Quyen Nguyen: Color-coded surgery

103,549 views ใƒป 2011-12-13

TED


์•„๋ž˜ ์˜๋ฌธ์ž๋ง‰์„ ๋”๋ธ”ํด๋ฆญํ•˜์‹œ๋ฉด ์˜์ƒ์ด ์žฌ์ƒ๋ฉ๋‹ˆ๋‹ค.

๋ฒˆ์—ญ: Jungsoo Kim ๊ฒ€ํ† : Woo Hwang
00:15
I want to talk to you
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์ „ ์—ฌ๋Ÿฌ๋ถ„๊ป˜ ์˜ํ•™์—์„œ ๊ฐ€์žฅ ํฐ ํ™˜์ƒ ์ค‘ ํ•˜๋‚˜์— ๋Œ€ํ•ด
00:17
about one of the biggest myths in medicine,
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๋ง์”€๋“œ๋ฆฌ๊ณ  ์‹ถ์Šต๋‹ˆ๋‹ค
00:19
and that is the idea
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๊ทธ๊ฒƒ์€ ๋ฐ”๋กœ ์šฐ๋ฆฌ์—๊ฒŒ ํ•„์š”ํ•œ ๊ฒƒ์€
00:21
that all we need are more medical breakthroughs
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๋” ๋งŽ์€ ์˜ํ•™์ ์ธ ๋ฐœ์ „์ด๊ณ , ์ด๋ฅผ ํ†ตํ•ด ์šฐ๋ฆฌ์˜ ๋ชจ๋“  ๋ฌธ์ œ๋Š”
00:24
and then all of our problems will be solved.
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ํ•ด๊ฒฐ๋  ์ˆ˜ ์žˆ๋‹ค๋Š” ์ƒ๊ฐ์ž…๋‹ˆ๋‹ค
00:27
Our society loves to romanticize
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์šฐ๋ฆฌ ์‚ฌํšŒ๋Š” ํ•œ ๋ช…์˜ ๋ฐœ๋ช…๊ฐ€๊ฐ€
00:30
the idea of the single, solo inventor
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์–ด๋Š ๋‚  ์ €๋… ๋Šฆ๊ฒŒ๊นŒ์ง€ ์‹คํ—˜์‹ค์—์„œ ์—ฐ๊ตฌํ•˜๋‹ค๊ฐ€,
00:32
who, working late in the lab one night,
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์—„์ฒญ๋‚œ ๋ฐœ๊ฒฌ์„ ํ•˜๊ณ ,
00:35
makes an earthshaking discovery,
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์งœ์ž”ํ•˜๋ฉด์„œ ํ•˜๋ฃป๋ฐค๋งŒ์— ๋ชจ๋“  ๊ฒŒ ๋ฐ”๋€Œ๋Š” ์ด์•ผ๊ธฐ๋ฅผ
00:38
and voila, overnight everything's changed.
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๋‚ญ๋งŒ์ ์œผ๋กœ ๋ฌ˜์‚ฌํ•˜๊ธธ ์ข‹์•„ํ•ฉ๋‹ˆ๋‹ค
00:42
That's a very appealing picture,
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์ด๊ฒŒ ์•„์ฃผ ๋งค๋ ฅ์ ์ธ ์žฅ๋ฉด์ด๊ธด ํ•˜์ง€๋งŒ,
00:44
however, it's just not true.
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์ ˆ๋Œ€ ์‚ฌ์‹ค์ด ์•„๋‹™๋‹ˆ๋‹ค
00:47
In fact, medicine today is a team sport.
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์‹ค์ œ๋กœ๋Š” ์˜ค๋Š˜๋‚ ์˜ ์˜ํ•™์€ ํŒ€ ์Šคํฌ์ธ ์™€ ๊ฐ™์Šต๋‹ˆ๋‹ค
00:50
And in many ways,
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๊ทธ๋ฆฌ๊ณ  ์—ฌ๋Ÿฌ ๊ด€์ ์—์„œ
00:52
it always has been.
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ํ•ญ์ƒ ๊ทธ๋ž˜ ์™”์—ˆ๊ณ ์š”
00:54
I'd like to share with you a story
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์ „ ์—ฌ๋Ÿฌ๋ถ„๋“ค๊ป˜ ์ œ๊ฐ€ ์ผ์„ ํ•˜๋ฉด์„œ
00:56
about how I've experienced this very dramatically
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์–ด๋–ป๊ฒŒ ์ด๋ฅผ ์•„์ฃผ ์ธ์ƒ์ ์œผ๋กœ ๊ฒฝํ—˜ํ–ˆ๋Š” ์ง€์— ๋Œ€ํ•ด
00:59
in my own work.
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๋ง์”€๋“œ๋ฆฌ๊ณ ์ž ํ•ฉ๋‹ˆ๋‹ค
01:01
I'm a surgeon,
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์ €๋Š” ์™ธ๊ณผ์˜์‚ฌ์ž…๋‹ˆ๋‹ค
01:03
and we surgeons have always had
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๊ทธ๋ฆฌ๊ณ  ์ €ํฌ ์™ธ๊ณผ์˜๋“ค์€
01:05
this special relationship with light.
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ํ•ญ์ƒ ๋น›๊ณผ ํŠน๋ณ„ํ•œ ๊ด€๊ณ„๊ฐ€ ์žˆ์—ˆ์Šต๋‹ˆ๋‹ค
01:08
When I make an incision inside a patient's body, it's dark.
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์ œ๊ฐ€ ํ™˜์ž์˜ ๋ชธ ์•ˆ์—์„œ ์ˆ˜์ˆ ์„ ํ•  ๋•Œ, ๊ฑฐ๊ธด ์–ด๋‘ก์Šต๋‹ˆ๋‹ค
01:12
We need to shine light to see what we're doing.
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์ €ํฌ๊ฐ€ ๋ญ˜ ํ•˜๋Š” ์ง€ ๋ณด๊ธฐ ์œ„ํ•ด์„  ๋น›์„ ๋ฐํ˜€์•ผ ํ•˜์ฃ 
01:15
And this is why, traditionally,
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์ด๋Ÿฌํ•œ ์ด์œ  ๋•Œ๋ฌธ์— ์ „ํ†ต์ ์œผ๋กœ
01:18
surgeries have always started so early in the morning --
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์ˆ˜์ˆ ์€ ์•„์นจ ์ผ์ฐ๋ถ€ํ„ฐ ์‹œ์ž‘ํ–ˆ์Šต๋‹ˆ๋‹ค
01:20
to take advantage of daylight hours.
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๋‚ฎ์‹œ๊ฐ„์„ ์ด์šฉํ•˜๊ธฐ ์œ„ํ•ด์„œ์˜€์ฃ 
01:22
And if you look at historical pictures
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๊ทธ๋ฆฌ๊ณ  ์ดˆ๊ธฐ ์ˆ˜์ˆ ์‹ค์˜
01:24
of the early operating rooms,
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์˜ˆ์ „ ์‚ฌ์ง„๋“ค์„ ๋ณด๋ฉด,
01:26
they have been on top of buildings.
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๊ฑด๋ฌผ์˜ ๊ผญ๋Œ€๊ธฐ์— ์œ„์น˜ํ•ด ์žˆ์—ˆ์Šต๋‹ˆ๋‹ค
01:29
For example, this is the oldest operating room in the Western world,
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์˜ˆ๋ฅผ ๋“ค์–ด, ์ด ์‚ฌ์ง„์€ ๋Ÿฐ๋˜์— ์žˆ๋Š” ์„œ์–‘์—์„œ ๊ฐ€์žฅ ์˜ค๋ž˜๋œ
01:31
in London,
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์ˆ˜์ˆ ์‹ค์ธ๋ฐ,
01:33
where the operating room
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์ˆ˜์ˆ ์‹ค์€
01:35
is actually on top of a church
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์„ฑ๋‹น์˜ ๊ผญ๋Œ€๊ธฐ์—
01:37
with a skylight coming in.
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๋น›์ด ๋“ค์–ด์˜ค๋Š” ๊ณณ์— ์œ„์น˜ํ•ด ์žˆ์ฃ 
01:39
And then this is a picture
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๊ทธ๋ฆฌ๊ณ  ์ด๊ฒƒ์€
01:41
of one of the most famous hospitals in America.
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๋ฏธ๊ตญ์—์„œ ๊ฐ€์žฅ ์œ ๋ช…ํ•œ ๋ณ‘์›๋“ค ์ค‘ ํ•˜๋‚˜์˜ ์‚ฌ์ง„์ž…๋‹ˆ๋‹ค
01:44
This is Mass General in Boston.
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์—ฌ๊ธด ๋ณด์Šคํ„ด์— ์žˆ๋Š” Mass General(Massachusetts General Hospital)์ž…๋‹ˆ๋‹ค
01:46
And do you know where the operating room is?
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์ˆ˜์ˆ ์‹ค์ด ์–ด๋”” ์žˆ๋Š”์ง€ ์•„์‹œ๋‚˜์š”?
01:48
Here it is
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์—ฌ๊ธฐ ๊ฑด๋ฌผ ๋งจ ์œ—์ธต์—
01:50
on the top of the building
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๋น›์„ ๋“ค์–ด์˜ค๊ฒŒ ํ•˜๋Š”
01:52
with plenty of windows to let light in.
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์ˆ˜๋งŽ์€ ์ฐฝ๋ฌธ๋“ค๋กœ ๋‘˜๋Ÿฌ์Œ“์—ฌ ์žˆ์Šต๋‹ˆ๋‹ค
01:55
So nowadays in the operating room,
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์˜ค๋Š˜๋‚ ์˜ ์ˆ˜์ˆ ์‹ค์—์„œ
01:57
we no longer need to use sunlight.
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์ €ํฌ๋Š” ๋” ์ด์ƒ ํ–‡๋น›์„ ์“ธ ํ•„์š”๋Š” ์—†์Šต๋‹ˆ๋‹ค.
02:00
And because we no longer need to use sunlight,
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๋˜ ์ €ํฌ๊ฐ€ ํ–‡๋น›์ด ํ•„์š”๊ฐ€ ์—†๊ธฐ ๋•Œ๋ฌธ์—,
02:03
we have very specialized lights
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์ˆ˜์ˆ ์‹ค์„ ์œ„ํ•ด ๋งŒ๋“ค์–ด์ง„
02:05
that are made for the operating room.
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์•„์ฃผ ํŠน๋ณ„ํ•œ ๋น›์ด ์žˆ์ฃ 
02:07
We have an opportunity
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์ €ํฌ๋Š” ๋‹ค๋ฅธ ์ข…๋ฅ˜์˜ ๋น›์„
02:09
to bring in other kinds of lights --
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์ด์šฉํ•  ์ˆ˜ ์žˆ์Šต๋‹ˆ๋‹ค
02:11
lights that can allow us to see
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๊ทธ ๋น› ๋•๋ถ„์— ์ €ํฌ๋Š”
02:13
what we currently don't see.
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ํ˜„์žฌ ๋ˆˆ์œผ๋กœ ๋ณผ ์ˆ˜ ์—†๋Š” ๊ฒƒ์„ ๋ณผ ์ˆ˜ ์žˆ๊ฒŒ ๋˜์—ˆ์ฃ 
02:16
And this is what I think
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์ œ ์ƒ๊ฐ์—๋Š” ์ด๊ฒŒ ๋ฐ”๋กœ
02:18
is the magic of fluorescence.
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ํ˜•๊ด‘ ๋ฌผ์งˆ์˜ ๋งˆ๋ฒ•์ธ ๊ฒƒ ๊ฐ™์Šต๋‹ˆ๋‹ค
02:20
So let me back up a little bit.
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์ž ๊น๋งŒ ๋’ค๋กœ ๋Œ์•„๊ฐ€๊ฒ ์Šต๋‹ˆ๋‹ค
02:22
When we are in medical school,
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์˜๋Œ€์— ๋‹ค๋‹ ๋•Œ,
02:25
we learn our anatomy from illustrations such as this
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์ €ํฌ๋Š” ์‚ฌ๋žŒ์˜ ๊ธฐ๊ด€์„ ์ด๋ ‡๊ฒŒ ๋ชจ๋“  ๊ฒƒ์ด ์ƒ‰์น ๋˜์–ด ์žˆ๋Š”
02:28
where everything's color-coded.
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๊ทธ๋ฆผ์œผ๋กœ๋ถ€ํ„ฐ ๋ฐฐ์› ์Šต๋‹ˆ๋‹ค
02:31
Nerves are yellow, arteries are red,
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์‹ ๊ฒฝ์€ ๋…ธ๋ž€์ƒ‰, ๋™๋งฅ์€ ๋ถ‰์€์ƒ‰,
02:33
veins are blue.
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์ •๋งฅ์€ ํŒŒ๋ž€์ƒ‰์ด์—ˆ์ฃ 
02:35
That's so easy anybody could become a surgeon, right?
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๋„ˆ๋ฌด ์‰ฌ์›Œ์„œ ๋ˆ„๊ตฌ๋‚˜ ์™ธ๊ณผ์˜๋ฅผ ํ•  ์ˆ˜ ์žˆ์„๊บผ์—์š”, ๊ทธ๋ ‡์ฃ ?
02:39
However, when we have a real patient on the table,
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๊ทธ๋Ÿฌ๋‚˜ ์ˆ˜์ˆ ๋Œ€ ์œ„์— ์žˆ๋Š” ์‹ค์ œ ํ™˜์ž์˜
02:42
this is the same neck dissection --
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๋™์ผํ•œ ๋ชฉ ์ ˆ๊ฐœ๋ถ€๋Š” ์ด๋ ‡์Šต๋‹ˆ๋‹ค
02:45
not so easy to tell the difference
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๋‹ค๋ฅธ ๊ตฌ์กฐ๋“ค์˜ ์ฐจ์ด๋ฅผ
02:47
between different structures.
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๋งํ•˜๋Š” ๊ฒŒ ์‰ฝ์ง€๊ฐ€ ์•Š์ฃ 
02:49
We heard over the last couple days
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์šฐ๋ฆฌ๋Š” ์ง€๋‚œ ๋ฉฐ์น  ๋™์•ˆ
02:52
what an urgent problem
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์šฐ๋ฆฌ ์‚ฌํšŒ์—์„œ
02:54
cancer still is in our society,
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์•”์ด ์•„์ฃผ ๊ธ‰๋ฐ•ํ•œ ๋ฌธ์ œ์ด๋ฉฐ,
02:56
what a pressing need it is
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๋งค ๋ถ„ ๋งˆ๋‹ค ํ•œ ๋ช…์”ฉ ์ฃฝ์ง€ ์•Š๋Š” ๊ฒƒ์ด
02:58
for us to not have
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์–ผ๋งˆ๋‚˜ ๊ธด๊ธ‰ํ•œ ์š”๊ตฌ์ธ์ง€
03:00
one person die every minute.
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๋“ค์—ˆ์Šต๋‹ˆ๋‹ค
03:04
Well if cancer can be caught early,
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๋งŒ์•ฝ์— ์•”์ด ์กฐ๊ธฐ์— ๋ฐœ๊ฒฌ๋ผ์„œ
03:06
enough such that someone can have their cancer taken out,
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์—†์•จ ์ˆ˜ ์žˆ๋‹ค๋ฉด,
03:11
excised with surgery,
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์ฆ‰ ์ˆ˜์ˆ ๋กœ ์ œ๊ฑฐํ•  ์ˆ˜ ์žˆ๋‹ค๋ฉด,
03:13
I don't care if it has this gene or that gene,
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์ „ ๊ทธ๊ฒŒ ์–ด๋–ค ์œ ์ „์ž๋ฅผ ๊ฐ€์ง€๊ณ  ์žˆ๋˜์ง€,
03:15
or if it has this protein or that protein,
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๋˜ ์–ด๋–ค ๋‹จ๋ฐฑ์งˆ์„ ๊ฐ€์ง€๊ณ  ์žˆ๋Š”์ง€ ์‹ ๊ฒฝ์“ฐ์ง€ ์•Š์Šต๋‹ˆ๋‹ค
03:17
it's in the jar.
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์ด๋ฏธ ์œ ๋ฆฌ๋ณ‘ ์•ˆ์— ๋“ค์–ด์žˆ์œผ๋‹ˆ๊นŒ์š”
03:19
It's done, it's out, you're cured of cancer.
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์ˆ˜์ˆ ์€ ๋๋‚ฌ๊ณ , ์•”์€ ์ œ๊ฑฐ๋˜์—ˆ๊ณ , ํ™˜์ž๋Š” ์น˜๋ฃŒ๋œ๊ฑฐ์ฃ 
03:22
This is how we excise cancers.
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์ด๊ฒŒ ๋ฐ”๋กœ ์ €ํฌ๊ฐ€ ์•”์„ ์ œ๊ฑฐํ•˜๋Š” ๋ฐฉ๋ฒ•์ž…๋‹ˆ๋‹ค
03:24
We do our best, based upon our training
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์ €ํฌ๋Š” ์ €ํฌ๊ฐ€ ๋ฐฐ์šด ๊ฒƒ,
03:27
and the way the cancer looks and the way it feels
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์•” ๊ทธ ์ž์ฒด, ๋Š๋ผ๋Š” ๋Œ€๋กœ,
03:30
and its relationship to other structures and all of our experience,
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์•”๊ณผ ๋‹ค๋ฅธ ๊ตฌ์กฐ์™€์˜ ๊ด€๊ณ„, ๊ทธ๋ฆฌ๊ณ  ์ €ํฌ์˜ ๋ชจ๋“  ๊ฒฝํ—˜์— ๊ทผ๊ฑฐํ•ด์„œ ์ตœ์„ ์„ ๋‹ค ํ•˜๊ณ 
03:33
we say, you know what, the cancer's gone.
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์•”์€ ์ œ๊ฑฐ๋˜์—ˆ๋‹ค๊ณ  ๋งํ•˜์ฃ 
03:36
We've made a good job. We've taken it out.
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์ˆ˜์ˆ ์€ ์ž˜ ๋˜์—ˆ๊ณ , ์•”์„ ์ œ๊ฑฐํ–ˆ์Šต๋‹ˆ๋‹ค
03:39
That's what the surgeon is saying in the operating room
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์ด๊ฒŒ ๋ฐ”๋กœ ์ˆ˜์ˆ ์‹ค์—์„œ ํ™˜์ž๊ฐ€ ์ˆ˜์ˆ ๋Œ€์— ์žˆ์„ ๋•Œ
03:41
when the patient's on the table.
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์™ธ๊ณผ์˜๊ฐ€ ํ•˜๋Š” ๋ง์ž…๋‹ˆ๋‹ค
03:43
But then we actually don't know that it's all out.
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ํ•˜์ง€๋งŒ ์ €ํฌ๋Š” ์‹ค์ œ๋กœ ์•”์˜ ๋ชจ๋“  ๋ถ€๋ถ„์ด ์ œ๊ฑฐ๋˜์—ˆ๋Š” ์ง€๋Š” ๋ชจ๋ฆ…๋‹ˆ๋‹ค
03:46
We actually have to take samples from the surgical bed,
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์‚ฌ์‹ค ์ €ํฌ๋Š” ํ™˜์ž์—๊ฒŒ์„œ ๋‚˜์˜จ
03:49
what's left behind in the patient,
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์ˆ˜์ˆ ๋Œ€์—์„œ ์–ป์€ ์ƒ˜ํ”Œ์„
03:51
and then send those bits to the pathology lab.
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๋ณ‘๋ฆฌํ•™ ์‹คํ—˜์‹ค์— ๋ณด๋‚ด์•ผ ํ•ฉ๋‹ˆ๋‹ค
03:55
In the meanwhile, the patient's on the operating room table.
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๊ทธ ์™€์ค‘์—๋„ ํ™˜์ž๋Š” ์ˆ˜์ˆ ๋Œ€์— ๋ˆ„์›Œ์žˆ์ฃ 
03:57
The nurses, anesthesiologist, the surgeon,
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๊ฐ„ํ˜ธ์‚ฌ๋“ค, ๋งˆ์ทจ์˜, ์™ธ๊ณผ์˜,
03:59
all the assistants are waiting around.
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๊ทธ๋ฆฌ๊ณ  ๋ชจ๋“  ์˜๋ฃŒ์ง„์€ ๋Œ€๊ธฐ๋ฅผ ํ•ฉ๋‹ˆ๋‹ค
04:01
And we wait.
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๊ธฐ๋‹ค๋ฆฌ๊ณ , ๊ธฐ๋‹ค๋ฆฌ์ฃ 
04:03
The pathologist takes that sample,
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๋ณ‘๋ฆฌํ•™์ž๋Š” ๊ทธ ์ƒ˜ํ”Œ์„ ๊ฐ€์ง€๊ณ 
04:05
freezes it, cuts it, looks in the microscope one by one
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์–ผ๋ฆฌ๊ณ , ์ž๋ฅด๊ณ , ํ•˜๋‚˜ ํ•˜๋‚˜ ํ˜„๋ฏธ๊ฒฝ์œผ๋กœ ๊ด€์ฐฐ์„ ํ•œ ๋’ค์—
04:08
and then calls back into the room.
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์ˆ˜์ˆ ์‹ค๋กœ ์—ฐ๋ฝ์„ ๋„ฃ์Šต๋‹ˆ๋‹ค
04:10
And that may be 20 minutes later per piece.
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์•„๋งˆ ํ•œ ์กฐ๊ฐ ๋‹น 20๋ถ„ ์ •๋„ ๊ฑธ๋ฆฝ๋‹ˆ๋‹ค
04:12
So if you've sent three specimens,
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๊ทธ๋Ÿฌ๋‹ˆ๊นŒ 3์กฐ๊ฐ์˜ ์ƒ˜ํ”Œ์„ ๋ณด๋ƒˆ๋‹ค๋ฉด,
04:14
it's an hour later.
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ํ•œ ์‹œ๊ฐ„ ์ •๋„ ๊ฑธ๋ฆฐ๋‹ค๋Š” ๋ง์ด์ฃ 
04:16
And very often they say,
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๊ทธ๋ฆฌ๊ณ  ๊ทธ๋“ค์€ ์ž์ฃผ
04:18
"You know what, points A and B are okay,
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"์žˆ์ž–์•„์š”, A๋ž‘ B๋Š” ๊ดœ์ฐฎ์€๋ฐ,
04:21
but point C, you still have some residual cancer there.
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C์— ์—ฌ์ „ํžˆ ์•”์ด ๋‚จ์•„ ์žˆ๋„ค์š”
04:23
Please go cut that piece out."
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๊ทธ ๋ถ€๋ถ„์„ ์ œ๊ฑฐํ•ด์ฃผ์„ธ์š”"๋ผ๊ณ  ๋งํ•ฉ๋‹ˆ๋‹ค
04:26
So we go back and we do that again, and again.
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๊ทธ๋Ÿฌ๋ฉด ์ €ํฌ๋Š” ๋‹ค์‹œ ๊ทธ ์ผ์„ ๋ฐ˜๋ณตํ•ฉ๋‹ˆ๋‹ค
04:29
And this whole process:
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๊ทธ ์ „ ๊ณผ์ •์€ ์ด๋ ‡์Šต๋‹ˆ๋‹ค
04:31
"Okay you're done.
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"๋„ค ๋‹ค ๋์Šต๋‹ˆ๋‹ค
04:33
We think the entire tumor is out."
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์ข…์–‘์€ ๋ชจ๋‘ ์ œ๊ฑฐ๋œ ๊ฒƒ ๊ฐ™์Šต๋‹ˆ๋‹ค"
04:35
But very often several days later,
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ํ•˜์ง€๋งŒ ์ €ํฌ๋Š” ํ™˜์ž๊ฐ€ ์ง‘์œผ๋กœ ๊ฐ„
04:38
the patient's gone home,
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๋ฉฐ์น  ๋’ค ๊ฝค ์ž์ฃผ
04:40
we get a phone call:
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์ด๋Ÿฐ ์ „ํ™”๋ฅผ ๋ฐ›๊ฒŒ ๋ฉ๋‹ˆ๋‹ค
04:42
"I'm sorry,
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"์ •๋ง ์œ ๊ฐ์ž…๋‹ˆ๋‹ค๋งŒ
04:44
once we looked at the final pathology,
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๋งˆ์ง€๋ง‰ ๋ณ‘๋ฆฌํ•™ ๊ฒ€์‚ฌ,
04:46
once we looked at the final specimen,
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๊ทธ๋ฆฌ๊ณ  ์ƒ˜ํ”Œ์„ ์‚ดํŽด๋ดค๋Š”๋ฐ,
04:48
we actually found that there's a couple other spots
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์ฃผ๋ณ€ ์กฐ์ง์ด ์–‘์„ฑ๋ฐ˜์‘์„ ๋ณด์ด๋Š” ๊ณณ์ด
04:51
where the margins are positive.
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๋ช‡ ๊ตฐ๋ฐ ์žˆ๋Š” ๊ฒƒ์„ ๋ฐœ๊ฒฌํ–ˆ์Šต๋‹ˆ๋‹ค
04:54
There's still cancer in your patient."
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์—ฌ์ „ํžˆ ํ™˜์ž์—๊ฒŒ ์•”์ด ์žˆ๋Š” ๊ฒƒ ๊ฐ™์Šต๋‹ˆ๋‹ค
04:57
So now you're faced with telling your patient, first of all,
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์ด์ œ ์—ฌ๋Ÿฌ๋ถ„๋“ค์€ ํ™˜์ž๋“ค์—๊ฒŒ
05:00
that they may need another surgery,
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๊ทธ๋“ค์ด ๋˜ ๋‹ค๋ฅธ ์ˆ˜์ˆ ,
05:02
or that they need additional therapy
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๋˜๋Š” ๋ฐฉ์‚ฌ์„ ์ด๋‚˜ ์•ฝ๋ฌผ์น˜๋ฃŒ๊ฐ€ ํ•„์š”ํ• ์ง€๋„ ๋ชจ๋ฅธ๋‹ค๊ณ 
05:04
such as radiation or chemotherapy.
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๋งํ•ด์•ผ ํ•˜๋Š” ์ƒํ™ฉ์— ์ฒ˜ํ•ด์žˆ์Šต๋‹ˆ๋‹ค
05:08
So wouldn't it be better
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๊ทธ๋ ‡๋‹ค๋ฉด, ์™ธ๊ณผ์˜๋“ค์ด
05:10
if we could really tell,
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์ˆ˜์ˆ  ํ˜„์žฅ์—์„œ
05:12
if the surgeon could really tell,
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์—ฌ์ „ํžˆ ์•”์ด ๋‚จ์•„์žˆ๋Š”์ง€ ์•„๋‹Œ ์ง€๋ฅผ
05:15
whether or not there's still cancer on the surgical field?
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๋งํ•  ์ˆ˜ ์žˆ๋‹ค๋ฉด ๋” ์ข‹์ง€ ์•Š์„๊นŒ์š”?
05:18
I mean, in many ways, the way that we're doing it,
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์ œ ๋ง์€, ์ €ํฌ๊ฐ€ ์ˆ˜์ˆ ์„ ํ•˜๋Š” ๋ฐ ์žˆ์–ด์„œ,
05:21
we're still operating in the dark.
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์—ฌ๋Ÿฌ๋ชจ๋กœ ์–ด๋‘  ์†์— ์žˆ๋‹ค๋Š” ์˜๋ฏธ์ž…๋‹ˆ๋‹ค
05:25
So in 2004, during my surgical residency,
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2004๋…„ ์ œ๊ฐ€ ์™ธ๊ณผ ๋ ˆ์ง€๋˜ํŠธ์ผ ๋•Œ,
05:28
I had the great fortune
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์ €๋Š” 2008๋…„ ๋…ธ๋ฒจ ํ™”ํ•™์ƒ์„ ์ˆ˜์ƒํ•œ
05:30
to meet Dr. Roger Tsien,
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๋กœ์ € ์ฒธ(Roger Chen) ๋ฐ•์‚ฌ์™€
05:33
who went on to win the Nobel Prize for chemistry
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์ผ ํ•  ์ˆ˜ ์žˆ๋Š” ๊ธฐํšŒ๋ฅผ
05:36
in 2008.
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์–ป์—ˆ์Šต๋‹ˆ๋‹ค
05:38
Roger and his team
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๋กœ์ € ๋ฐ•์‚ฌ์™€ ๊ทธ์˜ ํŒ€์€
05:40
were working on a way to detect cancer,
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์•”์„ ์ฐพ์•„๋‚ผ ๋ฐฉ๋ฒ•์— ๋Œ€ํ•ด ์—ฐ๊ตฌํ•˜๊ณ  ์žˆ์—ˆ๊ณ ,
05:43
and they had a very clever molecule
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์•„์ฃผ ๋†€๋ผ์šด ๋ถ„์ž๋ฅผ
05:45
that they had come up with.
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๋ฐœ๊ฒฌํ–ˆ์Šต๋‹ˆ๋‹ค
05:47
The molecule they had developed
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๊ทธ๋“ค์ด ๋งŒ๋“ค์–ด ๋‚ธ ๋ถ„์ž๋Š”
05:49
had three parts.
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์„ธ ๋ถ€๋ถ„์œผ๋กœ ์ด๋ฃจ์–ด์ ธ ์žˆ์Šต๋‹ˆ๋‹ค
05:51
The main part of it is the blue part, polycation,
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์ฃผ์š” ๋ถ€๋ถ„์€ ์ด ํŒŒ๋ž€์ƒ‰์˜ polycation์ธ๋ฐ,
05:54
and it's basically very sticky
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์ธ์ฒด์— ์žˆ๋Š” ๋ชจ๋“  ์„ธํฌ์—
05:56
to every tissue in your body.
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์•„์ฃผ ์ž˜ ๋‹ฌ๋ผ ๋ถ™์Šต๋‹ˆ๋‹ค.
05:58
So imagine that you make a solution
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๊ทธ๋Ÿฌ๋‹ˆ๊นŒ ์ด ๋ˆ๋ˆํ•œ ๋ฌผ์งˆ๋กœ
06:00
full of this sticky material
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์ด๋ฃจ์–ด์ง„ ํ™”ํ•ฉ๋ฌผ์„ ๋งŒ๋“ค์–ด์„œ
06:02
and inject it into the veins of someone who has cancer,
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์•”์„ ๊ฐ€์ง€๊ณ  ์žˆ๋Š” ์‚ฌ๋žŒ์˜ ์ •๋งฅ์— ์ฃผ์‚ฌํ•˜๋ฉด
06:04
everything's going to get lit up.
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๋ชจ๋“  ๊ฒƒ์ด ๋น›์„ ๋‚ธ๋‹ค๊ณ  ์ƒ๊ฐํ•ด ๋ณด์„ธ์š”
06:06
Nothing will be specific.
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ํŠน๋ณ„ํ•  ๊ฑด ์—†์ฃ 
06:08
There's no specificity there.
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ํŠน๋ณ„ํ•จ์ด๋ž€ ์—†์Šต๋‹ˆ๋‹ค
06:10
So they added two additional components.
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๊ทธ๋ž˜์„œ ๊ทธ๋“ค์€ ๋‘ ๊ฐ€์ง€ ์š”์†Œ๋ฅผ ์ถ”๊ฐ€ํ–ˆ์Šต๋‹ˆ๋‹ค
06:12
The first one is a polyanionic segment,
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์ฒซ ๋ฒˆ์งธ๋Š” ์Šคํ‹ฐ์ปค ๋’ท๋ฉด์˜
06:15
which basically acts as a non-stick backing
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๋ˆ์ ์ด์ง€ ์•Š๋Š” ์ข…์ด์™€ ๊ฐ™์€ ์—ญํ• ์„ ํ•˜๋Š”
06:17
like the back of a sticker.
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๋‹ค์ค‘์„ฑ ์Œ์ด์˜จ ๋ถ€๋ถ„์ž…๋‹ˆ๋‹ค
06:19
So when those two are together, the molecule is neutral
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์ฆ‰, ๊ทธ ๋‘ ๋ถ€๋ถ„์ด ๊ฐ™์ด ์žˆ์œผ๋ฉด, ๊ทธ ๋ถ„์ž๋Š” ์ค‘๋ฆฝ์ ์ด๊ฒŒ ๋˜๊ณ 
06:22
and nothing gets stuck down.
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์•„๋ฌด๊ฒƒ๋„ ๋‹ฌ๋ผ ๋ถ™์ง€ ์•Š์Šต๋‹ˆ๋‹ค
06:24
And the two pieces are then linked
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๊ทธ๋ฆฌ๊ณ  ๊ทธ ๋‘ ์กฐ๊ฐ๋“ค์€
06:27
by something that can only be cut
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ํŠน์ •ํ•œ ๊ฐ€์œ„์— ์˜ํ•ด์„œ๋งŒ ์ž˜๋ฆฌ๋„๋ก
06:30
if you have the right molecular scissors --
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์—ฐ๊ฒฐ๋˜์–ด ์žˆ์Šต๋‹ˆ๋‹ค
06:32
for example, the kind of protease enzymes
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์˜ˆ๋ฅผ ๋“ค์ž๋ฉด ์ข…์–‘์ด ๋งŒ๋“ค์–ด ๋‚ด๋Š”
06:34
that tumors make.
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ํ”„๋กœํ…Œ์•„์ œ ํšจ์†Œ ๊ฐ™์€ ๊ฒƒ ๋ง์ด์ฃ 
06:36
So here in this situation,
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์ฆ‰ ์—ฌ๊ธฐ์„œ
06:38
if you make a solution full of this three-part molecule
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์ด ์„ธ ๋ถ„์ž์™€ ์ดˆ๋ก์ƒ‰์œผ๋กœ ๋ณด์ด๋Š” ์—ผ๋ฃŒ๋กœ
06:42
along with the dye, which is shown in green,
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๊ฐ€๋“ํ•œ ํ™”ํ•ฉ๋ฌผ์„ ๋งŒ๋“ค์–ด์„œ
06:44
and you inject it into the vein
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์•”ํ™˜์ž์˜ ์ •๋งฅ์— ์ฃผ์‚ฌ๋ฅผ ํ•˜๋ฉด,
06:47
of someone who has cancer,
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์ผ๋ฐ˜ ์„ธํฌ๋Š”
06:49
normal tissue can't cut it.
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์ ˆ๋‹จํ•  ์ˆ˜ ์—†์Šต๋‹ˆ๋‹ค
06:51
The molecule passes through and gets excreted.
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๋ถ„์ž๋Š” ๊ทธ๋ƒฅ ์ง€๋‚˜์ณ์„œ ๋ฐฐ์ถœ๋ฉ๋‹ˆ๋‹ค
06:54
However, in the presence of the tumor,
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ํ•˜์ง€๋งŒ ์ข…์–‘์ด ์žˆ๋‹ค๋ฉด,
06:56
now there are molecular scissors
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์ ˆ๋‹จ์ด ๊ฐ€๋Šฅํ•œ ๋ฐ”๋กœ ๊ทธ ๋ถ€๋ถ„์„
06:58
that can break this molecule apart
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์ž๋ฅผ ์ˆ˜ ์žˆ๋Š”
07:00
right there at the cleavable site.
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๋ถ„์ž ๊ฐ€์œ„๊ฐ€ ์žˆ๋Š” ๊ฒƒ์ž…๋‹ˆ๋‹ค
07:02
And now, boom,
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๊ทธ๋ฆฌ๊ณ  ์ด์ œ, ์งœ์ž”!
07:04
the tumor labels itself
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์ข…์–‘์ด ์Šค์Šค๋กœ๋ฅผ ํ‘œ์‹œํ•˜๋ฉฐ
07:06
and it gets fluorescent.
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๋น›์„ ๋ƒ…๋‹ˆ๋‹ค
07:08
So here's an example of a nerve
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๊ทธ๋ž˜์„œ ์ด๊ฒƒ์€ ์ข…์–‘์œผ๋กœ ๋‘˜๋Ÿฌ์‹ธ์—ฌ ์žˆ๋Š”
07:11
that has tumor surrounding it.
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์‹ ๊ฒฝ์ž…๋‹ˆ๋‹ค.
07:13
Can you tell where the tumor is?
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์ข…์–‘์ด ์–ด๋”” ์žˆ๋Š”์ง€ ์•„์‹œ๊ฒ ๋‚˜์š”?
07:15
I couldn't when I was working on this.
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์ €๋Š” ๊ตฌ๋ถ„ํ•  ์ˆ˜ ์—†์—ˆ์Šต๋‹ˆ๋‹ค.
07:18
But here it is. It's fluorescent.
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ํ•˜์ง€๋งŒ ์ด์ œ ํ˜•๊ด‘๋ฌผ์งˆ์„ ์‚ฌ์šฉํ•˜๋ฉด,
07:20
Now it's green.
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์ด์ œ ์ดˆ๋ก์ƒ‰์œผ๋กœ ๋ณด์ž…๋‹ˆ๋‹ค.
07:22
See, so every single one in the audience
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๋ณด์„ธ์š”, ์—ฌ๊ธฐ ๊ณ„์‹  ๋ชจ๋“  ๋ถ„๋“ค์ด ์ด์ œ
07:25
now can tell where the cancer is.
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์•”์ด ์–ด๋”” ์žˆ๋Š”์ง€ ๊ตฌ๋ถ„ํ•  ์ˆ˜ ์žˆ์„ ๊ฒ๋‹ˆ๋‹ค.
07:28
We can tell in the operating room, in the field,
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์šฐ๋ฆฌ๋Š” ์ด์ œ ์ˆ˜์ˆ ์‹ค์—์„œ, ์‹ค์ œ ํ˜„์žฅ์—์„œ,
07:31
at a molecular level,
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๋ถ„์ž์  ์ˆ˜์ค€์—์„œ,
07:33
where is the cancer and what the surgeon needs to do
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์™ธ๊ณผ์˜์‚ฌ๊ฐ€ ์ข…์–‘์ด ์–ด๋””์žˆ๋Š”์ง€,
07:35
and how much more work they need to do
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์–ด๋Š ์ •๋„ ์ž‘์—…์„ ํ•ด์„œ ์ œ๊ฑฐํ•ด์•ผ ํ•˜๋Š”์ง€,
07:37
to cut that out.
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์•Œ ์ˆ˜ ์žˆ์Šต๋‹ˆ๋‹ค.
07:40
And the cool thing about fluorescence
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ํ˜•๊ด‘๋ฌผ์งˆ์˜ ๋˜ ๋‹ค๋ฅธ ์žฅ์ ์€,
07:42
is that it's not only bright,
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์ด๊ฒŒ ๋ฐ์„ ๋ฟ๋งŒ ์•„๋‹ˆ๋ผ,
07:45
it actually can shine through tissue.
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์‹ค์ œ๋กœ ์กฐ์ง์„ ํ†ต๊ณผํ•ด์„œ ๋น›์„ ๋‚ผ ์ˆ˜ ์žˆ์Šต๋‹ˆ๋‹ค.
07:48
The light that the fluorescence emits
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ํ˜•๊ด‘๋ฌผ์งˆ์ด ๋ฐœ๊ด‘ํ•˜๋Š” ๋น›์€ ์กฐ์ง์„
07:51
can go through tissue.
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ํ†ต๊ณผํ•  ์ˆ˜ ์žˆ์ง€์š”.
07:53
So even if the tumor is not right on the surface,
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๊ทธ๋ž˜์„œ, ๋งŒ์•ฝ ์ข…์–‘์ด ํ‘œ๋ฉด์— ์žˆ์ง€ ์•Š๋”๋ผ๋„,
07:56
you'll still be able to see it.
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๋ณด์‹ค ์ˆ˜ ์žˆ์„ ๊ฒƒ ์ž…๋‹ˆ๋‹ค.
07:59
In this movie, you can see
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์ด ์˜์ƒ์„ ๋ณด์‹œ๋ฉด,
08:01
that the tumor is green.
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์ข…์–‘์€ ์ดˆ๋ก์ƒ‰ ์ž…๋‹ˆ๋‹ค.
08:04
There's actually normal muscle on top of it. See that?
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๊ทธ๋ฆฌ๊ณ  ์ข…์–‘ ๋ฐ”๋กœ ์œ„์— ์ •์ƒ ๊ทผ์œก ์กฐ์ง์ด ์žˆ์Šต๋‹ˆ๋‹ค. ๋ณด์ด์‹œ์ง€์š”?
08:07
And I'm peeling that muscle away.
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์ €๋Š” ๊ทธ ๊ทผ์œก์„ ๋ฒ—๊ธฐ๊ณ  ์žˆ๋Š” ์ค‘์ด๊ณ ์š”.
08:09
But even before I peel that muscle away,
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ํ•˜์ง€๋งŒ ์ œ๊ฐ€ ๊ทผ์œก์„ ์ ˆ๊ฐœํ•˜๊ธฐ๋„ ์ „์—
08:11
you saw that there was a tumor underneath.
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๊ทธ ๋ฐ‘์— ์žˆ๋Š” ์ข…์–‘์„ ๋ณด์…จ์„ ๊ฒƒ ์ž…๋‹ˆ๋‹ค.
08:14
So that's the beauty of having a tumor
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์ด๊ฒŒ ๋ฐ”๋กœ ํ˜•๊ด‘๋ฌผ์งˆ๋กœ ํ‘œ์‹œ๋œ
08:17
that's labeled with fluorescent molecules.
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์ข…์–‘์˜ ์žฅ์  ์ž…๋‹ˆ๋‹ค.
08:20
That you can, not only see the margins
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๋ณด์‹œ๋ฉด ์•„์‹œ๊ฒ ์ง€๋งŒ,
08:22
right there on a molecular level,
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๋ถ„์ž์  ์ˆ˜์ค€์—์„œ ํ‘œ์‹œ๋˜์–ด
08:24
but you can see it even if it's not right on the top --
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ํ‘œ๋ฉด์— ์žˆ์ง€ ์•Š๊ฑฐ๋‚˜ ์‹œ์•ผ์—์„œ ๋ฒ—์–ด๋‚œ
08:27
even if it's beyond your field of view.
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์ข…์–‘๋„ ํ™•์ธํ•  ์ˆ˜ ์žˆ์Šต๋‹ˆ๋‹ค.
08:30
And this works for metastatic lymph nodes also.
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์ด๊ฒƒ์€ ์ „์ด ๋ฆผํ”„์ ˆ(metastatic lymph nodes)์—์„œ๋„ ์ž˜ ํ‘œ์‹œ๋ฉ๋‹ˆ๋‹ค.
08:33
Sentinel lymph node dissection
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๊ฐ์‹œ๋ฆผํ”„์ ˆ(Sentinel lymph node) ํ•ด๋ถ€๋Š”
08:35
has really changed the way that we manage breast cancer, melanoma.
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์šฐ๋ฆฌ๊ฐ€ ์–ด๋–ป๊ฒŒ ์œ ๋ฐฉ์•”์„ ์ฒ˜์น˜ํ•˜๋Š”์ง€ ๋ฐ”๊พธ์—ˆ์Šต๋‹ˆ๋‹ค.
08:39
Women used to get
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์—ฌ์„ฑ๋ถ„์„์€ ๊ณผ๊ฑฐ์— ์ •๋ง
08:41
really debilitating surgeries
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๋ชจ๋“  axillary lymph nodes ์ ˆ๊ฐœ๊ฐ€ ํ•„์š”ํ•œ
08:43
to excise all of the axillary lymph nodes.
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์†์ƒ์ด ์‹ฌํ•œ ์ˆ˜์ˆ ์„ ๋ฐ›์•„์™”์Šต๋‹ˆ๋‹ค.
08:46
But when sentinel lymph node
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ํ•˜์ง€๋งŒ ๊ฐ์‹œ๋ฆผํ”„์ ˆ(sentinel lymph node)์ด
08:49
came into our treatment protocol,
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์ฒ˜์น˜ ํ”„๋กœํ† ์ฝœ์— ๋‚˜ํƒ€๋‚ฌ์„ ๋•Œ ๋ถ€ํ„ฐ,
08:52
the surgeon basically looks for the single node
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์™ธ๊ณผ์˜๋Š” ์ด์ œ ์•”์„ ๋ฐฐ์ˆ˜ํ•˜๋Š”
08:55
that is the first draining lymph node of the cancer.
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๋ฆผํ”„์ ˆ์„ ์ฐพ๊ธฐ๋งŒ ํ•˜๋ฉด ๋ฉ๋‹ˆ๋‹ค.
08:58
And then if that node has cancer,
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๊ทธ๋ฆฌ๊ณ  ๋งŒ์•ฝ ๊ทธ ๋ฆผํ”„์ ˆ์— ์•”์ด ์žˆ๋‹ค๋ฉด,
09:01
the woman would go on to get
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ํ™˜์ž๋Š” ์•ก์™€๋ถ€ ๋ฆผํ”„์ ˆ ์ ˆ์ œ์ˆ (ALND)์„
09:03
the axillary lymph node dissection.
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๋ฐ›์œผ๋ฉด ๋ฉ๋‹ˆ๋‹ค.
09:05
So what that means
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์ด๊ฒŒ ์˜๋ฏธํ•˜๋Š” ๋ฐ”๋Š” ๋ฐ”๋กœ
09:07
is if the lymph node did not have cancer,
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๋งŒ์•ฝ ๊ทธ ๋ฆผํ”„์ ˆ์— ์•”์ด ์—†๋‹ค๋ฉด,
09:10
the woman would be saved
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ํ™˜์ž๋Š” ๋ถˆํ•„์š”ํ•œ ์ˆ˜์ˆ ์„
09:12
from having unnecessary surgery.
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ํ•˜์ง€ ์•Š๊ฒŒ ๋ฉ๋‹ˆ๋‹ค.
09:14
But sentinel lymph node, the way that we do it today,
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ํ•˜์ง€๋งŒ ๊ฐ์‹œ๋ฆผํ”„์ ˆ์€,
09:17
is kind of like having a road map
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์ง€๋„์™€ ๊ฐ™์ด ์–ด๋””๋กœ ๊ฐˆ์ง€
09:19
just to know where to go.
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๊ทธ ๋ฐฉํ–ฅ์„ ์•Œ๋ ค์ค๋‹ˆ๋‹ค.
09:21
So if you're driving on the freeway
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๊ทธ๋ž˜์„œ ๋งŒ์•ฝ ๊ณ ์†๋„๋กœ์—์„œ ์šด์ „ํ•˜๋‹ค๊ฐ€,
09:23
and you want to know where's the next gas station,
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๋‹ค์Œ ์ฃผ์š”์†Œ๊ฐ€ ์–ด๋””์— ์žˆ๋Š”์ง€ ์•Œ๊ณ  ์‹ถ๋‹ค๋ฉด,
09:25
you have a map to tell you that that gas station is down the road.
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์ง€๋„๋Š” ๋‹ค์Œ๋ฒˆ ์ฃผ์š”์†Œ๊ฐ€ ์–ด๋”” ์žˆ๋Š”์ง€ ์•Œ๋ ค์ค๋‹ˆ๋‹ค.
09:28
It doesn't tell you whether or not
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ํ•˜์ง€๋งŒ ์ง€๋„๋Š” ์ฃผ์š”์†Œ์— ๊ธฐ๋ฆ„์ด ์žˆ๋Š”์ง€
09:30
the gas station has gas.
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์—†๋Š”์ง€๋Š” ์•Œ๋ ค์ฃผ์ง€ ์•Š์Šต๋‹ˆ๋‹ค.
09:32
You have to cut it out, bring it back home,
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๊ทธ๋ž˜์„œ ๋‹น์‹ ์€ ์ž˜๋ผ๋‚ด์–ด, ์ง‘์œผ๋กœ ๊ฐ€์ ธ์™€,
09:35
cut it up, look inside
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์ ˆ๊ฐœํ•˜๊ณ  ์•ˆ์„ ๋ณด์•„์„œ
09:37
and say, "Oh yes, it does have gas."
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"์•„ ๊ธฐ๋ฆ„์ด ์žˆ๊ตฌ๋‚˜"๋ผ๊ณ  ๋งํ•˜๊ฒŒ ๋ฉ๋‹ˆ๋‹ค.
09:39
So that takes more time.
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์‹œ๊ฐ„์€ ๋” ๋งŽ์ด ์†Œ์š”๋˜๊ณ ์š”.
09:41
Patients are still on the operating room table.
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ํ™˜์ž๋Š” ์•„์ง๋„ ์ˆ˜์ˆ ๋Œ€ ์œ„์— ๋ˆ„์›Œ ์žˆ๋Š” ์ƒํƒœ์ž…๋‹ˆ๋‹ค.
09:43
Anesthesiologists, surgeons are waiting around.
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๋งˆ์ทจ๊ณผ ์˜์‚ฌ์™€ ์™ธ๊ณผ์˜์‚ฌ๋Š” ๊ธฐ๋‹ค๋ฆฌ๊ณ  ์žˆ๋Š” ์ค‘ ์ด๊ณ ์š”.
09:45
That takes time.
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์‹œ๊ฐ„์ด ์†Œ์š”๋ฉ๋‹ˆ๋‹ค.
09:47
So with our technology, we can tell right away.
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ํ•˜์ง€๋งŒ ์šฐ๋ฆฌ์˜ ๊ธฐ์ˆ ๋กœ๋Š”, ๊ฒฐ๊ณผ๋ฅผ ๋ฐ”๋กœ ์•Œ ์ˆ˜ ์žˆ์Šต๋‹ˆ๋‹ค.
09:50
You see a lot of little, roundish bumps there.
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์—ฌ๊ธฐ์—๋Š” ์—ฌ๋Ÿฌ๊ฐœ์˜ ์ž‘๊ณ  ๋‘ฅ๊ทธ์Šค๋ฆ„ํ•œ ๊ฒƒ๋“ค์ด ์žˆ์Šต๋‹ˆ๋‹ค.
09:53
Some of these are swollen lymph nodes
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์ด์ค‘ ์ผ๋ถ€๋Š” ๋‹ค๋ฅธ ๊ฒƒ๋ณด๋‹ค ์•ฝ๊ฐ„ ์ปค ๋ณด์ด๋Š”
09:56
that look a little larger than others.
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๋ถ€์–ด์˜ค๋ฅธ ๋ฆผํ”„์ ˆ์ž…๋‹ˆ๋‹ค.
09:58
Who amongst us hasn't had swollen lymph nodes with a cold?
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๊ฐ๊ธฐ๋กœ ์ธํ•ด ๋ถ€์–ด์˜ค๋ฅธ ๋ฆผํ”„์ ˆ์€ ๋ˆ„๊ตฌ๋‚˜ ๊ฐ€์งˆ ์ˆ˜ ์žˆ์ง€ ์•Š์Šต๋‹ˆ๊นŒ?
10:01
That doesn't mean that there's cancer inside.
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๋ถ€์–ด์˜ค๋ฆ„์ด ๋ฆผํ”„์ ˆ์•ˆ์— ์•”์ด ์žˆ๋‹ค๋Š” ์˜๋ฏธ๋Š” ์•„๋‹™๋‹ˆ๋‹ค.
10:03
Well with our technology,
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๊ทธ๋ž˜์„œ ์šฐ๋ฆฌ์˜ ๊ธฐ์ˆ ๋กœ๋Š”,
10:05
the surgeon is able to tell immediately
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์™ธ๊ณผ์˜๊ฐ€ ์ฆ‰์‹œ ์–ด๋–ค ๋ฆผํ”„์ ˆ์—
10:08
which nodes have cancer.
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์•”์ด ์žˆ๋Š”์ง€ ์•Œ ์ˆ˜ ์žˆ์Šต๋‹ˆ๋‹ค.
10:10
I won't go into this very much,
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๋„ˆ๋ฌด ๊นŠ๊ฒŒ ๋“ค์–ด๊ฐ€์ง€๋Š” ์•Š๊ฒ ์ง€๋งŒ,
10:12
but our technology, besides being able
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์ข…์–‘๊ณผ ์ „์˜์„ฑ ๋ฆผํ”„์ ˆ์„ ํ˜•๊ด‘๋ฌผ์งˆ๋กœ
10:14
to tag tumor and metastatic lymph nodes with fluorescence,
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ํ‘œ์‹œํ•˜๋Š” ๊ฒƒ ์™ธ์—๋„,
10:18
we can also use the same smart three-part molecule
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์šฐ๋ฆฌ๋Š” ๊ฐ™์€ ๋ถ„์ž๋ฅผ ์‚ฌ์šฉํ•ด์„œ
10:22
to tag gadolinium onto the system
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์‹œ์Šคํ…œ์— ๊ฐ€๋Œ๋ฆฌ๋Š„(gadolinium)์„ ํƒœ๊ทธํ•ด์„œ
10:25
so you can do this noninvasively.
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๋น„์นจ์Šต์ ์œผ๋กœ ์ง„ํ–‰ํ•  ์ˆ˜ ์žˆ์Šต๋‹ˆ๋‹ค.
10:27
The patient has cancer,
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ํ™˜์ž๋Š” ์•”์ด ์žˆ์œผ๋ฉฐ,
10:29
you want to know if the lymph nodes have cancer
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์ ˆ๊ฐœํ•˜๊ธฐ๋„ ์ „์— ๋ฆผํ”„์ ˆ์— ์•”์ด ์žˆ๋Š”์ง€
10:31
even before you go in.
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์•Œ๊ณ ์‹ถ์„ ๊ฒƒ ์ž…๋‹ˆ๋‹ค.
10:33
Well you can see this on an MRI.
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MRI๋ฅผ ํ†ตํ•ด์„œ ํ™•์ธํ•  ์ˆ˜ ์žˆ์ง€์š”.
10:36
So in surgery,
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์ˆ˜์ˆ  ์ค‘์—๋Š”,
10:38
it's important to know what to cut out.
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์–ด๋–ค ๋ถ€๋ถ„์„ ์ž๋ฅผ์ง€๊ฐ€ ๋งค์šฐ ์ค‘์š”ํ•ฉ๋‹ˆ๋‹ค.
10:41
But equally important
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ํ•˜์ง€๋งŒ ๋™๋“ฑํ•˜๊ฒŒ ์ค‘์š”ํ•œ ๊ฒƒ์€
10:43
is to preserve things
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์ค‘์š”ํ•œ ๊ธฐ๋Šฅ์„ ํ•˜๋Š” ๊ฒƒ๋“ค์„
10:46
that are important for function.
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๋ณด์กดํ•˜๋Š” ๊ฒƒ ์ž…๋‹ˆ๋‹ค.
10:49
So it's very important to avoid inadvertent injury.
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๊ทธ๋ž˜์„œ ๋ถ€์ฃผ์˜ํ•œ ์†์ƒ์„ ๋ฐฉ์ง€ํ•˜๋Š” ๊ฒƒ์€ ์ค‘์š”ํ•ฉ๋‹ˆ๋‹ค.
10:52
And what I'm talking about
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๊ทธ๋ฆฌ๊ณ  ์ œ๊ฐ€ ๋งํ•˜๊ณ  ์žˆ๋Š” ๊ฒƒ์€
10:54
are nerves.
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์‹ ๊ฒฝ์ž…๋‹ˆ๋‹ค.
10:56
Nerves, if they are injured,
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์‹ ๊ฒฝ์ด ์†์ƒ๋œ๋‹ค๋ฉด,
10:58
can cause paralysis,
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๋งˆ๋น„๋ฅผ ์ผ์œผํ‚ค๊ฑฐ๋‚˜,
11:00
can cause pain.
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๊ณ ํ†ต์„ ์ค„ ์ˆ˜ ์žˆ์Šต๋‹ˆ๋‹ค.
11:03
In the setting of prostate cancer,
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์ „๋ฆฝ์„ ์•”์˜ ๊ฒฝ์šฐ,
11:05
up to 60 percent of men
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์ตœ๋Œ€ 60%์˜ ๋‚จ์„ฑ์ด,
11:07
after prostate cancer surgery
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์ „๋ฆฝ์„  ์•” ์ˆ˜์ˆ  ํ›„์—,
11:09
may have urinary incontinence
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์š”์‹ค๊ธˆ์ด๋‚˜ ๋ฐœ๊ธฐ๋ถ€์ „์ด
11:11
and erectile disfunction.
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์ƒ๊ธธ ์ˆ˜ ์žˆ์Šต๋‹ˆ๋‹ค.
11:13
That's a lot of people to have a lot of problems --
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์ด ๋ฌธ์ œ๋Š” ์ •๋ง ๋งŽ์€ ์‚ฌ๋žŒ์—๊ฒŒ ํ•ด๋‹น๋˜๋Š” ๋ฌธ์ œ์ด๋ฉฐ--
11:16
and this is even in
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ํ•˜์ง€๋งŒ ์‹ฌ์ง€์–ด
11:18
so-called nerve-sparing surgery,
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์‹ ๊ฒฝ๋ณด์กด ์ˆ˜์ˆ ์—์„œ๋„
11:20
which means that the surgeon is aware of the problem,
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์™ธ๊ณผ์˜๋Š” ๋ถ€์ž‘์šฉ ๋ฌธ์ œ๋ฅผ ์•Œ๊ณ  ์žˆ์œผ๋ฉฐ,
11:24
and they are trying to avoid the nerves.
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์‹ ๊ฒฝ์„ ํ”ผํ•˜๋ ค๊ณ  ๋…ธ๋ ฅํ•ฉ๋‹ˆ๋‹ค.
11:26
But you know what, these little nerves are so small,
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ํ•˜์ง€๋งŒ, ์ด ์‹ ๊ฒฝ๋“ค์€ ๋„ˆ๋ฌด ์ž‘์•„์„œ,
11:29
in the context of prostate cancer,
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์ „๋ฆฝ์„  ์•”์˜ ๊ฒฝ์šฐ,
11:32
that they are actually never seen.
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์‹ค์ œ๋กœ ๋ณด์ด๋Š” ๊ฒฝ์šฐ๋Š” ๋“œ๋ญ…๋‹ˆ๋‹ค.
11:34
They are traced
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์‹ ๊ฒฝ๋“ค์€
11:36
just by their known anatomical path
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๋งฅ๊ด€ ๊ตฌ์กฐ๋ฅผ ๋”ฐ๋ผ ์•Œ๋ ค์ง„ ํ•ด๋ถ€ํ•™์  ๊ตฌ์กฐ๋ฅผ
11:38
along vasculature.
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ํ†ตํ•ด ์ถ”์ ๋ฉ๋‹ˆ๋‹ค.
11:40
And they're known because somebody has decided to study them,
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์šฐ๋ฆฌ๊ฐ€ ์ด ์ •๋ณด๋ฅผ ์•„๋Š” ์ด์œ ๋Š” ๋ˆ„๊ตฐ๊ฐ€๊ฐ€ ์—ฐ๊ตฌํ•˜๊ธฐ๋กœ ๊ฒฐ์ •ํ–ˆ์—ˆ๊ณ ,
11:44
which means that we're still learning
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์•„์ง ์šฐ๋ฆฌ๋Š” ์‹ ๊ฒฝ๋“ค์ด ์–ด๋””์— ์žˆ๋Š”์ง€
11:46
about where they are.
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๋ฐฐ์šฐ๋Š” ๋‹จ๊ณ„์— ์žˆ๋‹ค๋Š” ์˜๋ฏธ์ž…๋‹ˆ๋‹ค.
11:48
Crazy to think that we're having surgery,
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์ˆ˜์ˆ ์„ ํ•˜๋Š”๋ฐ, ์•”์„ ์ฐพ์•„ ์ ˆ๊ฐœํ•ด์•ผํ•˜์ง€๋งŒ,
11:51
we're trying to excise cancer, we don't know where the cancer is.
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์•”์ด ์–ด๋””์žˆ๋Š”์ง€ ๋ชจ๋ฅด๋Š” ๊ฒƒ์€ ์ •๋ง ์ •์‹ ๋‚˜๊ฐ„ ๊ฒƒ์ž…๋‹ˆ๋‹ค.
11:54
We're trying to preserve nerves; we can't see where they are.
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์šฐ๋ฆฌ๋Š” ์‹ ๊ฒฝ์„ ๋ณด์กดํ•˜๋ ค ํ•˜์ง€๋งŒ, ์–ด๋””์žˆ๋Š”์ง€ ๋ณผ ์ˆ˜๊ฐ€ ์—†์Šต๋‹ˆ๋‹ค.
11:57
So I said, wouldn't it be great
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๊ทธ๋ž˜์„œ ์ œ๊ฐ€ ๋งํ•˜๊ธฐ๋ฅผ
11:59
if we could find a way
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์‹ ๊ฒฝ์ด ์–ด๋””์žˆ๋Š”์ง€ ์ฐพ์„ ์ˆ˜ ์žˆ๋Š” ๋ฐฉ๋ฒ•์ด ์žˆ๋‹ค๋ฉด
12:01
to see nerves with fluorescence?
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์ •๋ง ์ข‹์ง€ ์•Š์„๊นŒ์š”?
12:04
And at first this didn't get a lot of support.
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์ฒ˜์Œ์—๋Š” ๋งŽ์€ ์ง€์ง€๋ฅผ ๋ฐ›์ง€ ๋ชปํ–ˆ์Šต๋‹ˆ๋‹ค.
12:08
People said, "We've been doing it this way for all these years.
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์‚ฌ๋žŒ๋“ค์€ "์šฐ๋ฆฌ๋Š” ์ง€๊ธˆ๊นŒ์ง€ ๊ณ„์† ์ด๋ ‡๊ฒŒ ํ•ด์™”๋Š”๋ฐ,
12:10
What's the problem?
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๋ฌธ์ œ๊ฐ€ ์žˆ๋‚˜์š”?
12:12
We haven't had that many complications."
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๋งŽ์€ ๋ถ€์ž‘์šฉ์ด ์žˆ์ง€ ์•Š์•˜์Šต๋‹ˆ๋‹ค."๋ผ๊ณ  ๋งํ•ฉ๋‹ˆ๋‹ค.
12:15
But I went ahead anyway.
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ํ•˜์ง€๋งŒ ์ €๋Š” ๊ณ„์† ์ง„ํ–‰ํ–ˆ์Šต๋‹ˆ๋‹ค.
12:17
And Roger helped me.
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๋กœ์ €(Roger)๊ฐ€ ์ €๋ฅผ ๋„์™€์คฌ๊ณ ์š”.
12:19
And he brought his whole team with him.
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๊ทธ๋ฆฌ๊ณ  ๊ทธ๋Š” ๊ทธ์˜ ํŒ€์›๋“ค๊ณผ ๊ฐ™์ด ์™”์Šต๋‹ˆ๋‹ค.
12:22
So there's that teamwork thing again.
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์ž ์ด์ œ, ํŒ€์›Œํฌ๊ฐ€ ์žˆ์Šต๋‹ˆ๋‹ค.
12:26
And we eventually discovered molecules
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์šฐ๋ฆฌ๋Š” ๋๋‚ด ์‹ ๊ฒฝ์„ ํ‘œ์‹œํ•  ์ˆ˜ ์žˆ๋Š” ๋ถ„์ž๋ฅผ
12:29
that were specifically labeling nerves.
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๋ฐœ๊ฒฌํ–ˆ์Šต๋‹ˆ๋‹ค.
12:31
And when we made a solution of this,
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์šฐ๋ฆฌ๋Š” ๋ถ„์ž๋ฅผ ์šฉ์•ก์œผ๋กœ ๋งŒ๋“ค์–ด,
12:33
tagged with the fluorescence
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ํ˜•๊ด‘๋ฌผ์งˆ๋กœ ํ‘œ์‹œํ•œ ๋’ค,
12:35
and injected in the body of a mouse,
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์ฅ์— ์ฃผ์‚ฌํ•˜์˜€๊ณ ,
12:38
their nerves literally glowed.
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์ฅ์˜ ์‹ ๊ฒฝ์€ ๋ฐœ๊ด‘ํ–ˆ์Šต๋‹ˆ๋‹ค.
12:40
You can see where they are.
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์—ฌ๊ธฐ ๋ณด์‹œ๋ฉด ์‹ ๊ฒฝ์ด ์–ด๋””์žˆ๋Š”์ง€ ์•Œ ์ˆ˜ ์žˆ์Šต๋‹ˆ๋‹ค.
12:42
Here you're looking at a sciatic nerve of a mouse,
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์—ฌ๊ธฐ์„œ๋Š” ์ฅ์˜ ์ขŒ๊ณจ ์‹ ๊ฒฝ์„ ๋ณด๊ณ  ์žˆ์Šต๋‹ˆ๋‹ค.
12:46
and you can see that that big, fat portion you can see very easily.
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๊ทธ๋ฆฌ๊ณ  ์—ฌ๊ธฐ ํฌ๊ณ  ๋‘ํˆผํ•œ ๋ถ€๋ถ„์„ ์‰ฝ๊ฒŒ ๋ณผ ์ˆ˜ ์žˆ์Šต๋‹ˆ๋‹ค.
12:49
But in fact, at the tip of that where I'm dissecting now,
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ํ•˜์ง€๋งŒ ์‚ฌ์‹ค, ์ œ๊ฐ€ ํ•ด๋ถ€๋ฅผ ํ•˜๊ณ  ์žˆ๋Š” ๋ถ€๋ถ„์—
12:52
there's actually very fine arborizations
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์•„์ฃผ ์ž‘์€ ์ˆ˜์ง€์ƒ๋ถ€๊ฐ€ ์žˆ์œผ๋ฉฐ
12:55
that can't really be seen.
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๊ทธ ๋ถ€๋ถ„์„ ๋ณผ ์ˆ˜ ์—†์Šต๋‹ˆ๋‹ค.
12:57
You see what looks like little Medusa heads coming out.
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์—ฌ๊ธฐ์— ๋ฉ”๋‘์‚ฌ์˜ ๋จธ๋ฆฌ ๊ฐ™์€ ๊ฒƒ์„ ๋ณผ ์ˆ˜ ์žˆ์Šต๋‹ˆ๋‹ค.
13:01
We have been able to see nerves
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์šฐ๋ฆฌ๋Š” ์‹ ๊ฒฝ์„ ๋ณผ ์ˆ˜ ์žˆ์—ˆ๋Š”๋ฐ,
13:03
for facial expression, for facial movement, for breathing --
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์–ผ๊ตด ํ‘œ์ •, ์–ผ๊ตด ์›€์ง์ž„, ์ˆจ ์‰ฌ๋Š” ๊ฒƒ์— ๊ด€๋ จ๋œ--
13:06
every single nerve --
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๋ชจ๋“  ์‹ ๊ฒฝ์„-- ๊ทธ๋ฆฌ๊ณ 
13:08
nerves for urinary function around the prostate.
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์ „๋ฆฝ์„  ๊ทผ์ฒ˜์— ์žˆ๋Š” ๋น„๋‡จ๊ธฐ ์‹ ๊ฒฝ์„ ๋ณผ ์ˆ˜ ์žˆ์Šต๋‹ˆ๋‹ค.
13:11
We've been able to see every single nerve.
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์šฐ๋ฆฌ๋Š” ๋ชจ๋“  ์‹ ๊ฒฝ์„ ๋ณผ ์ˆ˜ ์žˆ์—ˆ์Šต๋‹ˆ๋‹ค.
13:14
When we put these two probes together ...
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๋‘๊ฐœ์˜ ํ”„๋กœ๋ธŒ๋ฅผ ๊ฐ™์ด ๋„ฃ์œผ๋ฉด...
13:18
So here's a tumor.
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์—ฌ๊ธฐ์— ์ข…์–‘์ด ์žˆ์Šต๋‹ˆ๋‹ค.
13:20
Do you guys know where the margins of this tumor is?
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์—ฌ๋Ÿฌ๋ถ„์€ ์ด ์ข…์–‘์˜ ํƒœ๋‘๋ฆฌ๊ฐ€ ์–ด๋””์ธ์ง€ ์•„์‹œ๊ฒ ๋‚˜์š”?
13:23
Now you do.
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์ด์ œ ํ™•์ธ ํ•  ์ˆ˜ ์žˆ์œผ์‹ญ๋‹ˆ๋‹ค.
13:26
What about the nerve that's going into this tumor?
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์ข…์–‘ ๊ทผ์ฒ˜์˜ ์‹ ๊ฒฝ์€ ์–ด๋–ป๊ฒŒ ํ•˜๊ณ ์š”?
13:29
That white portion there is easy to see.
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๋ณด๊ธฐ ์‰ฌ์šด ํ•˜์–€ ๋ถ€๋ถ„์ž…๋‹ˆ๋‹ค.
13:31
But what about the part that goes into the tumor?
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ํ•˜์ง€๋งŒ ์ข…์–‘์„ ๊ด€ํ†ตํ•˜๋Š” ์‹ ๊ฒฝ์€ ์–ด๋–ป๊ฒŒ ํ•˜๊ณ ์š”?
13:33
Do you know where it's going?
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ํ™•์ธํ•  ์ˆ˜ ์žˆ์œผ์‹ญ๋‹ˆ๊นŒ?
13:35
Now you do.
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์ด์ œ๋Š” ๊ทธ๋Ÿฌ์‹ค ๊ฒƒ ์ž…๋‹ˆ๋‹ค.
13:37
Basically, we've come up with a way
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๊ธฐ๋ณธ์ ์œผ๋กœ, ์šฐ๋ฆฌ๋Š”
13:39
to stain tissue
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์กฐ์ง์„ ์—ผ์ƒ‰ํ•˜๊ณ 
13:41
and color-code the surgical field.
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์ˆ˜์ˆ ์„ ์ƒ‰๊น” ๋ถ„๋ฅ˜ํ•  ์ˆ˜ ์žˆ๋Š” ๋ฐฉ๋ฒ•์„ ๋ฐœ๊ฒฌํ–ˆ์Šต๋‹ˆ๋‹ค.
13:43
This was a bit of a breakthrough.
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์ด๊ฒƒ์€ ๋Œ€๋‹จํ•œ ๋ŒํŒŒ๊ตฌ ์ด์ง€์š”.
13:46
I think that it'll change the way that we do surgery.
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์ €๋Š” ์ด๊ฒŒ ์ˆ˜์ˆ ์„ ๋ฐ”๊ฟ€ ๊ฒƒ์ด๋ผ๊ณ  ์ƒ๊ฐํ•ฉ๋‹ˆ๋‹ค.
13:50
We published our results
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์šฐ๋ฆฌ๋Š” ํŒ€์˜ ๊ฒฐ๊ณผ๋ฅผ
13:52
in the proceedings of the National Academy of Sciences
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๋ฏธ๊ตญ๊ตญ๋ฆฝ๊ณผํ•™์•„์นด๋ฐ๋ฏธ์™€
13:54
and in Nature Biotechnology.
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๋„ค์ด์ณ ๋ฐ”์ด์˜คํ…Œํฌ๋†€๋กœ์ง€์— ๋ฐœํ‘œํ–ˆ์Šต๋‹ˆ๋‹ค.
13:56
We received commentary in Discover magazine,
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์šฐ๋ฆฌ๋Š” ๋˜ํ•œ ๋””์Šค์ปค๋ฒ„ ๋งค๊ฑฐ์ง„๊ณผ ์ด์ฝ”๋…ธ๋ฏธ์ŠคํŠธ์—
13:59
in The Economist.
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๊ธฐ์‚ฌ๋ฅผ ์‹ค์—ˆ์Šต๋‹ˆ๋‹ค.
14:01
And we showed it to a lot of my surgical colleagues.
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๊ทธ๋ฆฌ๊ณ  ์šฐ๋ฆฌ๋Š” ์ˆ˜ ๋งŽ์€ ์™ธ๊ณผ์˜์‚ฌ์—๊ฒŒ ๋ณด์—ฌ์ฃผ์—ˆ์Šต๋‹ˆ๋‹ค.
14:04
They said, "Wow!
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๊ทธ๋“ค์€ "์™€!!
14:06
I have patients
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์ €๋Š” ์ด๊ฒƒ์œผ๋กœ ์ธํ•ด ์ด๋“์„ ์–ป์„
14:08
who would benefit from this.
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ํ™˜์ž๊ฐ€ ์žˆ์Šต๋‹ˆ๋‹ค.
14:10
I think that this will result in my surgeries
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์ €๋Š” ์ด๊ฒŒ ์ œ ์ˆ˜์ˆ ๊ฒฐ๊ณผ๋ฅผ
14:12
with a better outcome
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๋”์šฑ ํ–ฅ์ƒ์‹œํ‚ค๊ณ  ํ•ฉ๋ณ‘์ฆ์„
14:14
and fewer complications."
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์ค„์—ฌ์ค„ ๊ฒƒ์ด๋ผ๊ณ  ์ƒ๊ฐํ•ฉ๋‹ˆ๋‹ค."๋ผ๊ณ  ๋งํ–ˆ์Šต๋‹ˆ๋‹ค.
14:17
What needs to happen now
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์ด์ œ ํ•ด์•ผํ•  ์ผ์€
14:19
is further development of our technology
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์ด ๊ธฐ์ˆ ์„ ๋” ๋ฐœ์ „์‹œํ‚ค๋Š” ๊ฒƒ๊ณผ
14:22
along with development
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์ˆ˜์ˆ ์‹ค์—์„œ ์‚ฌ์šฉํ•  ์ˆ˜ ์žˆ๋Š”
14:24
of the instrumentation
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๊ธฐ๊ตฌ์˜ ๊ฐœ๋ฐœ,
14:26
that allows us to see
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์ˆ˜์ˆ ์‹ค์—์„œ ํ˜•๊ด‘๋ฌผ์งˆ ํ‘œ์‹œ๋ฅผ
14:28
this sort of fluorescence in the operating room.
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๋ตค์—ฌ์ฃผ๋Š” ๊ธฐ๊ตฌ์˜ ๊ฐœ๋ฐœ์ด ํ•„์š”ํ•ฉ๋‹ˆ๋‹ค.
14:31
The eventual goal
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์ตœ์ข… ๋ฌ™ํ‘œ๋Š” ๋ฐ”๋กœ
14:33
is that we'll get this into patients.
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์ž„์ƒ์— ์‚ฌ์šฉํ•˜๋Š” ๊ฒƒ ์ž…๋‹ˆ๋‹ค.
14:36
However, we've discovered
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ํ•˜์ง€๋งŒ, ์šฐ๋ฆฌ๊ฐ€ ๋ฐœ๊ฒฌํ•œ์ ์€
14:39
that there's actually no straightforward mechanism
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์ผํšŒ์šฉ ๋ถ„์ž๋ฅผ
14:41
to develop a molecule
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๊ฐœ๋ฐœํ•˜๋Š” ์‰ฌ์šด ๋ฐฉ๋ฒ•์ด
14:43
for one-time use.
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์—†๋‹ค๋Š” ์  ์ž…๋‹ˆ๋‹ค.
14:45
Understandably, the majority of the medical industry
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๋งŽ์€ ๋ถ€๋ถ„์˜ ์˜๋ฃŒ๊ณ„๋Š”
14:48
is focused on multiple-use drugs,
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์žฅ๊ธฐ๊ฐ„ ๋งค์ผ ๋ณต์šฉํ•˜๋Š” ์•ฝ ์ฒ˜๋Ÿผ
14:52
such as long-term daily medications.
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์—ฌ๋Ÿฌ์ฐจ๋ก€ ๋ณต์šฉํ•˜๋Š” ์•ฝ์— ๊ด€์‹ฌ์ด ์žˆ์Šต๋‹ˆ๋‹ค.
14:55
We are focused on making this technology better.
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์šฐ๋ฆฌ๋Š” ์ด ๊ธฐ์ˆ ์„ ๋”์šฑ ๋ฐœ์ „์‹œํ‚ค๋Š” ๊ฒƒ์— ์ง‘์ค‘๋˜์–ด ์žˆ์Šต๋‹ˆ๋‹ค.
14:58
We're focused on adding drugs,
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์šฐ๋ฆฌ๋Š” ์•ฝ๋ฌผ์„ ์ถ”๊ฐ€ํ•˜๊ณ 
15:01
adding growth factors,
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์„ฑ์žฅ์ธ์ž๋ฅผ ์ถ”๊ฐ€ํ•˜๋ฉฐ,
15:03
killing nerves that are causing problems
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๋ฌธ์ œ๋ฅผ ์ผ์œผํ‚ค๋Š” ์‹ ๊ฒฝ์„ ์ œ๊ฑฐํ•˜๋ฉฐ,
15:05
and not the surrounding tissue.
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์ฃผ๋ณ€ ์กฐ์ง์„ ๋ณด์กดํ•˜๋Š” ์•ฝ๋ฌผ ๊ฐœ๋ฐœ์— ๊ด€์‹ฌ ์žˆ์Šต๋‹ˆ๋‹ค.
15:08
We know that this can be done and we're committed to doing it.
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์šฐ๋ฆฌ๋Š” ํ•  ์ˆ˜ ์žˆ๋‹ค๊ณ  ๋ฏฟ์œผ๋ฉฐ ์—ฐ๊ตฌ๋ฅผ ์ง„ํ–‰ํ•˜๊ณ  ์žˆ์Šต๋‹ˆ๋‹ค.
15:12
I'd like to leave you with this final thought.
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๋งˆ์ง€๋ง‰์œผ๋กœ ์ƒ๊ฐ์„ ๋‚จ๊ธฐ๊ณ  ์‹ถ์Šต๋‹ˆ๋‹ค.
15:16
Successful innovation
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์„ฑ๊ณต์ ์ธ ํ˜์‹ ์€
15:18
is not a single breakthrough.
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ํ•˜๋‚˜์˜ ๋ŒํŒŒ๊ตฌ๊ฐ€ ์•„๋‹™๋‹ˆ๋‹ค.
15:21
It is not a sprint.
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์ „๋ ฅ์งˆ์ฃผ๊ฐ€ ์•„๋‹™๋‹ˆ๋‹ค.
15:24
It is not an event for the solo runner.
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ํ•œ๋ช…์˜ ์ฃผ์ž๊ฐ€ ์žˆ๋Š” ์ด๋ฒคํŠธ๊ฐ€ ์•„๋‹™๋‹ˆ๋‹ค.
15:28
Successful innovation
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์„ฑ๊ณต์ ์ธ ํ˜์‹ ์€
15:30
is a team sport, it's a relay race.
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ํŒ€ ์Šคํฌ์ธ ์ด๋ฉฐ, ์ด์–ด๋‹ฌ๋ฆฌ๊ธฐ ์ž…๋‹ˆ๋‹ค.
15:33
It requires one team for the breakthrough
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ํ•˜๋‚˜์˜ ๋ŒํŒŒ๊ตฌ๋ฅผ ์œ„ํ•ด ํ•˜๋‚˜์˜ ํŒ€์ด ํ•„์š”ํ•˜๋ฉฐ
15:37
and another team
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๋˜ ๋‹ค๋ฅธ ํŒ€์€
15:39
to get the breakthrough accepted and adopted.
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๋ŒํŒŒ๊ตฌ๋ฅผ ์ธ์ •ํ•˜๊ณ  ์ ์šฉํ•˜๋Š”๋ฐ ํ•„์š”ํ•ฉ๋‹ˆ๋‹ค.
15:41
And this takes the long-term steady courage
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์ด๊ฒƒ์€ ์žฅ๊ธฐ๊ฐ„ ์—ฐ๊ตฌ ์‹ ๋…๊ณผ
15:44
of the day-in day-out struggle
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๋งค์ผ๋งค์ผ ํž˜๊ฒน๊ฒŒ ๋‚˜์•„๊ฐ€๋Š” ๊ฒƒ,
15:46
to educate, to persuade
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๊ต์œกํ•˜๊ณ , ์„ค๋“ํ•˜๋ฉฐ
15:49
and to win acceptance.
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๋™์˜๋ฅผ ๋ฐ›์•„๋‚ด๋Š” ๊ฒƒ์— ์žˆ์Šต๋‹ˆ๋‹ค.
15:52
And that is the light that I want to shine
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๊ทธ๋ฆฌ๊ณ  ์ด๊ฒƒ์€ ์ œ๊ฐ€ ์˜ค๋Š˜๋‚ 
15:54
on health and medicine today.
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์˜ํ•™์— ๋น„์ถ”๊ณ  ์‹ถ์€ ๋น›์ž…๋‹ˆ๋‹ค.
15:56
Thank you very much.
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๊ฐ์‚ฌํ•ฉ๋‹ˆ๋‹ค.
15:58
(Applause)
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(๋ฐ•์ˆ˜)

Original video on YouTube.com
์ด ์›น์‚ฌ์ดํŠธ ์ •๋ณด

์ด ์‚ฌ์ดํŠธ๋Š” ์˜์–ด ํ•™์Šต์— ์œ ์šฉํ•œ YouTube ๋™์˜์ƒ์„ ์†Œ๊ฐœํ•ฉ๋‹ˆ๋‹ค. ์ „ ์„ธ๊ณ„ ์ตœ๊ณ ์˜ ์„ ์ƒ๋‹˜๋“ค์ด ๊ฐ€๋ฅด์น˜๋Š” ์˜์–ด ์ˆ˜์—…์„ ๋ณด๊ฒŒ ๋  ๊ฒƒ์ž…๋‹ˆ๋‹ค. ๊ฐ ๋™์˜์ƒ ํŽ˜์ด์ง€์— ํ‘œ์‹œ๋˜๋Š” ์˜์–ด ์ž๋ง‰์„ ๋”๋ธ” ํด๋ฆญํ•˜๋ฉด ๊ทธ๊ณณ์—์„œ ๋™์˜์ƒ์ด ์žฌ์ƒ๋ฉ๋‹ˆ๋‹ค. ๋น„๋””์˜ค ์žฌ์ƒ์— ๋งž์ถฐ ์ž๋ง‰์ด ์Šคํฌ๋กค๋ฉ๋‹ˆ๋‹ค. ์˜๊ฒฌ์ด๋‚˜ ์š”์ฒญ์ด ์žˆ๋Š” ๊ฒฝ์šฐ ์ด ๋ฌธ์˜ ์–‘์‹์„ ์‚ฌ์šฉํ•˜์—ฌ ๋ฌธ์˜ํ•˜์‹ญ์‹œ์˜ค.

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