Soon We'll Cure Diseases With a Cell, Not a Pill | Siddhartha Mukherjee | TED Talks

305,659 views ・ 2015-10-28

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μ•„λž˜ μ˜λ¬Έμžλ§‰μ„ λ”λΈ”ν΄λ¦­ν•˜μ‹œλ©΄ μ˜μƒμ΄ μž¬μƒλ©λ‹ˆλ‹€.

λ²ˆμ—­: Ju Hye Lim κ²€ν† : Jihyeon J. Kim
00:12
I want to talk to you about the future of medicine.
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μ—¬λŸ¬λΆ„κ»˜ μ•½μ˜ λ―Έλž˜μ— λŒ€ν•΄ 이야기해 λ“œλ¦¬κ³  μ‹ΆμŠ΅λ‹ˆλ‹€.
00:16
But before I do that, I want to talk a little bit about the past.
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κ·Έ 전에 과거에 λŒ€ν•΄ 쑰금 μ•Œμ•„λ³΄λ„λ‘ ν•˜μ£ .
00:21
Now, throughout much of the recent history of medicine,
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μ•½μ˜ 졜근 μ—­μ‚¬μ˜ λŒ€λΆ€λΆ„μ—μ„œ
00:24
we've thought about illness and treatment
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μš°λ¦¬λŠ” μ§ˆλ³‘κ³Ό μΉ˜λ£Œμ— λŒ€ν•΄
00:28
in terms of a profoundly simple model.
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ꡉμž₯히 λ‹¨μˆœν•œ λͺ¨ν˜•μœΌλ‘œ μƒκ°ν–ˆμŠ΅λ‹ˆλ‹€.
00:31
In fact, the model is so simple
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μ‹€μ œλ‘œ κ·Έ λͺ¨ν˜•μ€ λ„ˆλ¬΄ λ‹¨μˆœν•΄μ„œ
00:34
that you could summarize it in six words:
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μ—¬μ„― λ‹¨μ–΄λ‘œ μš”μ•½ν•  수 μžˆμŠ΅λ‹ˆλ‹€.
00:37
have disease, take pill, kill something.
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병에 걸리고, 약을 λ¨Ήκ³ , 무언가λ₯Ό 죽인닀.
00:43
Now, the reason for the dominance of this model
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이 방식이 μ§€λ°°μ μ΄μ—ˆλ˜ μ΄μœ λŠ”
00:47
is of course the antibiotic revolution.
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λ¬Όλ‘  ν•­μƒμ œ 혁λͺ… λ•Œλ¬Έμž…λ‹ˆλ‹€.
00:50
Many of you might not know this, but we happen to be celebrating
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μ—¬λŸ¬λΆ„ 쀑에 λ§Žμ€ 뢄듀이 잘 λͺ¨λ₯΄μ‹œκ² μ§€λ§Œ μš°λ¦¬λŠ” μ˜¬ν•΄
00:53
the hundredth year of the introduction of antibiotics into the United States.
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미ꡭ에 ν•­μƒμ œκ°€ λ“€μ–΄μ˜¨ 100주년을 μΆ•ν•˜ν•˜κ³  μžˆμŠ΅λ‹ˆλ‹€.
00:57
But what you do know
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μ—¬λŸ¬λΆ„λ“€μ΄ μ•„λŠ” 것은
00:59
is that that introduction was nothing short of transformative.
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ν•­μƒμ œμ˜ λ„μž…μ€ ν˜μ‹ μ μ΄μ—ˆλ‹€λŠ” κ²ƒμž…λ‹ˆλ‹€.
01:04
Here you had a chemical, either from the natural world
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μžμ—°μ—μ„œ κ°€μ Έμ™”λ“  μ—°κ΅¬μ‹€μ—μ„œ 인곡적으둜 ν•©μ„±λ˜μ—ˆλ“ 
01:08
or artificially synthesized in the laboratory,
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μ—¬κΈ° ν™”ν•™λ¬Όμ§ˆμ΄ μžˆμŠ΅λ‹ˆλ‹€.
01:11
and it would course through your body,
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그리고 이 λ¬Όμ§ˆμ€ λͺΈ 속을 흐λ₯΄λ©΄μ„œ
01:14
it would find its target,
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λ―Έμƒλ¬Όμ΄λ‚˜ λ―Έμƒλ¬Όμ˜ 뢀뢄인
01:17
lock into its target --
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λͺ©ν‘œλ₯Ό μ°Ύμ•„μ„œ
01:19
a microbe or some part of a microbe --
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거기에 달라뢙어
01:21
and then turn off a lock and a key
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μžλ¬Όμ‡ μ™€ μ—΄μ‡ λ₯Ό ν•΄μ œν•©λ‹ˆλ‹€.
01:25
with exquisite deftness, exquisite specificity.
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λ›°μ–΄λ‚œ λŠ₯μˆ™ν•¨κ³Ό νŠΉμˆ˜ν•œ λŠ₯λ ₯으둜 말이죠.
01:29
And you would end up taking a previously fatal, lethal disease --
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그러면 μ—¬λŸ¬λΆ„μ€ μ•žμ„œ λ§ν–ˆλ˜ νλ ΄μ΄λ‚˜ 맀독, κ²°ν•΅κ³Ό 같은
01:33
a pneumonia, syphilis, tuberculosis --
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치λͺ…적인 μ§ˆλ³‘μ„
01:37
and transforming that into a curable, or treatable illness.
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μΉ˜λ£Œν•  수 μžˆλŠ” μ§ˆλ³‘μœΌλ‘œ λ°”κΎΈκ²Œ λ©λ‹ˆλ‹€.
01:42
You have a pneumonia,
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폐렴에 걸리면
01:44
you take penicillin,
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νŽ˜λ‹ˆμ‹€λ¦°μ„ λ¨Ήκ³ 
01:45
you kill the microbe
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μ§ˆλ³‘μ„ μΌμœΌν‚¨ 미생물을 μ£½μ—¬μ„œ
01:47
and you cure the disease.
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병을 μΉ˜λ£Œν•©λ‹ˆλ‹€.
01:49
So seductive was this idea,
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이 λ°œμƒμ€ λ„ˆλ¬΄ 맀λ ₯μ μ΄μ–΄μ„œ,
01:52
so potent the metaphor of lock and key
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μžλ¬Όμ‡ μ™€ μ—΄μ‡ μ˜ μ€μœ μ™€ 무언가λ₯Ό μ£½μΈλ‹€λŠ” 것은
01:56
and killing something,
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λ„ˆλ¬΄λ‚˜ κ°•λ ¬ν•΄μ„œ
01:58
that it really swept through biology.
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생물학을 νœ©μ“Έμ—ˆμŠ΅λ‹ˆλ‹€.
02:00
It was a transformation like no other.
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전에 μ—†λ˜ 혁λͺ…μ΄μ—ˆμŠ΅λ‹ˆλ‹€.
02:04
And we've really spent the last 100 years
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그리고 μš°λ¦¬λŠ” μ§€λ‚œ 100λ…„ λ™μ•ˆ
02:07
trying to replicate that model over and over again
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이 λͺ¨ν˜•μ„ 당뇨병과 κ³ ν˜ˆμ••, 심μž₯병같은 λ§Œμ„±μ§ˆλ³‘μ—
02:10
in noninfectious diseases,
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λ˜‘κ°™μ΄ μ μš©ν•˜κΈ° μœ„ν•΄
02:12
in chronic diseases like diabetes and hypertension and heart disease.
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λŠμž„μ—†μ΄ λ…Έλ ₯ν–ˆμŠ΅λ‹ˆλ‹€.
02:17
And it's worked, but it's only worked partly.
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μ‹€μ œλ‘œ νš¨κ³Όκ°€ μžˆμ—ˆμ§€λ§Œ λΆ€λΆ„μ μœΌλ‘œλ§Œ λ¨Ήν˜”μŠ΅λ‹ˆλ‹€.
02:21
Let me show you.
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μ—¬λŸ¬λΆ„κ»˜ λ³΄μ—¬λ“œλ¦¬κ² μŠ΅λ‹ˆλ‹€.
02:22
You know, if you take the entire universe
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μΈκ°„μ˜ λͺΈμ—μ„œ μΌμ–΄λ‚˜λŠ”
02:25
of all chemical reactions in the human body,
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λͺ¨λ“  ν™”ν•™ λ°˜μ‘μ„ μ „μ²΄μ μœΌλ‘œ 보면,
02:29
every chemical reaction that your body is capable of,
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λͺΈμ—μ„œ 일어날 수 μžˆλŠ” λͺ¨λ“  ν™”ν•™ λ°˜μ‘μ„ 보면,
02:32
most people think that that number is on the order of a million.
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λŒ€λΆ€λΆ„μ˜ μ‚¬λžŒλ“€μ€ 백만 개 정도가 μžˆλ‹€κ³  μƒκ°ν•©λ‹ˆλ‹€.
02:35
Let's call it a million.
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그럼 백만 개라고 κ°€μ •ν•΄ λ΄…μ‹œλ‹€.
02:36
And now you ask the question,
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그리고 이제 이런 μ§ˆλ¬Έμ„ ν•˜κ²Œλ˜μ£ .
02:38
what number or fraction of reactions
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λͺ‡ 개의, μ•„λ‹ˆλ©΄ λͺ‡ λΆ€λΆ„μ˜ ν™”ν•™λ°˜μ‘μ΄
02:41
can actually be targeted
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μ˜ν•™κ³„μ—΄μ˜ λͺ¨λ“  화학인
02:43
by the entire pharmacopoeia, all of medicinal chemistry?
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전체 μ•½μ „μ˜ λͺ©ν‘œλ¬Όμ΄ 될 수 μžˆμ„κΉŒμš”?
02:48
That number is 250.
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250개 μž…λ‹ˆλ‹€.
02:51
The rest is chemical darkness.
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λ‚˜λ¨Έμ§€λŠ” 화학적 λ―Έμ§€μ˜ μ˜μ—­μž…λ‹ˆλ‹€.
02:54
In other words, 0.025 percent of all chemical reactions in your body
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λ‹€λ₯Έ 말둜, λͺΈμ†μ—μ„œ μΌμ–΄λ‚˜λŠ” λͺ¨λ“  ν™”ν•™ λ°˜μ‘μ˜ 0.025%κ°€
03:00
are actually targetable by this lock and key mechanism.
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μžλ¬Όμ‡ μ™€ μ—΄μ‡  λͺ¨ν˜•μœΌλ‘œ 해결될 수 μžˆλ‹€λŠ” κ²λ‹ˆλ‹€.
03:05
You know, if you think about human physiology
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인체 생리학을 μƒν˜Έμž‘μš©μ΄ μΌμ–΄λ‚˜λŠ”
03:08
as a vast global telephone network
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λ§ˆλ””μ™€ 쑰각이 μžˆλŠ”
03:12
with interacting nodes and interacting pieces,
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κ΄‘λŒ€ν•œ μ „ν™”ν†΅μ‹ λ§μœΌλ‘œ 보면,
03:16
then all of our medicinal chemistry
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μ˜ν•™ κ³„μ—΄μ˜ ν™”ν•™λΆ„μ•Ό 전체가
03:19
is operating on one tiny corner
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이 μ—°κ²°λ§μ˜ κ°€μž₯ λ°”κΉ₯μͺ½ κ°€μž₯자리의
03:22
at the edge, the outer edge, of that network.
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μž‘μ€ λͺ¨ν‰μ΄μ—μ„œ μž‘μ—…ν•˜κ³  μžˆμŠ΅λ‹ˆλ‹€.
03:24
It's like all of our pharmaceutical chemistry
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우리의 λͺ¨λ“  μ œμ•½ κ³„μ—΄μ˜ 화학이
03:28
is a pole operator in Wichita, Kansas
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10-15개의 ν†΅μ‹ λ§μ΄λ‚˜ λ§Œμ§€λ©΄μ„œ
03:32
who is tinkering with about 10 or 15 telephone lines.
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지방 μ†Œλ„μ‹œμ— 본사λ₯Ό 두고 μžˆλŠ” 격이죠.
03:36
So what do we do about this idea?
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그럼 μš°λ¦¬κ°€ μ–΄λ–»κ²Œ ν•΄μ•Ό ν• κΉŒμš”?
03:40
What if we reorganized this approach?
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이 방법을 κ°œμ‘°ν•˜λŠ” 건 μ–΄λ–€κ°€μš”?
03:44
In fact, it turns out that the natural world
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사싀, μžμ—°μ€ λˆ„κ΅°κ°€κ°€ μ§ˆλ³‘μ— λŒ€ν•΄ μ–΄λ–»κ²Œ
03:47
gives us a sense of how one might think about illness
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병, μ•½, λͺ©ν‘œλ¬Ό 말고 μ „ν˜€ κΈ‰μ§„μ μœΌλ‘œ λ‹€λ₯Έ 생각을
03:52
in a radically different way,
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ν•  수 μžˆλŠ”μ§€λ₯Ό 보여쀄 수 μžˆμŠ΅λ‹ˆλ‹€.
03:54
rather than disease, medicine, target.
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ν•  수 μžˆλŠ”μ§€λ₯Ό 보여쀄 수 μžˆμŠ΅λ‹ˆλ‹€.
03:59
In fact, the natural world is organized hierarchically upwards,
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사싀, μžμ—°μ€ 상ν–₯식 μœ„κ³„μ§ˆμ„œλ‘œ μ‘°μ§λ˜μ–΄ μžˆμŠ΅λ‹ˆλ‹€.
04:02
not downwards, but upwards,
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ν•˜ν–₯식이 μ•„λ‹ˆλΌ 상ν–₯μ‹μ΄μš”.
04:04
and we begin with a self-regulating, semi-autonomous unit called a cell.
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반자치적이고 자율적인 μ„Έν¬μ—μ„œλΆ€ν„° μΆœλ°œν•˜μ£ .
04:11
These self-regulating, semi-autonomous units
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이 자율적이고 반자치적인 세포 λ‹¨μœ„λŠ”
04:14
give rise to self-regulating, semi-autonomous units called organs,
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반자치적이고 자율적인 μž₯κΈ°λ₯Ό λ§Œλ“€μ–΄λƒ…λ‹ˆλ‹€.
04:19
and these organs coalesce to form things called humans,
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그리고 μž₯기듀이 λͺ¨μ—¬ 인간을 λ§Œλ“€μ£ .
04:23
and these organisms ultimately live in environments,
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그리고 λΆ€λΆ„μ μœΌλ‘œ 자율적이고 반자치적인
04:27
which are partly self-regulating and partly semi-autonomous.
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μΈκ°„μ΄λΌλŠ” 생물이 μžμ—°ν™˜κ²½ μ†μ—μ„œ μƒν™œν•˜κ²Œ λ©λ‹ˆλ‹€.
04:32
What's nice about this scheme, this hierarchical scheme
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ν•˜ν–₯식이 μ•„λ‹Œ 상ν–₯식인 이 μœ„κ³„μ§ˆμ„œμ— μ˜ν•œ
04:35
building upwards rather than downwards,
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μ œλ„μ˜ 쒋은 점은
04:38
is that it allows us to think about illness as well
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μš°λ¦¬κ°€ μ§ˆλ³‘μ— λŒ€ν•΄ λ‹€λ₯Έ λ°©μ‹μœΌλ‘œ 사고할 수 있게
04:41
in a somewhat different way.
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해주기도 ν•œλ‹€λŠ” κ²ƒμž…λ‹ˆλ‹€.
04:44
Take a disease like cancer.
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암을 예둜 λ“€μ–΄λ³΄κ² μŠ΅λ‹ˆλ‹€.
04:48
Since the 1950s,
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1950λ…„λŒ€λΆ€ν„° μš°λ¦¬λŠ”
04:49
we've tried rather desperately to apply this lock and key model to cancer.
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μžλ¬Όμ‡ μ™€ μ—΄μ‡  λͺ¨ν˜•μ„ 암에 μ μš©ν•˜λ €κ³  ν•„μ‚¬μ μœΌλ‘œ λ…Έλ ₯ν–ˆμŠ΅λ‹ˆλ‹€.
04:54
We've tried to kill cells
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λ‹€μ–‘ν•œ ν™”ν•™μš”λ²•κ³Ό ν‘œμ μΉ˜λ£Œλ₯Ό μ΄μš©ν•΄
04:57
using a variety of chemotherapies or targeted therapies,
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세포λ₯Ό μ£½μ΄λ €λŠ” μ‹œλ„λ„ ν–ˆμŠ΅λ‹ˆλ‹€.
05:02
and as most of us know, that's worked.
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거의 λͺ¨λ‘κ°€ μ•Œλ‹€μ‹œν”Ό νš¨κ³Όκ°€ μžˆμ—ˆμŠ΅λ‹ˆλ‹€.
05:04
It's worked for diseases like leukemia.
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λ°±ν˜ˆλ³‘κ°™μ€ 병에 νš¨κ³Όκ°€ μžˆμ—ˆκ³ 
05:06
It's worked for some forms of breast cancer,
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λͺ‡λͺ‡ μ’…λ₯˜μ˜ μœ λ°©μ•”μ—λ„ νš¨κ³Όκ°€ μžˆμ—ˆμŠ΅λ‹ˆλ‹€.
05:09
but eventually you run to the ceiling of that approach.
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ν•˜μ§€λ§Œ κ²°κ΅­μ—λŠ” 이 λ°©μ‹μ˜ ν•œκ³„μ— λ‹€λ‹€λžμŠ΅λ‹ˆλ‹€.
05:12
And it's only in the last 10 years or so
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암세포가 아무것도 μ—†λŠ” κ³³μ—μ„œ μžλΌμ§€ μ•Šκ³ 
05:15
that we've begun to think about using the immune system,
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인간 μ•ˆμ—μ„œ μžλž€λ‹€λŠ” κ±Έ κΈ°μ–΅ν•΄λ‚΄μ„œ
05:18
remembering that in fact the cancer cell doesn't grow in a vacuum.
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λ©΄μ—­ 체계λ₯Ό μ΄μš©ν•  생각을 ν•œ 것은
05:21
It actually grows in a human organism.
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채 10년도 λ˜μ§€ μ•Šμ•˜μŠ΅λ‹ˆλ‹€.
05:23
And could you use the organismal capacity,
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생λͺ…체가 κ°€μ§€λŠ” λŠ₯λ ₯인
05:25
the fact that human beings have an immune system, to attack cancer?
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μΈκ°„μ˜ 면역체계λ₯Ό 암을 κ³΅κ²©ν•˜λŠ” 데 μ΄μš©ν•  수 μžˆμ„κΉŒμš”?
05:29
In fact, it's led to the some of the most spectacular new medicines in cancer.
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사싀 이 λ°œμƒμ€ κ°€μž₯ λ›°μ–΄λ‚œ ν•­μ•”μ œλ“€μ„ 발λͺ…ν•˜κ²Œ ν•΄μ£Όμ—ˆμŠ΅λ‹ˆλ‹€.
05:34
And finally there's the level of the environment, isn't there?
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λ§ˆμ§€λ§‰μœΌλ‘œ ν™˜κ²½μ˜ μˆ˜μ€€λ„ 영ν–₯을 λ―ΈμΉ©λ‹ˆλ‹€.
05:38
You know, we don't think of cancer as altering the environment.
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μš°λ¦¬λŠ” 암이 ν™˜κ²½μ„ λ³€ν™”μ‹œν‚¨λ‹€κ³  μƒκ°ν•˜μ§€ μ•ŠμŠ΅λ‹ˆλ‹€.
05:41
But let me give you an example of a profoundly carcinogenic environment.
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κ·Ήμ‹¬ν•˜κ²Œ 암을 μœ λ°œν•˜λŠ” ν™˜κ²½μ„ ν•˜λ‚˜ 예둜 λ“€μ–΄λ“œλ¦¬κ² μŠ΅λ‹ˆλ‹€.
05:46
It's called a prison.
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λ°”λ‘œ 감μ˜₯μž…λ‹ˆλ‹€.
05:48
You take loneliness, you take depression, you take confinement,
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κ°‡ν˜€μ„œ μ™Έλ‘œμ›€μ„ 느끼고 μš°μšΈμ¦μ„ μ–»κ²Œ λ©λ‹ˆλ‹€.
05:53
and you add to that,
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거기에 λ”ν•΄μ„œ
05:55
rolled up in a little white sheet of paper,
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μžκ·Έλ§ˆν•œ ν•˜μ–€ 쒅이에 무언가 돌돌 λ§λ €μžˆμŠ΅λ‹ˆλ‹€
05:59
one of the most potent neurostimulants that we know, called nicotine,
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μš°λ¦¬κ°€ μ•„λŠ” κ°€μž₯ κ°•λ ₯ν•œ μ‹ κ²½μžκ·Ήλ¬Όμ§ˆ 쀑 ν•˜λ‚˜μΈ λ‹ˆμ½”ν‹΄μ΄μ£ .
06:02
and you add to that one of the most potent addictive substances that you know,
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κ·Έκ±Έ μš°λ¦¬κ°€ μ•„λŠ” κ°€μž₯ 쀑독성 μžˆλŠ” 물질과 λ”ν•˜λ©΄
06:07
and you have a pro-carcinogenic environment.
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암이 유발되기 쒋은 ν™˜κ²½μ΄ μ‘°μ„±λ©λ‹ˆλ‹€.
06:11
But you can have anti-carcinogenic environments too.
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ν•­λ°œμ•”μ μΈ ν™˜κ²½λ„ μ‘°μ„±ν•  수 μžˆμŠ΅λ‹ˆλ‹€.
06:14
There are attempts to create milieus,
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μΌλ‘€λ‘œ μœ λ°©μ•”μ˜ 치료λ₯Ό μœ„ν•΄
06:16
change the hormonal milieu for breast cancer, for instance.
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ν™˜κ²½μ„ μ‘°μ„±ν•˜κ³  호λ₯΄λͺ¬ ν™˜κ²½μ„ λ°”κΎΈλ €λŠ” λ…Έλ ₯이 μ§„ν–‰λ˜κ³  μžˆμŠ΅λ‹ˆλ‹€.
06:20
We're trying to change the metabolic milieu for other forms of cancer.
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λ‹€λ₯Έ μ•”μ˜ κ²½μš°λ„ λ¬Όμ§ˆλŒ€μ‚¬ ν™˜κ²½μ„ λ°”κΎΈλ €κ³  ν•˜κ³  μžˆμŠ΅λ‹ˆλ‹€.
06:23
Or take another disease, like depression.
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μš°μšΈμ¦κ°™μ€ λ‹€λ₯Έ 병을 λ“€μ–΄λ΄…μ‹œλ‹€.
06:26
Again, working upwards,
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λ˜‘κ°™μ΄ 상ν–₯μ‹μœΌλ‘œ
06:29
since the 1960s and 1970s, we've tried, again, desperately
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1960λ…„λŒ€μ™€ 70λ…„λŒ€λΆ€ν„° μš°λ¦¬λŠ” 신경세포 μ‚¬μ΄μ—μ„œ κΈ°λŠ₯을 ν•˜λŠ”
06:33
to turn off molecules that operate between nerve cells --
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μ„Έλ‘œν† λ‹Œκ³Ό λ„νŒŒλ―Όκ°™μ€ λΆ„μžμ˜ κΈ°λŠ₯을 λ©ˆμΆ”λ €κ³ 
06:37
serotonin, dopamine --
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각고의 λ…Έλ ₯을 ν•˜λ©°
06:39
and tried to cure depression that way,
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이 λ°©μ‹μœΌλ‘œ μš°μšΈμ¦μ„ μΉ˜λ£Œν•˜λ € ν–ˆμŠ΅λ‹ˆλ‹€.
06:41
and that's worked, but then that reached the limit.
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νš¨κ³ΌλŠ” μžˆμ—ˆμ§€λ§Œ 곧 ν•œκ³„μ— λΆ€λ”ͺν˜”μŠ΅λ‹ˆλ‹€.
06:45
And we now know that what you really probably need to do
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우린 μ΄μ œλŠ” μž₯기와 λ‡Œμ˜ 생리λ₯Ό ꡬ쑰와 λͺ¨ν˜•μ„ λ°”κΎΈλŠ” 일이
06:47
is to change the physiology of the organ, the brain,
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ν•„μš”ν•˜λ‹€λŠ” 것을
06:50
rewire it, remodel it,
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그리고 수 λ§Žμ€ 연ꡬ결과가
06:52
and that, of course, we know study upon study has shown
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λŒ€ν™”μš”λ²•μ΄ λ°”λ‘œ κ·Έ 일을 ν•œλ‹€λŠ” 것을
06:55
that talk therapy does exactly that,
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증λͺ…ν•΄μ£Όμ—ˆλ‹€λŠ” κ±Έ μ••λ‹ˆλ‹€.
06:57
and study upon study has shown that talk therapy
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그리고 μˆ˜λ§Žμ€ 연ꡬ결과가 μ•½λ¬Όκ³Ό κ²°ν•©λœ λŒ€ν™”μš”λ²•μ΄
06:59
combined with medicines, pills,
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λ‘˜ 쀑 ν•˜λ‚˜λ§Œ μ‚¬μš©ν•˜λŠ” 것보닀
07:02
really is much more effective than either one alone.
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훨씬 νš¨κ³Όμ μ΄λΌλŠ” κ±Έ 증λͺ…ν•΄μ£Όμ—ˆμŠ΅λ‹ˆλ‹€.
07:05
Can we imagine a more immersive environment that will change depression?
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μš°μšΈμ¦μ— λ³€ν™”λ₯Ό κ°€μ Έμ˜€λŠ” μ’€ 더 μ‹€κ°λ‚˜λŠ” ν™˜κ²½μ„ μƒμƒν•˜μ‹€ 수 μžˆλ‚˜μš”?
07:09
Can you lock out the signals that elicit depression?
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μš°μšΈμ¦μ„ μœ λ°œν•˜λŠ” μ‹ ν˜Έλ“€μ„ 차단할 수 μžˆμ„κΉŒμš”?
07:13
Again, moving upwards along this hierarchical chain of organization.
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λ˜‘κ°™μ΄ 상ν–₯식 쑰직ꡬ쑰 μ•ˆμ—μ„œ 말이죠.
07:19
What's really at stake perhaps here
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μ§€κΈˆ μ •μž‘ μœ„κΈ°μ˜ 상황에 λ†“μ—¬μžˆλŠ” 건
07:22
is not the medicine itself but a metaphor.
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약이 μ•„λ‹ˆλΌ μ€μœ λ²•μž…λ‹ˆλ‹€.
07:25
Rather than killing something,
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μ‹ λΆ€μ „μ¦μ΄λ‚˜ 당뇨병
07:27
in the case of the great chronic degenerative diseases --
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κ³ ν˜ˆμ••, κ΄€μ ˆμ—Όκ°™μ€ 유λͺ…ν•œ λ§Œμ„± 퇴행성 μ§ˆν™˜μ˜ 경우
07:31
kidney failure, diabetes, hypertension, osteoarthritis --
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μš°λ¦¬μ—κ²Œ μ •μž‘ ν•„μš”ν•œ 건 무언가λ₯Ό μ£½μ΄λŠ” 것이 μ•„λ‹ˆλΌ
07:35
maybe what we really need to do is change the metaphor to growing something.
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무언가λ₯Ό ν‚€μš°λŠ” κ²ƒμœΌλ‘œ λΉ„μœ λ₯Ό λ°”κΎΈλŠ” 것일지도 λͺ¨λ¦…λ‹ˆλ‹€.
07:38
And that's the key, perhaps,
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λ°”λ‘œ 그것이 μ˜ν•™μ— λŒ€ν•œ 우리의 사고λ₯Ό
07:40
to reframing our thinking about medicine.
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μž¬κ΅¬μ„±ν•˜λŠ” μ—΄μ‡ κ°€ 될 μˆ˜λ„ μžˆμŠ΅λ‹ˆλ‹€.
07:43
Now, this idea of changing,
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변화와 μΈμ§€μ˜ 변동을
07:46
of creating a perceptual shift, as it were,
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κ°€μ Έμ˜€λ € ν•˜λŠ” 이 생각은
07:49
came home to me to roost in a very personal manner about 10 years ago.
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10λ…„ 전에 ꡉμž₯히 사적인 λ°©μ‹μœΌλ‘œ 제 머릿속에 λ“€μ–΄μ˜€κ²Œ λ˜μ—ˆμŠ΅λ‹ˆλ‹€.
07:52
About 10 years ago -- I've been a runner most of my life --
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10λ…„μ „ 쯀에 μ €λŠ” μΈμƒμ˜ λŒ€λΆ€λΆ„μ„ λ‹¬λ¦¬λŠ” 데 λ³΄λƒˆμŠ΅λ‹ˆλ‹€.
07:55
I went for a run, a Saturday morning run,
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ν•˜λ£¨λŠ” ν† μš”μΌ 아침에 달리고
07:57
I came back and woke up and I basically couldn't move.
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집에 λŒμ•„μ™”λŠ”λ° λ‹€μŒλ‚  μΌμ–΄λ‚˜λ‹ˆ λͺΈμ„ 움직일 μˆ˜κ°€ μ—†μ—ˆμŠ΅λ‹ˆλ‹€.
07:59
My right knee was swollen up,
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였λ₯Έμͺ½ 무릎이 λΆ€μ–΄μžˆμ—ˆκ³ 
08:01
and you could hear that ominous crunch of bone against bone.
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λΌˆμ™€ λΌˆκ°€ λΆ€λ”ͺνžˆλ©΄μ„œ μœΌλ“œλ“κ±°λ¦¬λŠ” λΆˆκΈΈν•œ μ†Œλ¦¬κ°€ λ‚¬μŠ΅λ‹ˆλ‹€.
08:06
And one of the perks of being a physician is that you get to order your own MRIs.
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μ˜μ‚¬λΌμ„œ 쒋은 점은 자기 MRIλ₯Ό 슀슀둜 찍을 수 μžˆλ‹€λŠ” κ²λ‹ˆλ‹€.
08:11
And I had an MRI the next week, and it looked like that.
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μ €λŠ” κ·Έ λ‹€μŒμ£Όμ— MRIλ₯Ό μ°μ—ˆκ³  λ°”λ‘œ μ΄λž¬μŠ΅λ‹ˆλ‹€.
08:15
Essentially, the meniscus of cartilage that is between bone
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뼈 사이에 μžˆλŠ” λ°˜μ›”μƒμ—°κ³¨μ΄
08:19
had been completely torn and the bone itself had been shattered.
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μ™„μ „νžˆ 찒어지고 λΌˆλŠ” 산산쑰각 λ‚˜μžˆμ—ˆμŠ΅λ‹ˆλ‹€.
08:22
Now, if you're looking at me and feeling sorry,
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μ§€κΈˆ μ €λ₯Ό λΆˆμŒν•΄ν•˜λŠ” 뢄이 κ³„μ‹œλ‹€λ©΄
08:25
let me tell you a few facts.
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λͺ‡ 가지 μ•Œλ €λ“œλ¦΄ 게 μžˆμŠ΅λ‹ˆλ‹€.
08:27
If I was to take an MRI of every person in this audience,
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μ§€κΈˆ μ—¬κΈ° 계신 λͺ¨λ“  λΆ„μ˜ MRIλ₯Ό μ œκ°€ 찍을 수 μžˆλ‹€λ©΄
08:31
60 percent of you would show signs
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이 쀑 60%의 μ‚¬λžŒλ“€μ΄
08:33
of bone degeneration and cartilage degeneration like this.
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μ΄κ²ƒμ²˜λŸΌ λΌˆμ™€ 연골이 ν‡΄ν–‰μ„±μ§ˆν™˜μ— κ±Έλ €μžˆμ„ κ²λ‹ˆλ‹€.
08:36
85 percent of all women by the age of 70
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70μ„Έκ°€ 되면 85%의 여성이
08:40
would show moderate to severe cartilage degeneration.
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쀑간 μ •λ„μ—μ„œ κ·Ήμ‹¬ν•œ 연골 퇴행을 보일 κ²λ‹ˆλ‹€.
08:43
50 to 60 percent of the men in this audience
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μ—¬κΈ° 계신 λ‚¨μ„±μ˜ 50-60%도
08:45
would also have such signs.
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이런 증상을 κ°–κ³ μžˆμ„ κ²λ‹ˆλ‹€.
08:47
So this is a very common disease.
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이건 맀우 ν”ν•œ μ§ˆν™˜μž…λ‹ˆλ‹€.
08:48
Well, the second perk of being a physician
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μ˜μ‚¬λΌμ„œ 두 번째둜 쒋은 점은
08:51
is that you can get to experiment on your own ailments.
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자기의 λ³‘μœΌλ‘œ μ‹€ν—˜μ„ ν•  수 μžˆλ‹€λŠ” κ²λ‹ˆλ‹€.
08:54
So about 10 years ago we began,
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10λ…„ μ „μ―€λΆ€ν„°
08:56
we brought this process into the laboratory,
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μš°λ¦¬λŠ” 이 퇴행성 μ§ˆν™˜μ„
08:58
and we began to do simple experiments,
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κΈ°κ³„μ μœΌλ‘œ 고치기 μœ„ν•΄
09:00
mechanically trying to fix this degeneration.
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μ—°κ΅¬μ‹€μ—μ„œ κ°„λ‹¨ν•œ μ‹€ν—˜μ„ ν•˜κΈ° μ‹œμž‘ν–ˆμŠ΅λ‹ˆλ‹€.
09:03
We tried to inject chemicals into the knee spaces of animals
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μ—°κ³¨μ˜ 퇴행을 λ§‰μœΌλ €κ³  λ™λ¬Όλ“€μ˜ 무릎 사이에 μžˆλŠ” 곡간에
09:08
to try to reverse cartilage degeneration,
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ν™”ν•™λ¬Όμ§ˆμ„ μ£Όμž…ν•˜κΈ°λ„ ν–ˆμŠ΅λ‹ˆλ‹€.
09:10
and to put a short summary on a very long and painful process,
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이 κΈΈκ³  κ³ ν†΅μŠ€λŸ¬μš΄ 과정을 짧게 μš”μ•½ν•˜μžλ©΄
09:15
essentially it came to naught.
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μ „ν˜€ μ†Œλ“μ΄ μ—†μ—ˆμŠ΅λ‹ˆλ‹€.
09:17
Nothing happened.
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아무 일도 μΌμ–΄λ‚˜μ§€ μ•Šμ•˜μŠ΅λ‹ˆλ‹€.
09:18
And then about seven years ago, we had a research student from Australia.
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3년이 μ§€λ‚œ 뒀에 ν˜Έμ£Όμ—μ„œ 연ꡬ원 ν•œ λͺ…이 μ™”μŠ΅λ‹ˆλ‹€.
09:23
The nice thing about Australians
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호주인의 쒋은 점은
09:25
is that they're habitually used to looking at the world upside down.
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세상을 거꾸둜 λ³΄λŠ” 것에 μŠ΅κ΄€μ μœΌλ‘œ μ΅μˆ™ν•˜λ‹€λŠ” κ²ƒμž…λ‹ˆλ‹€.
09:28
(Laughter)
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(μ›ƒμŒ)
09:29
And so Dan suggested to me, "You know, maybe it isn't a mechanical problem.
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κ·Έλž˜μ„œ λŒ„μ€ 제게 이런 κ°€λŠ₯성을 μ œμ‹œν–ˆμŠ΅λ‹ˆλ‹€.
09:33
Maybe it isn't a chemical problem. Maybe it's a stem cell problem."
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"κΈ°κ³„μ μ΄κ±°λ‚˜ 화학적인 λ¬Έμ œκ°€ μ•„λ‹ˆλΌ 쀄기세포 문제일 μˆ˜λ„ μžˆμ–΄μš”."
09:39
In other words, he had two hypotheses.
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κ·ΈλŸ¬λ‹ˆκΉŒ λŒ„μ—κ² 가섀이 2개 μžˆμ—ˆμŠ΅λ‹ˆλ‹€.
09:41
Number one, there is such a thing as a skeletal stem cell --
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첫 λ²ˆμ§ΈλŠ” 피와 신경계에 쀄기세포가 μžˆλŠ” κ²ƒμ²˜λŸΌ,
09:45
a skeletal stem cell that builds up the entire vertebrate skeleton,
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뼈, 연골, μ„¬μœ μ‘°μ§κ³Ό 같은
09:49
bone, cartilage and the fibrous elements of skeleton,
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μ²™μΆ”λ™λ¬Όμ˜ 전체 골격을 ν˜•μ„±ν•˜λŠ”
09:51
just like there's a stem cell in blood,
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골격 쀄기세포가
09:53
just like there's a stem cell in the nervous system.
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μ‘΄μž¬ν•œλ‹€λŠ” κ²ƒμ΄μ—ˆμŠ΅λ‹ˆλ‹€.
09:55
And two, that maybe that, the degeneration or dysfunction of this stem cell
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두 λ²ˆμ§ΈλŠ”, 이 μ€„κΈ°μ„Έν¬μ˜ ν‡΄ν–‰μ΄λ‚˜ κΈ°λŠ₯μž₯μ• κ°€
09:59
is what's causing osteochondral arthritis, a very common ailment.
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맀우 ν”ν•œ μ§ˆν™˜μΈ 골연골 κ΄€μ ˆμ—Όμ„ μœ λ°œν•œλ‹€λŠ” κ²ƒμ΄μ—ˆμŠ΅λ‹ˆλ‹€.
10:03
So really the question was, were we looking for a pill
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κ·ΈλŸ¬λ‹ˆκΉŒ μ§„μ§œ λ¬Έμ œλŠ” μš°λ¦¬κ°€ μ •μž‘ 세포λ₯Ό μ°Ύμ•„μ•Ό ν•˜λŠ”λ°
10:06
when we should have really been looking for a cell.
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약을 μ°Ύκ³  μžˆλŠ” 것인가 μ˜€μŠ΅λ‹ˆλ‹€.
10:08
So we switched our models,
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κ·Έλž˜μ„œ μš°λ¦¬λŠ” λͺ¨ν˜•μ„ λ°”κΏ¨μŠ΅λ‹ˆλ‹€.
10:11
and now we began to look for skeletal stem cells.
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그리고 골격 쀄기세포λ₯Ό μ°ΎκΈ° μ‹œμž‘ν–ˆμ£ .
10:15
And to cut again a long story short,
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κΈ΄ 이야기λ₯Ό 짧게 μ€„μ΄μžλ©΄
10:18
about five years ago, we found these cells.
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5λ…„ 전에 쀄기세포λ₯Ό μ°Ύμ•˜μŠ΅λ‹ˆλ‹€.
10:21
They live inside the skeleton.
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이 μ„Έν¬λŠ” 뼈 μ•ˆμ— μžˆμŠ΅λ‹ˆλ‹€.
10:24
Here's a schematic and then a real photograph of one of them.
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μ—¬κΈ° 도식과 μ‹€μ œ 사진이 μžˆμŠ΅λ‹ˆλ‹€.
10:27
The white stuff is bone,
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흰 물질이 뼈이고
10:29
and these red columns that you see and the yellow cells
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μ—¬κΈ° λ³΄μ΄λŠ” λΉ¨κ°„ 쀄과 λ…Έλž€ 세포가
10:32
are cells that have arisen from one single skeletal stem cell --
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ν•˜λ‚˜μ˜ 골격 μ€„κΈ°μ„Έν¬μ—μ„œ λ‚˜μ˜¨ μ„Έν¬λ“€μž…λ‹ˆλ‹€.
10:35
columns of cartilage, columns of bone coming out of a single cell.
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ν•˜λ‚˜μ˜ μ„Έν¬μ—μ„œ μ—¬λŸ¬ μ€„μ˜ 연골과 λΌˆκ°€ λ‚˜μ˜¨ 것이죠.
10:38
These cells are fascinating. They have four properties.
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이 세포듀은 맀λ ₯μ μž…λ‹ˆλ‹€. λ„€ 가지 νŠΉμ§•μ΄ 있죠.
10:42
Number one is that they live where they're expected to live.
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μ²«μ§ΈλŠ” 이 세포듀이 μ‚΄μ•„μ•Ό ν•  곳에 μ‚°λ‹€λŠ” κ²ƒμž…λ‹ˆλ‹€.
10:45
They live just underneath the surface of the bone,
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이 세포듀은 뼈의 ν‘œλ©΄ λ°”λ‘œ μ•„λž˜μ— μ‚½λ‹ˆλ‹€.
10:48
underneath cartilage.
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연골 μ•„λž˜μ—μš”.
10:49
You know, in biology, it's location, location, location.
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μ•„μ‹œκ² μ§€λ§Œ μƒλ¬Όν•™μ—μ„œλŠ” μœ„μΉ˜κ°€ μ€‘μš”ν•˜κ±°λ“ μš”.
10:52
And they move into the appropriate areas and form bone and cartilage.
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세포듀은 μ ν•©ν•œ μœ„μΉ˜λ‘œ μ΄λ™ν•΄μ„œ λΌˆμ™€ 연골을 ν˜•μ„±ν•©λ‹ˆλ‹€.
10:56
That's one.
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그게 첫 번째 νŠΉμ„±μž…λ‹ˆλ‹€.
10:58
Here's an interesting property.
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ν₯미둜운 νŠΉμ„±μ΄ 또 μžˆμŠ΅λ‹ˆλ‹€.
10:59
You can take them out of the vertebrate skeleton,
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이 세포듀을 μ²™μΆ”λ™λ¬Όμ˜ λΌˆμ—μ„œ μΆ”μΆœν•˜μ—¬
11:02
you can culture them in petri dishes in the laboratory,
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μ—°κ΅¬μ‹€μ˜ 페트리 μ ‘μ‹œμ— λ°°μ–‘ν•˜λ©΄
11:04
and they are dying to form cartilage.
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세포듀은 연골을 ν˜•μ„±ν•˜κ³  μ‹Άμ–΄ 죽으렀 ν•©λ‹ˆλ‹€.
11:06
Remember how we couldn't form cartilage for love or money?
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μ‚¬λž‘μœΌλ‘œλ“  λˆμœΌλ‘œλ“  연골을 λ§Œλ“€ 수 μ—†λ˜ κ±° κΈ°μ–΅λ‚˜μ‹œλ‚˜μš”?
11:09
These cells are dying to form cartilage.
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이 세포듀은 연골을 ν˜•μ„±ν•˜κ³  μ‹Άμ–΄ μ•ˆλ‹¬ λ‚˜μžˆμŠ΅λ‹ˆλ‹€.
11:11
They form their own furls of cartilage around themselves.
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세포듀은 자기 주변에 자기의 연골을 λ‘λ¦…λ‹ˆλ‹€.
11:14
They're also, number three,
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μ„Έ 번째 νŠΉμ„±μœΌλ‘œλŠ”
11:16
the most efficient repairers of fractures that we've ever encountered.
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μš°λ¦¬κ°€ μ—¬νƒœκΉŒμ§€ λ³Έ 것 쀑에 κ°€μž₯ λ›°μ–΄λ‚œ 골절 μˆ˜λ¦¬κ³΅μ΄λΌλŠ” κ²λ‹ˆλ‹€.
11:20
This is a little bone, a mouse bone that we fractured
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μš°λ¦¬λŠ” 생μ₯μ˜ 뼈인 이 μž‘μ€ 뼈λ₯Ό κ³¨μ ˆμ‹œμΌœμ„œ
11:23
and then let it heal by itself.
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슀슀둜 μΉ˜μœ ν•˜κ²Œ λ‘μ—ˆμŠ΅λ‹ˆλ‹€.
11:25
These stem cells have come in and repaired, in yellow, the bone,
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쀄기 세포가 μ—¬κΈ° κ°œμž…ν•˜μ—¬ λ…Έλž€μƒ‰μΈ λΌˆμ™€
11:28
in white, the cartilage, almost completely.
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흰색인 연골을 거의 μ™„λ²½ν•˜κ²Œ κ³ μ³λ†“μ•˜μŠ΅λ‹ˆλ‹€.
11:31
So much so that if you label them with a fluorescent dye
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λ„ˆλ¬΄ μ™„λ²½ν•΄μ„œ 세포에 ν˜•κ΄‘ μ•ˆλ£Œλ₯Ό μΉ ν•˜λ©΄
11:34
you can see them like some kind of peculiar cellular glue
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골절된 λΆ€μœ„λ₯Ό 이 세포듀이 λ…νŠΉν•œ 세포 μ ‘μ°©μ œκ°™μ΄
11:38
coming into the area of a fracture,
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κ΅­μ†Œμ μœΌλ‘œλ§Œ μΉ˜λ£Œν•˜κ³ 
11:40
fixing it locally and then stopping their work.
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μž‘μ—…μ„ λ©ˆμΆ”λŠ” κ±Έ λ³Ό 수 μžˆμŠ΅λ‹ˆλ‹€.
11:43
Now, the fourth one is the most ominous,
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λ„€ λ²ˆμ§Έκ°€ κ°€μž₯ μ•ˆ 쒋은 νŠΉμ„±μΈλ°
11:45
and that is that their numbers decline precipitously,
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λ‚˜μ΄λ“€μˆ˜λ‘ μ„Έν¬μ˜ μˆ˜κ°€ κΈ‰κ²©νžˆ μ€„μ–΄λ“ λ‹€λŠ” κ²λ‹ˆλ‹€.
11:49
precipitously, tenfold, fiftyfold, as you age.
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10배둜, 50배둜 κΈ‰κ²©νžˆμš”.
11:54
And so what had happened, really,
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κ·ΈλŸ¬λ‹ˆκΉŒ κ²°κ΅­ μš°λ¦¬μ—κ²
11:56
is that we found ourselves in a perceptual shift.
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μΈμ§€μ˜ 변동이 μ°Ύμ•„μ˜¨ κ²ƒμ΄μ—ˆμŠ΅λ‹ˆλ‹€.
11:59
We had gone hunting for pills
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약을 찾으렀고 μ‹œμž‘ν–ˆλ‹€κ°€
12:01
but we ended up finding theories.
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이둠을 λ°œκ²¬ν•˜κ²Œ 된 것이죠.
12:04
And in some ways
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μ–΄λ–€ λ©΄μ—μ„œλŠ”
12:05
we had hooked ourselves back onto this idea:
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우린 세포와 생물과 ν™˜κ²½μ— κ΄€ν•œ 아이디어에 λ‹€μ‹œ λ¬Άμ—¬λ²„λ ΈμŠ΅λ‹ˆλ‹€.
12:08
cells, organisms, environments,
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12:11
because we were now thinking about bone stem cells,
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μ™œλƒν•˜λ©΄ μ΄μ œλŠ” 뼈 쀄기세포에 λŒ€ν•΄ μƒκ°ν•˜κ²Œ λ˜μ—ˆκ³ 
12:13
we were thinking about arthritis in terms of a cellular disease.
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κ΄€μ ˆμ—Όμ„ 세포 μ§ˆν™˜μ˜ μΌμ’…μœΌλ‘œ μƒκ°ν•˜κ²Œ λ˜μ—ˆκΈ° λ•Œλ¬Έμž…λ‹ˆλ‹€.
12:17
And then the next question was, are there organs?
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κ·Έλž˜μ„œ κ·Έ λ‹€μŒ μ§ˆλ¬Έλ“€μ€ 이런 κ²ƒμ΄μ—ˆμŠ΅λ‹ˆλ‹€.
12:20
Can you build this as an organ outside the body?
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μž₯기도 될까? 이걸 λͺΈ λ°–μ—μ„œ μž₯기둜 λ§Œλ“€ 수 μžˆμ„κΉŒ?
12:22
Can you implant cartilage into areas of trauma?
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외상을 μž…μ€ λΆ€μœ„μ— 연골을 이식할 수 μžˆμ„κΉŒ?
12:26
And perhaps most interestingly,
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그리고 μ–΄μ©Œλ©΄ κ°€μž₯ ν₯미둜운 질문으둜,
12:28
can you ascend right up and create environments?
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κΌ­λŒ€κΈ°λ‘œ λ°”λ‘œ μ˜¬λΌκ°€μ„œ ν™˜κ²½μ„ λ§Œλ“€μ–΄λ‚Ό 수 μžˆμ„κΉŒ?
12:30
You know, we know that exercise remodels bone,
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μš°λ¦¬λŠ” μš΄λ™μ΄ 뼈λ₯Ό κ°œμ‘°ν•΄μ€€λ‹€λŠ” κ±Έ μ•Œμ§€λ§Œ
12:33
but come on, none of us is going to exercise.
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κ·Έλ ‡λ‹€κ³  ν•΄μ„œ 아무도 μš΄λ™μ„ ν•˜μ§„ μ•ŠμŠ΅λ‹ˆλ‹€.
12:36
So could you imagine ways of passively loading and unloading bone
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그렇기에 연골을 μƒˆλ‘œ λ§Œλ“€κ±°λ‚˜ 퇴행을 λ©ˆμΆ”κ³  μž¬μƒμ‹œν‚¬ 수 μžˆλ„λ‘
12:41
so that you can recreate or regenerate degenerating cartilage?
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뼈λ₯Ό μˆ˜λ™μ μœΌλ‘œ λΉΌκ³  μ±„μš°λŠ” 방법을 상상할 수 μžˆλ‚˜μš”?
12:46
And perhaps more interesting, and more importantly,
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그리고 μ–΄μ©Œλ©΄ κ°€μž₯ ν₯미둭고도 κ°€μž₯ μ€‘μš”ν•œ μ§ˆλ¬Έμ€,
12:48
the question is, can you apply this model more globally outside medicine?
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이 λͺ¨ν˜•μ„ μ˜ν•™ 외에도 μ„Έκ³„μ μœΌλ‘œ μ μš©ν•  수 μžˆμ„κΉŒ μž…λ‹ˆλ‹€.
12:52
What's at stake, as I said before, is not killing something,
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μ•„κΉŒλ„ λ§ν–ˆλ“―μ΄ μ§€κΈˆ κΈ‰ν•œ 일은 무언가λ₯Ό μ£½μ΄λŠ” 게 μ•„λ‹ˆλΌ
12:56
but growing something.
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자라게 ν•˜λŠ” κ²λ‹ˆλ‹€.
12:58
And it raises a series of, I think, some of the most interesting questions
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이건 κ°€μž₯ ν₯미둜운 μ§ˆλ¬Έλ“€μ„ λΆˆλŸ¬μΌμœΌν‚΅λ‹ˆλ‹€.
13:03
about how we think about medicine in the future.
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μš°λ¦¬κ°€ 미래의 μ˜ν•™μ— λŒ€ν•΄ μ–΄λ–»κ²Œ 생각해야 ν•˜λŠ”μ§€μ— λŒ€ν•΄μ„œμš”.
13:07
Could your medicine be a cell and not a pill?
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μΉ˜λ£Œμ œκ°€ 약이 μ•„λ‹Œ 세포가 될 수 μžˆμ„κΉŒ?
13:10
How would we grow these cells?
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이 세포듀을 μ–΄λ–»κ²Œ 자라게 ν• κΉŒ?
13:13
What we would we do to stop the malignant growth of these cells?
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이 세포듀이 악성이 λ˜μ§€ μ•Šκ²Œ λ§‰μœΌλ €λ©΄ μ–΄λ–»κ²Œ ν•΄μ•Όν• κΉŒ?
13:16
We heard about the problems of unleashing growth.
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μš°λ¦¬λŠ” μ„±μž₯을 μ΄‰λ°œμ‹œν‚€λŠ” 것에 μžˆλŠ” λ¬Έμ œμ μ— λŒ€ν•΄ λ“€μ–΄λ³Έ 적이 μžˆμž–μ•„μš”.
13:20
Could we implant suicide genes into these cells
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μžμ‚΄ μœ μ „μžλ₯Ό 이 세포듀에 μ΄μ‹ν•΄μ„œ
13:23
to stop them from growing?
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μ„±μž₯을 멈좜 수 μžˆμ„κΉŒ?
13:25
Could your medicine be an organ that's created outside the body
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λͺΈ λ°–μ—μ„œ λ§Œλ“€μ–΄μ Έμ„œ λͺΈ 속에 μ΄μ‹λœ μž₯κΈ°κ°€
13:29
and then implanted into the body?
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μΉ˜λ£Œλ²•μΌ 수 μžˆμ„κΉŒ?
13:30
Could that stop some of the degeneration?
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그게 퇴행을 멈좜 수 μžˆμ„κΉŒ?
13:33
What if the organ needed to have memory?
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μž₯기에 κΈ°μ–΅ κΈ°λŠ₯이 ν•„μš”ν•˜λ‹€λ©΄ μ–΄λ–‘ν• κΉŒ?
13:35
In cases of diseases of the nervous system some of those organs had memory.
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신경계 μ§ˆν™˜μ˜ 경우 λͺ‡λͺ‡ μž₯κΈ°μ—λŠ” κΈ°μ–΅ κΈ°λŠ₯이 μžˆμ—ˆμŠ΅λ‹ˆλ‹€.
13:40
How could we implant those memories back in?
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κ·Έ 기얡듀을 λ„λ‘œ μ΄μ‹μ‹œν‚¬ 수 μžˆμ„κΉŒ?
13:42
Could we store these organs?
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이 μž₯기듀을 보관할 수 μžˆμ„κΉŒ?
13:44
Would each organ have to be developed for an individual human being
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μž₯기듀이 κ°œκ°œμΈμ„ μœ„ν•΄ λ°°μ–‘λ˜μ–΄μ„œ
13:47
and put back?
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μ΄μ‹λ˜μ–΄μ•Ό ν• κΉŒ?
13:50
And perhaps most puzzlingly,
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그리고 κ°€μž₯ μ–΄λ €μš΄ λ¬Έμ œλŠ”,
13:53
could your medicine be an environment?
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μΉ˜λ£Œμ œκ°€ ν™˜κ²½μΌ 수 μžˆμ„κΉŒ?
13:56
Could you patent an environment?
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ν™˜κ²½μ— νŠΉν—ˆλ₯Ό λ‚Ό 수 μžˆμ„κΉŒ?
13:57
You know, in every culture,
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λͺ¨λ“  λ¬Έν™”κΆŒμ—μ„œ
14:01
shamans have been using environments as medicines.
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무속인듀은 ν™˜κ²½μ„ 치료제둜 μ‚¬μš©ν•΄ μ™”μŠ΅λ‹ˆλ‹€.
14:04
Could we imagine that for our future?
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λ―Έλž˜μ— μš°λ¦¬λ„ κ·Έλ ‡κ²Œ λ κΉŒμš”?
14:08
I've talked a lot about models. I began this talk with models.
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μ €λŠ” λͺ¨ν˜•μ— λŒ€ν•΄ λ§Žμ€ μ–˜κΈ°λ₯Ό ν–ˆκ³  강연을 λͺ¨ν˜• μ΄μ•ΌκΈ°λ‘œ μ‹œμž‘ν–ˆμŠ΅λ‹ˆλ‹€.
14:11
So let me end with some thoughts about model building.
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κ·ΈλŸ¬λ‹ˆκΉŒ λͺ¨ν˜•μ— λŒ€ν•œ μ΄μ•ΌκΈ°λ‘œ 끝을 λ§Ίκ² μŠ΅λ‹ˆλ‹€.
14:14
That's what we do as scientists.
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그게 우리 κ³Όν•™μžλ“€μ΄ ν•˜λŠ” μΌμ΄λ‹ˆκΉŒμš”.
14:16
You know, when an architect builds a model,
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건좕가듀은 λͺ¨ν˜•μ„ λ§Œλ“€μ–΄μ„œ
14:19
he or she is trying to show you a world in miniature.
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μ‚¬λžŒλ“€μ—κ²Œ 세상을 μΆ•μ†ŒνŒμœΌλ‘œ 보여주렀고 ν•©λ‹ˆλ‹€.
14:22
But when a scientist is building a model,
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ν•˜μ§€λ§Œ κ³Όν•™μžλ“€μ€ λͺ¨ν˜•μ„ λ§Œλ“€μ–΄μ„œ
14:25
he or she is trying to show you the world in metaphor.
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세상을 μ€μœ μ μœΌλ‘œ 보여주렀고 ν•©λ‹ˆλ‹€.
14:29
He or she is trying to create a new way of seeing.
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세상을 λ³΄λŠ” μƒˆλ‘œμš΄ 방식을 λ§Œλ“œλ €κ³  ν•˜λŠ” κ±°μ£ .
14:33
The former is a scale shift. The latter is a perceptual shift.
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μ „μžλŠ” 크기의 λ³€ν™”μ΄μ§€λ§Œ ν›„μžλŠ” μ§€κ°μ˜ λ³€ν™”μž…λ‹ˆλ‹€.
14:38
Now, antibiotics created such a perceptual shift
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ν•­μƒμ œλŠ” 우리의 μ˜ν•™μ— λŒ€ν•œ 인식에 ꡉμž₯히 큰 변동을 κ°€μ Έμ™€μ„œ
14:43
in our way of thinking about medicine that it really colored, distorted,
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μš°λ¦¬κ°€ μ§€λ‚œ λͺ‡ λ°±λ…„ κ°„ κ°–κ³  있던 사고방식을
14:47
very successfully, the way we've thought about medicine for the last hundred years.
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맀우 μ„±κ³΅μ μœΌλ‘œ μ™œκ³‘μ‹œν‚€κ³  μƒ‰μ•ˆκ²½μ„ μ”Œμ› μŠ΅λ‹ˆλ‹€.
14:52
But we need new models to think about medicine in the future.
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ν•˜μ§€λ§Œ 미래의 μ˜ν•™μ— λŒ€ν•΄ μƒκ°ν•˜λ €λ©΄ μƒˆλ‘œμš΄ λͺ¨ν˜•μ΄ ν•„μš”ν•©λ‹ˆλ‹€.
14:56
That's what's at stake.
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이것이 μ§€κΈˆ μœ„κΈ°μ— μ²˜ν•΄ μžˆμŠ΅λ‹ˆλ‹€.
14:59
You know, there's a popular trope out there
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μ§€κΈˆ κ°€μž₯ 널리 νΌμ ΈμžˆλŠ” λΉ„μœ λŠ”
15:02
that the reason we haven't had the transformative impact
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λ³‘μ˜ 치료λ₯Ό λ³€ν™”μ‹œν‚€λŠ”
15:06
on the treatment of illness
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영ν–₯이 μ—†μ—ˆλ˜ μ΄μœ κ°€
15:08
is because we don't have powerful-enough drugs,
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μš°λ¦¬μ—κ²Œ μΆ©λΆ„νžˆ κ°•ν•œ 약이 μ—†κΈ° λ•Œλ¬Έμ΄λΌκ³  λ§ν•©λ‹ˆλ‹€.
15:11
and that's partly true.
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λΆ€λΆ„μ μœΌλ‘œλŠ” λ§žλŠ” λ§μž…λ‹ˆλ‹€.
15:14
But perhaps the real reason is
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ν•˜μ§€λ§Œ μ–΄μ©Œλ©΄ μ§„μ§œ μ΄μœ λŠ”
15:15
that we don't have powerful-enough ways of thinking about medicines.
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μ˜ν•™μ— λŒ€ν•œ μΆ©λΆ„νžˆ κ°•λ ₯ν•œ 사고방식이 μ—†κΈ° λ•Œλ¬Έμ΄ μ•„λ‹κΉŒμš”.
15:20
It's certainly true that
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λ¬Όλ‘  신약을 λ°œκ²¬ν•˜λŠ” 건
15:23
it would be lovely to have new medicines.
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멋진 μΌμž…λ‹ˆλ‹€.
15:26
But perhaps what's really at stake are three more intangible M's:
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ν•˜μ§€λ§Œ μ •λ§λ‘œ μœ„κΈ°μ— μ²˜ν•œ 건 λˆˆμ— 보이지 μ•ŠλŠ” 이 μ„Έ 가지 μž…λ‹ˆλ‹€.
15:31
mechanisms, models, metaphors.
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λ©”μ»€λ‹ˆμ¦˜, λͺ¨ν˜•, 그리고 μ€μœ λ²•μ΄μš”.
15:35
Thank you.
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κ°μ‚¬ν•©λ‹ˆλ‹€.
15:36
(Applause)
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(λ°•μˆ˜)
15:45
Chris Anderson: I really like this metaphor.
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크리슀 μ•€λ”μŠ¨ : 이 μ€μœ κ°€ 정말 λ§ˆμŒμ— λ“­λ‹ˆλ‹€.
15:49
How does it link in?
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이것과도 관련이 μžˆλŠ”μ§€ κΆκΈˆν•œλ°μš”,
15:50
There's a lot of talk in technologyland
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기술 λΆ„μ•Όμ—μ„œ μ˜ν•™μ˜ λ§žμΆ€ν™”μ— λŒ€ν•΄
15:53
about the personalization of medicine,
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λ§Žμ€ 이야기가 μ˜€κ°€κ³  μžˆμŠ΅λ‹ˆλ‹€.
15:55
that we have all this data and that medical treatments of the future
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μš°λ¦¬μ—κ² λ§Žμ€ 데이터가 있고 λ―Έλž˜μ—λŠ” μ˜λ£Œκ°€
15:59
will be for you specifically, your genome, your current context.
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κ°œμΈμ„ μœ„ν•΄, 개인의 κ²Œλ†ˆκ³Ό 상황에 λ§žμΆ€ν™”λ  κ²ƒμ΄λΌκ³ μš”.
16:03
Does that apply to this model you've got here?
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이게 μ„ μƒλ‹˜μ˜ λͺ¨ν˜•μ—λ„ 적용될 수 μžˆλ‚˜μš”?
16:07
Siddhartha Mukherjee: It's a very interesting question.
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μ‹―λ‹€λ₯΄νƒ€ 무컀지: ν₯미둜운 μ§ˆλ¬Έμ΄κ΅°μš”.
16:10
We've thought about personalization of medicine
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μš°λ¦¬λŠ” μ˜ν•™μ˜ λ§žμΆ€ν™”λ₯Ό μœ μ „μ²΄ν•™μ˜ λ§₯λ½μ—μ„œ
16:12
very much in terms of genomics.
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주둜 μƒκ°ν–ˆμŠ΅λ‹ˆλ‹€.
16:14
That's because the gene is such a dominant metaphor,
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μœ μ „μžλŠ” 맀우 지배적인 μ€μœ μ΄κΈ° λ•Œλ¬Έμ—
16:16
again, to use that same word, in medicine today,
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λ˜‘κ°™μ€ 말을 λ‹€μ‹œ ν•˜μžλ©΄, μ˜€λŠ˜λ‚ μ˜ μ˜ν•™ λΆ„μ•Όμ—μ„œ
16:19
that we think the genome will drive the personalization of medicine.
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κ²Œλ†ˆμ΄ μ˜ν•™μ˜ λ§žμΆ€ν™”λ₯Ό κ°€μ Έμ˜¬ 것이라고 μš°λ¦¬λŠ” μƒκ°ν•©λ‹ˆλ‹€.
16:23
But of course the genome is just the bottom
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λ¬Όλ‘  κ²Œλ†ˆμ€ λ§ν•˜μžλ©΄, 쑴재의 μ‚¬μŠ¬μ—μ„œ κ°€μž₯ 밑뢀뢄에 μžˆμ„ λΏμž…λ‹ˆλ‹€.
16:26
of a long chain of being, as it were.
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16:30
That chain of being, really the first organized unit of that, is the cell.
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쑴재의 μ‚¬μŠ¬μ—μ„œ κ°€μž₯ 기본적인 쑰직 λ‹¨μœ„λŠ” 세포죠.
16:34
So, if we are really going to deliver in medicine in this way,
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κ·Έλ ‡κΈ° λ•Œλ¬Έμ— μš°λ¦¬κ°€ μ˜ν•™μ„ 정말 μ΄λ ‡κ²Œ λ°œμ „μ‹œν‚¬ 것이라면
16:37
we have to think of personalizing cellular therapies,
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세포 μš”λ²•μ„ λ§žμΆ€ν™” ν•˜λŠ” 것에 λŒ€ν•΄μ„œ λ¨Όμ € μƒκ°ν•˜κ³ 
16:40
and then personalizing organ or organismal therapies,
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μž₯κΈ°λ‚˜ 유기체적 μš”λ²•μ„ λ§žμΆ€ν™”ν•΄μ•Ό ν•©λ‹ˆλ‹€.
16:43
and ultimately personalizing immersion therapies for the environment.
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그리고 μ΅œμ’…μ μœΌλ‘œ ν™˜κ²½ μΈ‘λ©΄μ—μ„œμ˜ μž κΉ€ μš”λ²•μ„ λ§žμΆ€ν™”ν•΄μ•Ό ν•˜μ£ .
16:47
So I think at every stage, you know --
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κ·Έλ ‡κΈ° λ•Œλ¬Έμ— μ œκ°€ 보기엔
16:50
there's that metaphor, there's turtles all the way.
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λͺ¨λ“  단계에 이 μ€μœ λ²•μ΄ κ΄€μ—¬λ©λ‹ˆλ‹€.
16:52
Well, in this, there's personalization all the way.
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μ „λ‹¨κ³„μ—μ„œ λ§žμΆ€ν™”κ°€ 이루어지죠.
16:55
CA: So when you say medicine could be a cell
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크리슀: κ·ΈλŸ¬λ‹ˆκΉŒ μΉ˜λ£Œμ œκ°€ 약이 μ•„λ‹Œ
16:58
and not a pill,
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세포가 될 수 μžˆλ‹€λŠ” λ§μ”€μ—μ„œ
17:00
you're talking about potentially your own cells.
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μ„Έν¬λŠ” 자기 세포일 μˆ˜λ„ μžˆλŠ” κ±°κ΅°μš”.
17:02
SM: Absolutely. CA: So converted to stem cells,
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μ‹―λ‹€λ₯΄νƒ€: λ¬Όλ‘ μž…λ‹ˆλ‹€. 크리슀: 그럼 μ€„κΈ°μ„Έν¬λ‘œ λ³€ν™˜λ˜κ³ 
17:04
perhaps tested against all kinds of drugs or something, and prepared.
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μ–΄μ©Œλ©΄ μ˜¨κ°– μ•½λ¬Όκ³Ό μ‹€ν—˜ν•΄λ³΄κ³  μ€€λΉ„λ˜κ³ μš”.
17:09
SM: And there's no perhaps. This is what we're doing.
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μ‹―λ‹€λ₯΄νƒ€: 가정이 μ•„λ‹™λ‹ˆλ‹€. 이게 μš°λ¦¬κ°€ ν•˜κ³  μžˆλŠ” μΌμž…λ‹ˆλ‹€.
17:11
This is what's happening, and in fact, we're slowly moving,
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μ§€κΈˆ μΌμ–΄λ‚˜κ³  μžˆλŠ” 일이고 우린 천천히 λ‚˜μ•„κ°€κ³  μžˆμŠ΅λ‹ˆλ‹€.
17:15
not away from genomics, but incorporating genomics
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μœ μ „μ²΄ν•™μ—μ„œ λ©€μ–΄μ§€λŠ” 게 μ•„λ‹ˆλΌ μœ μ „μ²΄ν•™μ„ μ„Έν¬λ‚˜ μž₯κΈ°, ν™˜κ²½μ²˜λŸΌ
17:19
into what we call multi-order, semi-autonomous, self-regulating systems,
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μš°λ¦¬κ°€ 닀쀑 λͺ…령체계, λ°˜λ…λ¦½μ  자율 규제적이라고 λΆ€λ₯΄λŠ” 것과
17:24
like cells, like organs, like environments.
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κ²°ν•©μ‹œν‚€κ³  μžˆμŠ΅λ‹ˆλ‹€.
17:26
CA: Thank you so much.
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크리슀: 정말 κ°μ‚¬ν•©λ‹ˆλ‹€.
17:28
SM: Pleasure. Thanks.
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μ‹―λ‹€λ₯΄νƒ€: μ˜κ΄‘μž…λ‹ˆλ‹€. κ°μ‚¬ν•©λ‹ˆλ‹€.
(λ°•μˆ˜)
이 μ›Ήμ‚¬μ΄νŠΈ 정보

이 μ‚¬μ΄νŠΈλŠ” μ˜μ–΄ ν•™μŠ΅μ— μœ μš©ν•œ YouTube λ™μ˜μƒμ„ μ†Œκ°œν•©λ‹ˆλ‹€. μ „ 세계 졜고의 μ„ μƒλ‹˜λ“€μ΄ κ°€λ₯΄μΉ˜λŠ” μ˜μ–΄ μˆ˜μ—…μ„ 보게 될 κ²ƒμž…λ‹ˆλ‹€. 각 λ™μ˜μƒ νŽ˜μ΄μ§€μ— ν‘œμ‹œλ˜λŠ” μ˜μ–΄ μžλ§‰μ„ 더블 ν΄λ¦­ν•˜λ©΄ κ·Έκ³³μ—μ„œ λ™μ˜μƒμ΄ μž¬μƒλ©λ‹ˆλ‹€. λΉ„λ””μ˜€ μž¬μƒμ— 맞좰 μžλ§‰μ΄ μŠ€ν¬λ‘€λ©λ‹ˆλ‹€. μ˜κ²¬μ΄λ‚˜ μš”μ²­μ΄ μžˆλŠ” 경우 이 문의 양식을 μ‚¬μš©ν•˜μ—¬ λ¬Έμ˜ν•˜μ‹­μ‹œμ˜€.

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