1. From the Department of Medicine, Okinawa Miyako Hospital (M.M., S.S.), and the Department of Medicine, Okinawa Chubu Hospital (M.K.) — both in Okinawa, Japan; Harvard Kennedy School, Cambridge, MA (M.M.); the Department of Medicine, Johns Hopkins University School of Medicine, Baltimore (R.M.); and the Departments of Medicine and Pediatrics, University of Minnesota Medical School, Minneapolis (A.P.J.O.).