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1 ( ) , : yes (midazolam 3 mg) - Degree of sedation: light - Paradoxical reaction: no 2. Antispasmodics (cimetropium 5mg): yes 3. Past-medical history: specific history (-) 4. Antiplatelet or anticoagulation drug: no 5. Indication: : , . : , , . Pulse oximeter ( ) .. knob White balance Contrast (= enhancement) Two finger method: Endoscope is unstable and the forearm is painful.

2 Three finger method: Endoscope is quite stable and there is no forearm pain. Bad Good , .. up . Where is the hypopharynx? - The portion of the pharynx below the upper edge of the epiglottis pyriform sinus . tongue vestibular fold ventricle vocal fold piriform recess posterior wall of pharynx epiglottis vallecula epiglottic tubercle ary-epiglottic fold trachea cuneiform cartilage corniculate cartilage Pyriform sinus . epiglottic cancer : papillary squamous cell carcinoma Epiglottic mass 2 - 3 cm 25 cm : 27 cm : cf> 35 cm : cm Spinal indentation PZ 3 cm Stomach Esophagus Esophagogastric junction (EGJ) = Proximal margin of gastric folds = Distal end of palisade zone = Pinchcock action (PCA) = Squamocolumnar junction (hiatal hernia) Hernia sac Ampulla A-ring = muscular ring B-ring = mucosal ring = SC junction B-ring A-ring Diaphragmatic orfice SCJ = B-ring Hernia sac Diaphragmatic orfice Ampulla Paraesophageal hernia hernia sac ulcer scar diaphragmatic opening gastric folds CT.

3 - 4 . Situs Inversus . Mid-antrum lesser curvature transverse fold = Pseudo-angle Midantrum transverse fold . Midantrum transverse fold Pylorus midantrum transverse fold (= pseudoangle) . antrum . (1) (2) ? SCJ 2 cm . : Prepyloric antrum = far distal part of gastric antrum (very close to the pyloric ring) Prepyloric antrum . ? Saddle area ? - Saddle area Top of saddle area = 1 2 Blind area (1) (2) .. PEG tube J turn U turn 3 J turn U turn : 6 : 9 (2002) 3 and 8 , 3 8.

4 Clipping at SMC proximal edge 1 cm 2 ( ) (superior duodenal angle, SDA) - .. 2 shortening . Duodenal GIST : 8 1 2 3 4 20cm from IT GE junction Fundus & Cardia Mid-body ESGE guideline, 2002 5 7 8 6 Angle Antrum Duodenal bulb 2nd part . AGC, P/D, Subserosa, LN (+) : GAVE Easy touch bleeding (absolute indication) Lesions limited to the mucosal layer Well and/or moderately differentiated adenocarcinomas Tumors 2 cm in length Absence of ulcer Tumors without lymphovascular involvement. EGC - ESD: M/D adenocarcinoma, cm, SM 1,000 um no residual tumor after surgery EGC - P/D adenocarcinoma, SM2, LN 0/66 EGC - signet ring cell carcinoma, mucosal, LN 0/39 AGC - M/D adenocarcinoma, x , SS penetration, LN 3/74 AGC - P/D adenocarcinoma, serosa penetration, LN 2/32 EGC at the angle of His - M/D, x cm, SM3 invasion, LN (-) Bx #1.

5 Adenocarcinoma, M/D Bx #2. suspected malignancy.