The 1st Asian Congress of Abdominal Radiology Phoenix Seagaia Resort, Miyazaki, Japan June 1(Fri.) – 2(Sat.), 2007 【SAMPLE】】ABSTRACT SUBMITTING FORM Call for Paper …………… October 12, 2006 Final Abstract Deadline…… …… February 1, 2007 Submitting Procedure 1. This form should be filled out by a presenter and please click gray boxes to do so. 2. Please save this form as the presenter’s name. (Ex. “Jane P. Smith.doc”) 3. Please attach the form to your e-mail and send it to [email protected] 4. Once we receive your abstract, we will send a confirmation to the presenter by e-mail. Please note that submitting your abstract will not be completed without our confirmation mail. In case you do not hear from us within a week, please contact us regarding your abstract. Our contact information is at the bottom of this page. Please type only in ENGLISH. Ⅰ. PRESENTER’S GENERAL INFORMATION Ms. Name & Affiliation First Name: John Middle Initial: P. Mr. Dr. Prof. Last Name: Seidel Title/Position: President of XXX Medical Center Affiliation: Department of Interventional Radiology, XXX University Faculty of Medicine Mailing Address Street: 3-19-3 Toyosaki, Kita-Ku Province/State: Osaka City: Osaka City Country: Japan Postal/Zip Code: 531-0072 Contact Address Tel: +81-6-6377-2188 Fax: +81-6-6377-2075 E-mail Address: [email protected] Secretariat of The 1st Asian Congress of Abdominal Radiology C/o Convention Linkage, Inc. PIAS TOWER 11F, 3-19-3 Toyosaki, Kita-ku, Osaka, 531-0072 Japan Tel: +81-6-6377-2188 Fax: +81-6-6377-2075 E-mail: [email protected] 1/1 2/2 The 1st Asian Congress of Abdominal Radiology Phoenix Seagaia Resort, Miyazaki, Japan June 1(Fri.) – 2(Sat.), 2007 Ⅱ. CO-AUTHORS First Middle Name 1. Asami 3. Cristina 2. Initial Maria 4. F. C. Last Name Fukui Borrajo Magnolia Affiliation Country XXXX University Faculty of Medicine Japan XXXX University of Medicine Philippines XXXX Center USA 5. 6. 7. 8. 9. 10. 11. 12. 13. 14. 15. 16. 17. 18. Ⅲ. SCIENTIFIC TOPICS (Please specify topics of your abstract.) Diagnostic Imagings - Gastrointestinal Neoplasms - Hepatobiliary and Pancreas - Portal Venous System - Peritoneum and Mesenteries - Genitourinary Tracts - Retroperitoneum - Others ( Less Invasive Therapy / Interventional Radiology - Image-guided Treatment for Abdominal Neoplasms - Transarterial Treatment for Abdominal Neoplasms - Stenting of Gastrointestinal Tract - Vascular Interventional Radiology - Others ( ) ) Secretariat of The 1st Asian Congress of Abdominal Radiology C/o Convention Linkage, Inc. PIAS TOWER 11F, 3-19-3 Toyosaki, Kita-ku, Osaka, 531-0072 Japan Tel: +81-6-6377-2188 Fax: +81-6-6377-2075 E-mail: [email protected] 3/3 The 1st Asian Congress of Abdominal Radiology Phoenix Seagaia Resort, Miyazaki, Japan June 1(Fri.) – 2(Sat.), 2007 Please type only in ENGLISH. Ⅳ. ABSTRACT Please let us know which type of presentation you would like to make for this abstract. Please also understand that you might be asked to change it after we have accepted your abstract. Presentation type: Oral / Poster *Please Note: In order to use full function of Word’s system, for instance “auto character counting”, “symbols” and “particular characters”, please create your abstract on another Word file first, not on this form, then copy and paste it onto this form. Title (within 20 words) Title title title title title title title title title title Abstract (within 250 words) Abstract Body Abstract Body Abstract Body Abstract Body Abstract Body Abstract Body Abstract Body Abstract Body Abstract Body Abstract Body Abstract Body Abstract Body Abstract Body Abstract Body Abstract Body Abstract Body Abstract Body Abstract Body Abstract Body Abstract Body Abstract Body Abstract Body. Abstract Body Abstract Body. Abstract Body Abstract Body Abstract Body Abstract Body Abstract Body Abstract Body Abstract Body Abstract Body Abstract Body Abstract Body Abstract Body Abstract Body Abstract Body Abstract Body Abstract Body Abstract Body Abstract Body Abstract Body Abstract Body Abstract Body Abstract Body Abstract Body. Abstract Body Abstract Body Abstract Body Abstract Body. Abstract Body Abstract Body Abstract Body Abstract Body Abstract Body Abstract Body. Before you send this file to us, -Please save this file in your PC first. -File name should be your name. (Ex. Jane P. Smith.doc). -Please make sure to send this file to [email protected] by February 1, 2007 (Japan time). We DO NOT accept after this date. Correction: In case you need to make changes, please fill out this form again and submit it to the conference secretariat below. Thank you very much for your cooperation. Secretariat of The 1st Asian Congress of Abdominal Radiology C/o Convention Linkage, Inc. PIAS TOWER 11F, 3-19-3 Toyosaki, Kita-ku, Osaka, 531-0072 Japan Tel: +81-6-6377-2188 Fax: +81-6-6377-2075 E-mail: [email protected]