1) Dr. Mohamed Shekhani and Dr. Hiwa Abubakir Husein from the Kurdistan center for gastroenterology & hepatology traveled to Japan for science and training from March 1-19, 2011. 2) They received training and presented research at Kumamoto RC Hospital and Aichi Cancer Center in Nagoya, Japan. 3) They observed advanced endoscopy techniques for diagnosing and treating gastrointestinal cancers including endoscopic mucosal dissection, magnifying endoscopy, narrow-band imaging, and chromoendoscopy. Endoscopists in Japan demonstrated high standards of patient care and endoscopy skills.

1. From Iraqi Kurdistan to Japan: science & picnic. 1-19/3/2011. Dr. Mohamed Shekhani Dr. Hiwa Abubakir Husein. Kurdistan center for gastroenterology & hepatology, As-Sulaimaniyah –Iraqi Kurdistan.

2. Arriving at Nagoya: the Suchi welcome party

3. The popular Japanese suchi dish : Raw fish

4. Nagoya city center

5. Nagoya city center

6. Nagoya city center

7. Nagoya city center

8. Nagoya city center

9. Given a chance to present in Kumamoto RC Hospital.

10. Welcome party in Kumomoto city.

11. Kumomoto city & castle.

12. Kumomoto: Japanese gardens Aso mountain& the green tea Ice cream.

13. Given chance to deliver talks in Aichi cancer center-Nagoya.

14. Aichi cancer center: Nagoya

15. Aichi cancer center endoscopy unit: with Dr. yamao kenji

23. Intra-papillary capillary loops (IPCL) AVM: arborescent vascular network, PA: perforating artery, PV: perforating vein

24. IPCL pattern

25. Non-magnifying NBI image White-light image Lugol chromoendoscopy NBI image

26. Magnifying NBI image Mucosal esophageal squamous cell carcinoma

27. Magnifying NBI image Submucosal esophageal squamous cell carcinoma

28. Stomach ME : Microvascular& Surface microstructure pattern

29. Case1 Case2

30. Which is a malignant lesion? Focal gastritis Gastric cancer

31. Magnifying Endoscopy

32. CRC ME: Pit pattern

33. Ⅰ Ⅱ Ⅲ S Ⅲ L Ⅳ Ⅴ N Ⅴ I Normal round crypts, regular Enlarged stellar crypts, regular Narrowed round pits, irregular Branched or gyrus-like crests Irregular surface Amorphous surface Elongated, sinuous crests Pit pattern （ Kudo & Turuta’s classification ）

34. Ⅰ Ⅱ Ⅲ S Ⅲ L Ⅳ Ⅴ N Ⅴ I normal pattern Hyperplastic polyp Serrated adenoma irregular pattern non-structure pattern regular pattern Pit pattern and treatment selection No treatment Endoscopic resection Surgery Endoscopic resection or Surgery Nonneoplastic Neoplastic, adenomatous Neoplastic, cancer

35. （インジゴカルミン散布） 0-IIa slightly elevated

36. Chromoscopy （ Indigo carmine ） （ Magnify ）

37. Visiting Hiroshima: The Dome will remind us of the Destructive effects of WMD.

38. Nagoya city streets& markets

39. Nagoya city& castle Bullet train

40. Nagoya city streets& markets

41. Nagoya city streets& markets

42. Nagoya city streets& markets

43. Tempura farewell party& Healthy Japanese dishes.