagasaki University Graduate School of Biomedical Sciences; T. Shimizu, MD, Department of Immunology and Rheumatology, Nagasaki University Graduate School of Biomedical Sciences; S. Fukui, MD, Department of Immunology and Rheumatology, Nagasaki University Graduate School of Biomedical Sciences; M. Umeda, MD, Department of Immunology and Rheumatology, Nagasaki University Graduate School of Biomedical Sciences; A. Nishino, MD, Department of Immunology and Rheumatology, Nagasaki University Graduate School of Biomedical Sciences; T. Suzuki, MD, PhD, Japanese Red Cross Nagasaki Genbaku Hospital; Y. Horai, MD, PhD, Department of Immunology and Rheumatology, Nagasaki University Graduate School of Biomedical Sciences; A. Okada, MD, PhD, Japanese Red Cross Nagasaki Genbaku Hospital; T. Nishimura, PhD, Department of Public Health, Nagasaki University Graduate School of Biomedical Sciences; T. Koga, MD, PhD, Department of Immunology and Rheumatology, Nagasaki University Graduate School of Biomedical Sciences; S. Kawashiri, MD
| | - Katsumi Eguchi
- From the Department of Immunology and Rheumatology, and Department of Public Health, and Department of Health Sciences, Nagasaki University Graduate School of Biomedical Sciences; Japanese Red Cross Nagasaki Genbaku Hospital; Department of Radiology and Radiation Research, Nagasaki University Hospital, Nagasaki; Department of Clinical Immunology and Rheumatology, Hiroshima University, Hiroshima; Department of Radiology, Institute of Biomedical Sciences, Tokushima University Graduate School, Tokushima; Sasebo Chuo Hospital, Sasebo, Japan.Y. Nakashima, MD, Department of Immunology and Rheumatology, Nagasaki University Graduate School of Biomedical Sciences; M. Tamai, MD, PhD, Department of Immunology and Rheumatology, Nagasaki University Graduate School of Biomedical Sciences; J. Kita, MD, PhD, Department of Immunology and Rheumatology, Nagasaki University Graduate School of Biomedical Sciences; T. Michitsuji, MD, Department of Immunology and Rheumatology, Nagasaki University Graduate School of Biomedical Sciences; T. Shimizu, MD, Department of Immunology and Rheumatology, Nagasaki University Graduate School of Biomedical Sciences; S. Fukui, MD, Department of Immunology and Rheumatology, Nagasaki University Graduate School of Biomedical Sciences; M. Umeda, MD, Department of Immunology and Rheumatology, Nagasaki University Graduate School of Biomedical Sciences; A. Nishino, MD, Department of Immunology and Rheumatology, Nagasaki University Graduate School of Biomedical Sciences; T. Suzuki, MD, PhD, Japanese Red Cross Nagasaki Genbaku Hospital; Y. Horai, MD, PhD, Department of Immunology and Rheumatology, Nagasaki University Graduate School of Biomedical Sciences; A. Okada, MD, PhD, Japanese Red Cross Nagasaki Genbaku Hospital; T. Nishimura, PhD, Department of Public Health, Nagasaki University Graduate School of Biomedical Sciences; T. Koga, MD, PhD, Department of Immunology and Rheumatology, Nagasaki University Graduate School of Biomedical Sciences; S. Kawashiri, MD
| | - Atsushi Kawakami
- From the Department of Immunology and Rheumatology, and Department of Public Health, and Department of Health Sciences, Nagasaki University Graduate School of Biomedical Sciences; Japanese Red Cross Nagasaki Genbaku Hospital; Department of Radiology and Radiation Research, Nagasaki University Hospital, Nagasaki; Department of Clinical Immunology and Rheumatology, Hiroshima University, Hiroshima; Department of Radiology, Institute of Biomedical Sciences, Tokushima University Graduate School, Tokushima; Sasebo Chuo Hospital, Sasebo, Japan.Y. Nakashima, MD, Department of Immunology and Rheumatology, Nagasaki University Graduate School of Biomedical Sciences; M. Tamai, MD, PhD, Department of Immunology and Rheumatology, Nagasaki University Graduate School of Biomedical Sciences; J. Kita, MD, PhD, Department of Immunology and Rheumatology, Nagasaki University Graduate School of Biomedical Sciences; T. Michitsuji, MD, Department of Immunology and Rheumatology, Nagasaki University Graduate School of Biomedical Sciences; T. Shimizu, MD, Department of Immunology and Rheumatology, Nagasaki University Graduate School of Biomedical Sciences; S. Fukui, MD, Department of Immunology and Rheumatology, Nagasaki University Graduate School of Biomedical Sciences; M. Umeda, MD, Department of Immunology and Rheumatology, Nagasaki University Graduate School of Biomedical Sciences; A. Nishino, MD, Department of Immunology and Rheumatology, Nagasaki University Graduate School of Biomedical Sciences; T. Suzuki, MD, PhD, Japanese Red Cross Nagasaki Genbaku Hospital; Y. Horai, MD, PhD, Department of Immunology and Rheumatology, Nagasaki University Graduate School of Biomedical Sciences; A. Okada, MD, PhD, Japanese Red Cross Nagasaki Genbaku Hospital; T. Nishimura, PhD, Department of Public Health, Nagasaki University Graduate School of Biomedical Sciences; T. Koga, MD, PhD, Department of Immunology and Rheumatology, Nagasaki University Graduate School of Biomedical Sciences; S. Kawashiri, MD
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