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        담석의 내시경 치료

        유병무 대한소화기내시경학회 2010 Clinical Endoscopy Vol.41 No.5

        Gallstone diseases include gallbladder stones, extrahepatic bile duct stones and intrahepatic duct stones. In the past, the main treatment modality was a surgical operation. With the development of endoscopic treatment, the main treatment modality is shifting towards endoscopic treatment. After the development of endoscopic sphincterotomy, endoscopic stone removal using a basket or balloon has been the major treatment modality for extrahepatic bile duct stones. For huge extrahepatic bile duct stones, mechanical or laser lithotripsy are used as ancillary equipment. Direct peroral cholangioscopic methods using a slim endoscopy or a Spyglass system now being rapidly developed instead of the “mother and baby” scope. If extrahapatic bile duct stones fail to be removed with peroral endoscopic treatment, then the stones can be treated via a percutaneous route (a percutaneous transhepatic route or a percutaneous transabdominal route). For intrahepatic duct stones, the location of stones, the site and degree of bile duct stricture and the existence of parenchymal atrophy are important factors to decide the treatment modality. The treatment modality is usually decided on according to the Tsunoda classification. Gallbladder stones usually need cholecystectomy because of recurrence. Endoscopic treatment is an indication for treating inoperable calculous cholecystitis patients. Endoscopic treatment for gallstone disesae will continue to rapidly develop in the future to the benefit of both the patients and endoscopists. 담석은 그 위치에 따라 담낭 담석, 간외 담석, 간내 담석으로 분류할 수 있으며, 위치에 따라 치료 방침이 달라진다. 담석은 과거에는 수술이 주치료 방법이었으나 내시경 및 술기의 발달로 인하여 근래에는 많은 경우에 내시경 치료가 일차적인 치료방법으로 선호되고 있다. 담석의 내시경 치료는 내시경유두괄약근절개술 및 담석 제거를 위한 여러가지 부속기구가 개발되면서 급격히 발전하기 시작하였다. 간외 담석의 내시경 치료는 유두괄약근절개술 시행 후 바스켓이나 풍선도관을 이용하는 것이 일반적인 치료 방침이나 거대 담석의 제거에 기계식쇄석술이나 레이저쇄석술이 사용되기도 한다. 이러한 시술로도 제거가 어려운 경우에는 세경내시경을 이용하여 담도를 직접 관찰하고 담석을 제거하는 시술이 시행되기도 한다. 간외담석의 치료는 경구경유두 시술이 가장 간단한 치료 방법이나 경구경유두 접근에 실패하거나 담석제거에 실패한 경우에는 경피적 경로를 통하여 제거할 수 있다. 간내 담석이나 담낭 담석의 내시경적 치료는 주로 경피적 경로(경피경간 또는 경피경복적 경로)를 통하여 시행하게 된다. 간내 담석은 담석의 위치, 간내 담도의 협착위치 및 정도, 간실질의 위축 여부에 따라 치료방법이 결정되며 주로 Tsunoda 분류 방법이 치료 방침을 결정하는데 사용되고 있다. 담낭 담석은 수술적 치료가 원칙이지만 수술이 불가능한 환자에서는 담낭염이 있는 경우 경피적 경로를 통하여 내시경 치료를 시행할 수 있다. 담석의 내시경 치료는 지금까지 발전이 있어왔지만 향후에도 환자와 내시경 시술의 모두에게 도움이 되는 방향으로 발전해 갈 것으로 생각한다.

      • KCI등재

        대순진리회 목적(目的)에 관한 연구

        유병무 대진대학교 대순사상학술원 2016 대순사상논총 Vol.26 No.-

        The purpose of this study is to promote the understanding of the objective of Daesoon Thought through ‘examining the Objectives of Daesoonjinrihoe.’ The objective of Daesoon thought was set when Kang Jeungsan Sangje descended to human world, upon the plea of divine sages, buddhas, and bodhisattvas, and determined to save the world and relieve people far and wide. For building an Earthly Paradise with Daesoon thought, Sangje carried out the great work of Reordering of the Universe for nine years and passed into heaven. Cho Jeongsan Doju, who received the heavenly religious orthodox through divine revelation from Sangje, served the late will of Sangje and established Main Tenets, Creeds, and objective of Daesoon thought. The objective set by Doju was continued to Park Wudang Dojeon and formed the Objectives of Daesoonjinrihoe. The Objectives of Daesoonjinrihoe consist of three sets of objectives in sequential order, which are related in organic, mutual beneficient, and integrative with one another. The Objectives starts from individual cultivation and expand into worldly reformation: 1)one’s Spiritual transformation through Guarding against self-deception 2)Renewal of human beings through Realizing Earthly Immortality 3)Opening of new world through Building of Earthly Paradise. Also, in these Objectives of Daesoonjinrihoe, Three Realms of Heaven, Earth, and Humanity keep close relations to enter into new world. These Objectives are based on the ‘thought of mutual beneficence’ and are realized with Daesoon thought, which is the Dao of ‘Crowned King’ that goes beyond the previous thoughts of Confucianism, Buddhism and Taoism. Objectives of Daesoonjinrihoe have following details in each objective as following; (1) ‘Guarding against self-deception-Spiritual Transformation’ is for human nature. In Daesoon thought, human has the potential to restore conscience, which is true nature, and return to undefiled essence by ‘guarding against self-deception’. In other words, it views that one can reach into the stage of spiritual alignment with the Dao once he recovers conscience through cultivation of Daesoonjinrihoe based on the idea of ‘Guarding against self-deception’. (2) ‘Realizing Earthly Immortality-Renewal of human beings’ is for ideal human character. ‘Realizing Earthly Immortality’ in Daesoon Thought indicates the advent of ideal human beings called ‘Dotong gunja’(virtuous beings who are aligned with the Dao). They are leaders who integrate politics and religion in helping people to renew themselves and make the world into Earthly Paradise. (3) ‘Building an Earthly Paradise-Opening of new world’ is for ideal society. Daesoon thought aims to making a peaceful world by creating an ideal society of heaven on this earth. Park Wudang Dojeon, who led Daesoonjinrihoe, emphasized the importance of Three Basic Activities: Spreading of Sangje’s virtue, Edification, and Cultivation: and Three Major Activities: Aid and charity, Social welfare, and Education. Dojeon said “One should make effort to reach the utmost goodness through enlightening their bright virtue and cultivating their talent virtue.” In this words, he made clear that the Objectives of Daesoonjinrihoe can be realized when people enlighten their bright virtue and cultivate themselves with their talent virtue. In conclusion, the Objectives of Daesoon thought were clarified of their meanings by Sangje, established into laws by Doju, and actualized by Dojoen in various activities of Daesoonjinrihoe.

      • 성경신(誠敬信)의 의미 고찰 : 종도 차경석(車京石)의 행적(行蹟)과 성경신 변화 과정을 통한 고찰

        유병무 대진대학교 대순사상학술원 2014 대순사상논총 Vol.22 No.-

        The object of this thesis is to consider the meaning of sincerity(誠), reverence(敬) and faith(信) through Cha gyungseok's historical record. Cha gyungseok(車京石, 1880-1936) is a key disciple of Kang Jeungsan Sangjenim(姜甑山, 1871∼1909) to whom Cha kyungseok has begun to follow since 1907, completing his wandering around Yeonghak-gye(英學契), Iljin-hoe(一進會) and Cheondo-gyo(天道敎) after the loss of his father[Cha Jikoo(車致九), 1851-1894] in Tonghak peasants revolution. To examine the meaning of sincerity, reverence and faith as cardinal points in Daesoonjinrihoe(大巡眞理會) creed, this research has taken note of Cha kyungseok's sincerity, reverence and faith who is said to be thought of himself as a head of Reconstruction Work for the Tonghak spitit's resolution of grievances, despite the Sangjenim's intention of using him for different usage due to his sincerity, reverence and faith. Especially, emphasis was given to the illumination of Cha gyungseok's change of sincerity, reverence and faith through closely reviewing his life prior to the encounter with Sangjenim, the process of following Sangjenim and his whereabouts after the ascension of Sangjenim. In addition, through Jeonkyeong(典經), this research also examines Cha kyeong seok's sincerity, reverence and faith along with his ambition contained in that sincerity, reverence and faith. Up to his ascension, Sangjenim has never saved his advice on Cha gyungseok's ambition. Leaving Sangjenim's advice behind, Cha gyungseok moves on to become a head of the Reconstruction Work for the Tonghak spitit's resolution of grievances without deserting the dream of being the Son of Heaven. Although, he showed his prowess as a religious sect leader called Bocheon-gyo boasting its 6 million believers and as a provisional emperor of the country named Sikuk, he ends his life as a head for the Resolution of grievances of kings, princes, generals and premiers due to the change of faith on Sangjenim and interruption of Japanese Imperial Government, without accomplishing his dream. The feature of past disciples suggests the direction of cultivation for our cultivators. Through Cha gyungseok's sincerity, reverence and faith, we could look back upon the meaning of sincerity, reverence and faith and conclude that a real sincerity, reverence and faith is the heart-mind trying to participate in Reconstruction Work of Heaven and Earth with a pure mind, contrary to the one coming out of greed.

      • KCI등재

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