TEDMED 2011
Yoav Medan: Ultrasound surgery -- healing without cuts
Yoav Medan: Operacija ultrazvukom -- liječenje bez rezova
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Zamislite operaciju bez noževa. Na TEDMED-u, Yoav Medan govori o tehnici koja koristi MRI kako bi pronašla problematična mjesta i fokusirani ultrazvuk kako bi liječila probleme poput lezija mozga, miome maternice i nekoliko vrsta karcinomskih izraslina.
Yoav Medan - Medical inventor
With his team, Yoav Medan is developing a tool for incision-less surgery via focused ultrasound. Full bio
With his team, Yoav Medan is developing a tool for incision-less surgery via focused ultrasound. Full bio
Double-click the English transcript below to play the video.
00:15
Over the last 13 years --
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Tijekom posljednjih 13 godina --
00:17
one, three, 13 years --
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jedne, tri, 13 godina --
00:19
I've been part of an exceptional team at InSightec in Israel
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bio sam dio jedinstvenog tima u InSightec-u u Izraelu
00:22
and partners around the world
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i partneri iz cijelog svijeta
00:24
for taking this idea, this concept,
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zbog provođenja ove ideje, ovog koncepta,
00:27
noninvasive surgery,
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neinvazivne operacije,
00:29
from the research lab to routine clinical use.
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od istraživačkog laboratorija do rutinske kliničke upotrebe.
00:32
And this is what I'll tell you about.
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I to je ono o čemu ću vam govoriti.
00:34
13 years --
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13 godina --
00:36
for some of you, you can empathize with that number.
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neki od vas mogu suosjećati s tom brojkom.
00:39
For me, today, on this date,
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Za mene , danas, ovaj dan,
00:41
it's like a second bar mitzvah experience.
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ovo je poput druge bar mitzve.
00:43
(Laughter)
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(Smijeh)
00:46
So this dream
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Dakle, ovaj san
00:49
is really enabled
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je zapravo omogućen
00:51
by the convergence
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konvergencijom
00:53
of two known technologies.
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dviju poznatih tehnologija.
00:55
One is the focused ultrasound,
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Jedna je fokusirani ultrazvuk,
00:57
and the other one is the
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a druga je
01:00
vision-enabled magnetic resonance imaging.
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magnetna rezonanca koja omogućava slikoviti prikaz.
01:03
So let's first talk about focused ultrasound.
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Pa, hajdemo prvo razgovarati o fokusiranom ultrazvuku.
01:07
And I hold in my hand
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Ja u ruci držim
01:09
a tissue-mimicking phantom.
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fantoma koji predstavlja tkivo.
01:11
It is made out of silicon.
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Napravljen je od silikona.
01:13
It is transparent, made just for you.
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Proziran je, napravljen samo za vas.
01:16
So you see, it's all intact,
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Kao što vidite, sve je netaknuto,
01:19
completely transparent.
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potpuno prozirno.
01:21
I'll take you now to the acoustic lab.
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Sada ću vas odvesti do zvučnog laboratorija.
01:24
You see the phantom within the aquarium.
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Vidite fantoma u akvariju.
01:26
This is a setup I put in a physics lab.
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Ovo je instalacija koju sam sastavio u laboratoriju fizike.
01:28
On the right-hand side,
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Na desnoj strani
01:30
you see an ultrasonic transducer.
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vidite ultrazvučni transduser.
01:32
So the ultrasonic transducer
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Dakle, ultrazvučni transduser
01:35
emits basically an ultrasonic beam
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emitira zapravo ultrazvučnu zraku
01:37
that focuses inside the phantom.
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koja se fokusira unutar fantoma.
01:40
Okay, when you hear the click,
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OK, kada čujete klik,
01:44
this is when the energy starts to emit
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tad će se energija početi emitirati
01:46
and you see a little lesion form
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i vidjet ćete malu leziju
01:49
inside the phantom.
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unutar fantoma.
01:52
Okay, so everything around it
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OK, dakle, sve okolo
01:54
is whole and intact.
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je čitavo i netaknuto.
01:56
It's just a lesion formed inside.
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Imamo samo leziju formiranu unutra.
01:58
So think about, this is in your brain.
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Zamislite da je ovo u vašem mozgu.
02:01
We need to reach a target inside the brain.
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Mi trebamo dosegnuti metu unutar vašeg mozga.
02:03
We can do it without harming any tissue.
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Mi to možemo učiniti bez ozljeđivanja bilo kojeg tkiva.
02:06
So this is, I think,
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Ovo je, po mom mišljenju,
02:08
the first kosher Hippocratic surgical system.
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prvi kosher hipokratični operacijski sustav.
02:11
(Laughter)
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(Smijeh)
02:13
Okay, so let's talk a little bit about ultrasound,
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OK, hajdemo malo pričati o ultrazvuku,
02:15
the force of ultrasound.
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o snazi ultrazvuka.
02:17
You know all about imaging, right, ultrasound imaging.
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Vi znate sve o slikama, je li tako, o ultrazvučnim slikama.
02:20
And you know also about lithotripsy --
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I također znate o litotripsiji --
02:23
breaking kidney stones.
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razbijanju bubrežnih kamenaca.
02:26
But ultrasound can be shaped
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Međutim, ultrazvuk može biti oblikovan
02:29
to be anything in between,
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da bude bilo što između,
02:32
because it's a mechanical force.
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jer je on mehanička sila.
02:35
Basically, it's a force acting on a tissue
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U osnovi, to je sila koja djeluje na tkivo
02:37
that it transverses.
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koje mu se preprečava.
02:39
So you can change the intensity, the frequency,
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Tako da možete mijenjati intenzitet, frekvenciju,
02:42
the duration, the pulse shape of the ultrasound
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trajanje, oblik pulsa ultrazvuka
02:45
to create anything
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kako bi oblikovao bilo što
02:47
from an airbrush to a hammer.
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od zračnog kista do čekića.
02:50
And I am going to show you
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A ja ću vam pokazati
02:52
multiple applications in the medical field
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višestruke primjene u polju medicine
02:54
that can be enabled
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koje mogu biti omogućene
02:56
just by focusing,
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samim fokusiranjem,
02:58
physically focusing.
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fizikalnim fokusiranjem.
03:01
So this idea
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Stoga, ova ideja
03:03
of harnessing focused ultrasound to treat lesions in the brain
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o korištenju fokusiranog ultrazvuka za liječenje lezija na mozgu,
03:06
is not new at all.
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nije uopće nova.
03:08
When I was born, this idea was already conceived
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Kada sam rođen, ova ideja je već bila začeta
03:11
by pioneers such as the Fry brothers
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od strane pionira poput braće Fry
03:14
and Lars Leksell,
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i Larsa Leksella,
03:16
who is know actually
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koji je također poznat
03:18
as the inventor of the gammaknife.
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kao izumitelj gamma noža.
03:20
But you may not know
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Ali ono što možda ne znate
03:22
that he tried to perform lobotomies in the brain,
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je da je on pokušao izvesti lobotomiju mozga,
03:24
noninvasively,
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neinvazivno,
03:26
with focused ultrasound in the '50s.
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s fokusiranim ultrazvukom u pedesetima.
03:29
He failed,
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On nije uspio,
03:31
so he then invented the gammaknife.
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pa je onda izumio gamma nož.
03:33
And it makes you ponder
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Zanima vas zašto
03:36
why those pioneers failed.
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ti pioniri nisu uspjeli.
03:40
And there was something fundamental
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Tu je postojalo nešto osnovno
03:42
that they were missing.
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što im je nedostajalo.
03:44
They were missing the vision.
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Nedostajala im je slika.
03:46
It wasn't until the invention of the MR
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Tek nakon izuma MR-a
03:49
and really the integration of MR
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i istinske integracije MR-a
03:51
with focused ultrasound
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s fokusiranim ultrazvukom
03:53
that we could get the feedback --
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mogli smo dobiti povratnu informaciju --
03:56
both the anatomical and the physiological
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i anatomsku i fiziološku
03:59
in order to have a completely noninvasive, closed-loop
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s ciljem postignuća potpuno neinvazivne,
04:03
surgical procedure.
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operacije zatvorene petlje.
04:06
So this is how it looks, you know,
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Dakle, ovako izgleda
04:08
the operating room of the future today.
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operacijska sala iz budućnosti danas.
04:11
This is an MR suite with a focused ultrasound system.
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Ovo je MR odijelo s fokusiranim ultrazvučnim sustavom.
04:14
And I will give you several examples.
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A ja ću vam dati nekoliko primjera.
04:16
So the first one is in the brain.
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Dakle, prvi je na mozgu.
04:18
One of the neurological conditions
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Jedan od neuroloških stanja
04:21
that can be treated with focused ultrasound
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koji je moguće liječiti fokusiranim ultrazvukom
04:23
are movement disorders,
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su poremećaji motorike,
04:25
like Parkinson's or essential tremor.
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poput Parkinsonovog ili esencijalnog tremora.
04:28
What is typical to those conditions,
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Ono što je tipično za ta stanja,
04:31
to essential tremor for example,
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primjerice za esencijalni tremor,
04:34
is inability
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je nemogućnost pacijenata
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to drink or eat cereal or soup
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da piju ili jedu žitarice ili juhu
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without spilling everything all over you,
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bez prosipanja svega po sebi,
04:44
or write legibly so people can understand it,
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ili da čitljivo pišu kako bi ljudi mogli razumjeti,
04:47
and be really independent in your life
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te da su uistinu neovisni u svom životu
04:50
without the help of others.
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bez pomoći drugih ljudi.
04:52
So I'd like you to meet John.
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Volio bih da upoznate Johna.
04:55
John is a retired professor of history
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John je umirovljeni profesor povijesti
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from Virginia.
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iz Virginie.
04:59
So he suffered from essential tremor for many years.
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On je bolovao od esencijalnog tremora mnogo godina.
05:02
And medication didn't help him anymore.
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I lijekovi mu više nisu pomagali.
05:06
And many of those patients refused to undergo surgery
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I mnogi od tih pacijenata odbijaju podvrći se operaciji,
05:09
to have people cut into their brain.
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dopustiti ljudima da im režu mozak.
05:11
And about four or five months ago,
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Prije četiri ili pet mjeseci,
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he underwent an experimental procedure.
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on je podvrgnut eksperimentalnom postupku.
05:19
It is approved under an FDAIDE
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On je odobren od strane FDAIDE
05:22
at the University of Virginia
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na Sveučilištu Virginia
05:24
in Charlottesville
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u Charlottesvillu
05:26
using focused ultrasound
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koristeći fokusirani ultrazvuk
05:28
to ablate a point in his thalamus.
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kao oštricu, ciljna točka bila je u njegovom talamusu.
05:33
And this is his handwriting.
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A ovo je on rukom napisao.
05:36
"On June 20th," if you can read it,
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“Lipanj 20.,” ako možete pročitati
05:39
"2011."
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“2011”.
05:42
This is his handwriting
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Ovo je rukom napisao
05:44
on the morning of the treatment
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u jutro tretmana
05:46
before going into the MR
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prije odlaska na MR.
05:48
So now I'll take you through
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Sada ću vam pokazati
05:50
[what] a typical procedure like that looks like,
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kako tipični postupak izgleda,
05:53
[what] noninvasive surgery looks like.
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kako neinvazivna operacija izgleda.
05:56
So we put the patient on the MR table.
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Stavimo pacijenta na MR stol.
05:59
We attach a transducer, in this case, to the brain,
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Pričvrstimo transduser, u ovom slučaju na mozak,
06:01
but if it will be a different organ,
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ali ako bi u pitanju bio drugi organ,
06:03
it will be a different transducer attached to the patient.
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bio bi drugačiji transduser pričvršćen na pacijenta.
06:07
And the physician
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Zatim liječnici
06:09
will then take a regular MR scan.
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naprave normalanu MR sliku.
06:12
And the objective of that?
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Koja je svrha toga?
06:14
I don't have a pointer here,
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Nemam pokazivač ovdje,
06:16
but you see the green, sort of rectangle or trapezoid?
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ali možete li vidjeti zeleni pravokutnik ili trapez?
06:21
This is the sort of general area of the treatment.
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To je glavna regija za tretman.
06:23
It's a safety boundary
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Postoji sigurna granica
06:25
around the target.
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oko mete.
06:27
It's a target in the thalamus.
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Meta je talamus.
06:29
So once those pictures are acquired
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U onom trenutku kad se slike dobiju
06:31
and the physician has drawn
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i liječnk nacrta
06:34
all the necessary safety limits and so on,
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sve potrebne osiguravajuće granice i tako dalje,
06:37
he selects basically a point --
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on zapravo odabire točku --
06:39
you see the round point in the middle where the cursor is --
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vidite okruglu točku u sredini gdje je pokazivač --
06:42
and he presses this blue button called "sonicate."
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i pritisne plavi gumb nazvan “ozvuči”.
06:45
We call this instance of injecting the energy,
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Mi taj trenutak ubrizgavanja energije
06:48
we call it sonication.
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zovemo ozvučivanje.
06:50
The only handwork the physician does here
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Jedini ručni rad koji liječnik ovdje
06:53
is moving a mouse.
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radi je pomicanje miša.
06:55
This is the only device he needs in this treatment.
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To je jedini uređaj koji mu je potreban za ovaj tretman.
06:58
So he presses "sonicate," and this is what happens.
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Kad on pritisne “ozvuči” ovo se dogodi.
07:01
You see the transducer, the light blue.
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Vidite transduser, svijetlo plavi.
07:03
There's water in between the skull and the transducer.
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Ovdje je voda između lubanje i transdusera.
07:06
And it does this burst of energy.
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Ona radi ovu eksploziju energije.
07:08
It elevates the temperature.
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To podiže temperaturu.
07:10
We first need to verify
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Prvo moramo potvrditi
07:12
that we are on target.
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da smo na meti.
07:14
So the first sonication
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Tako da je prvo ozvučivanje
07:16
is at lower energy.
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na nižoj energiji.
07:18
It doesn't do any damage,
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Ono ne radi nikakvu štetu,
07:20
but it elevates the temperature
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nego podiže temperaturu
07:22
by a few degrees.
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za nekoliko stupnjeva.
07:24
And one of the unique capabilities
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Jedna od jedinstvenih sposobnosti
07:26
that we leverage with the MR
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MR-a
07:28
is the ability to measure temperature noninvasively.
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je neinvazivna sposobnost mjerenja temperature.
07:32
This is really a unique capability of the MR.
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To je uistinu jedinstvena sposobnost MR-a.
07:35
It is not being used
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To se inače ne koristi
07:37
in regular diagnostic imaging.
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u normalnoj dijagnostici.
07:39
But here we can get
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Ali ovdje, mi možemo dobiti
07:41
both the anatomical imaging and the temperature maps in real time.
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i anatomski prikaz i temperaturne mape u stvarnom vremenu.
07:44
And you can see the points there on the graph.
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Možete vidjeti točke ovdje na grafu.
07:47
The temperature was raised
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Temperatura je privremeno podignuta
07:49
to 43 degrees C temporarily.
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na 43 stupnja C.
07:51
This doesn't cause any damage.
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To ne uzrokuje nikakvu štetu.
07:53
But the point is we are right on target.
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Bit ovoga je da smo točno na meti.
07:55
So once the physician verifies
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Jednom kad liječnik potvrdi
07:58
that the focus spot is on the target he has chosen,
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da je točka fokusa na meti izabrana,
08:01
then we move to perform
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onda učinimo
08:04
a full-energy ablation
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punoenergetsko odsijecanje
08:06
like you see here.
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kao što ovdje možete vidjeti.
08:08
And you see the temperature rises
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Možete vidjeti da temperatura raste
08:11
to like 55 to 60 degrees C.
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na otprilike 55 do 60 stupnjeva C.
08:13
If you do it for more than a second,
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Ako to radite duže od sekunde,
08:15
it's enough to basically destroy
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to je dovoljno da uništite
08:18
the proteins of the cells.
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sve proteine u stanici.
08:22
This is the outcome from a patient perspective --
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Ovo je ishod iz pacijentove perspektive --
08:24
same day after the treatment.
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isti dan nakon operacije.
08:27
This is an immediate relief.
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Ovo je trenuračno poboljšanje.
08:29
(Applause)
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(Pljesak)
08:34
Thank you.
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Hvala.
08:36
John is one of [about] a dozen
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John je jedan od desetak
08:39
very heroic, courageous people
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vrlo hrabrih ljudi
08:43
who volunteered for the study.
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koji su volontirali u ovoj studiji.
08:45
And you have to understand
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Morate razumjeti
08:47
what is in people's mind
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što je tim ljudima na pameti
08:49
when they are willing to take the risk.
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kada su odlučni prihvatiti taj rizik.
08:52
And this is a quote from John after he wrote it.
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Ovo je Johnov citat nakon što je to napisao.
08:55
He said, "Miraculous."
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Rekao je: „Ovo je čudo.“
08:57
And his wife said, "This is the happiest moment of my life."
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A njegova žena je rekla : „Ovo je najsretniji trenutak moga života.“
09:01
And you wonder why.
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Pitate se zašto.
09:03
I mean, one of the messages I like to carry over
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Hoću reći, jedna od poruka koju želim poslati je
09:06
is, what about defending quality of life?
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kako zaštititi kvalitetu života?
09:09
I mean, those people lose their independence.
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Ti ljudi izgube svoju neovisnost.
09:11
They are dependent on others.
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Ovisni su o drugima.
09:13
And John today is fully independent.
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Danas je John potpuno neovisan.
09:16
He returned to a normal life routine.
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Vratio se normalnoj životnoj rutini.
09:19
And he also plays golf,
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Također igra golf,
09:21
like you do in Virginia
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kao što se to radi u Virginiji
09:23
when you are retired.
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kad si umirovljen.
09:28
Okay, so you can see here the spot.
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Ok, možete ovdje vidjeti ovu maglu.
09:32
It's like three millimeters in the middle of the brain.
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Otprilike 3 mm u sredini mozga.
09:34
There's no damage outside.
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Nema štete vani.
09:36
He suffers from no neurodeficit.
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On ne boluje od neurološkog deficita.
09:39
There's no recovery needed, no nothing.
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Nije potreban oporavak, ništa.
09:42
He's back to his normal life.
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Može se vratiti svom normalnom životu.
09:44
Let's move now
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Prijeđimo sad
09:46
to a more painful subject.
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na bolniju temu.
09:48
Pain is something
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Bol
09:50
that can make your life miserable.
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može učiniti vaš život lošim.
09:52
And people are suffering from all kinds of pain
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A ljudi pate od različitih bolova
09:54
like neuropathic pain, lower-back pain
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poput neuropatskih bolova, bolova u križima
09:58
and cancer pain from bone metastases,
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te bol koju izazivaju koštane metastaze,
10:01
when the metastases get to your bones,
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kada metastaze dođu do vašeg mozga,
10:04
sometimes they are very painful.
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ponekad je vrlo bolno.
10:07
All those I've indicated
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Sve ovo što sam nabrojao
10:09
have already been shown
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pokazalo se
10:11
to be successfully treated
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da može biti uspješno liječeno
10:13
by focused ultrasound
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fokusiranim ultrazvukom,
10:16
relieving the pain, again, very fast.
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uklanjajući bol, opet, vrlo brzo.
10:19
And I would like to tell you
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Htio bih vam pričati
10:21
about PJ.
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o PJ.
10:25
He's a 78 year-old farmer
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On je 78- godišnji farmer
10:29
who suffered from -- how should I say it? --
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koji je bolovao od -- kako da to kažem? --
10:32
it's called pain in the butt.
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zove se bolovi u guzi.
10:34
He had metastases in his right buttock,
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Imao je metastaze u svom desnom dijelu stražnjice,
10:37
and he couldn't sit
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sjediti nije mogao
10:39
even with medication.
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čak ni s lijekovima.
10:41
He had to forgo all the farm activities.
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Morao je zaboraviti sve aktivnosti na farmi.
10:48
He was treated with radiation therapy,
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Liječen je radioterapijom,
10:50
state-of-the-art radiation therapy,
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najsuvremenijom radioterapijom,
10:52
but it didn't help.
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ali nije pomoglo.
10:54
Many patients like that favor radiation therapy.
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Mnogim pacijentima poput njega pomaže radioterapija.
10:57
And again, he volunteered
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Dakle, on se prijavio
10:59
to a pivotal study
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za središnju studiju
11:01
that we ran worldwide,
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koju smo proveli širom svijeta,
11:04
also in the U.S.
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također u SAD-u.
11:08
And his wife actually took him.
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Zapravo ga je dovela njegova žena.
11:11
They drove like three hours
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Vozili su se oko tri sata
11:13
from their farm to the hospital.
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od njihove farme do bolnice.
11:16
He had to sit on a cushion,
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Morao je sjediti na jastučiću,
11:19
stand still, not move,
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mirno stajati, bez micanja,
11:21
because it was very painful.
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jer je bilo vrlo bolno.
11:24
He took the treatment,
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Primio je tretman
11:26
and on the way back,
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i na povratku
11:29
he drove the truck by himself.
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on sam je vozio kamionet.
11:33
So again, this is an immediate relief.
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Ponavljam, ovo je trenutačno poboljšanje.
11:36
And you have to understand
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Morate razumjeti
11:38
what those people feel
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kako se ti ljudi osjećaju
11:40
and what their family experiences
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i što njihove obitelji iskuse
11:43
when it happens.
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kad se to dogodi.
11:45
He returned again
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On se vratio
11:47
to his daily routine on the farm.
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svojoj dnevnoj rutini na farmi.
11:49
He rides his tractor.
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Vozi traktor.
11:51
He rides his horse to their mountain cabin regularly.
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Redovito jaše konja kad ide u njihovu planinsku kolibu.
11:55
And he has been very happy.
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Te je vrlo sretan.
11:58
But now, you ask me,
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Sad me pitate,
12:01
but what about war, the war on cancer?
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ali što s ratom protiv raka?
12:03
Show us some primary cancer.
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Pokaži nam neki primarni karcinom.
12:06
What can be done there?
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Što bi se tu moglo učiniti?
12:08
So I have good news and bad news.
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Imam dobre i loše vijesti.
12:10
The good news: there's a lot that can be done.
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Dobre vijesti: postoji puno toga što se može učiniti.
12:13
And it has been shown actually outside of the U.S.
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I to je zapravo pokazano izvan SAD-a.
12:16
And doing that in the U.S.
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U SAD-u
12:20
is very painful.
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je to vrlo bolno.
12:22
I don't see, without this nation
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Ne vidim kako bi se to ostvarilo
12:26
taking it as some collective will
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bez da ova nacija na to gleda kao nekakvu kolektivnu volju
12:30
or something that is a national goal to make that happen,
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ili tako nešto što je nacionalni cilj
12:33
it will not happen.
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koji se treba ostvariti.
12:35
And it's not just because of regulation;
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Nije samo zbog odredbi,
12:37
it's because of the amount of money needed
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također i zbog svote novca koja je potrebna
12:40
under the current evidence-based medicine
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na trenutnoj
12:44
and the size of trials and so on
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medicini utemeljenoj na dokazima
12:46
to make it happen.
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te veličini kliničkih pokusa itd.
12:48
So the first two applications
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Prve dvije primjene
12:50
are breast cancer and prostate cancer.
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su rak dojke i rak prostate.
12:53
They were the first to be treated by focused ultrasound.
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Oni su prvi liječeni fokusiranim ultrazvukom.
12:56
And we have better-than-surgery results in breasts.
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U slučaju dojke imamo rezultate koji su bolji od rezultata dobivenih operacijom.
13:01
But I have a message for the men here.
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Ali ovdje imam poruku za muškarce.
13:03
We heard here yesterday Quyen
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Jučer smo ovdje čuli Guillena
13:06
talking about the adverse event trait
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kako govori o negativnom učinku poteza
13:09
in prostate cancer.
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kod raka prostate.
13:11
There is a unique opportunity now
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Sada postoji jedinstvena mogućnost
13:13
with focused ultrasound guided by MR,
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s fokusiranim ultrazvukom nadgledanim MR-om
13:16
because we can actually think about
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jer sad zapravo možemo razmišljati o
13:19
prostate lumpectomy --
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uklanjanju kvržica na prostati --
13:21
treating just the focal lesion
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tretirajući samo fokalnu leziju
13:23
and not removing the whole gland,
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te ne odstranjivanju cijele žlijezde
13:25
and by that, avoiding all the issues
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te time izbjegavajući sve probleme
13:28
with potency and incontinence.
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s potencijom i inkontinencijom.
13:32
Well, there are other cancer tumors in the abdomen --
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Postoje i drugi tumori u abdomenu --
13:38
quite lethal, very lethal actually --
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prilično malo, zapravo jako malo --
13:40
pancreas, liver, kidney.
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gušterača, jetra, bubreg.
13:43
The challenge there
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Izazov ovdje
13:45
with a breathing and awake patient --
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s budnim pacijentom koji diše --
13:48
and in all our treatments,
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a u svim našim tretmanima
13:50
the patient is awake and conscious
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pacijent je budan i svjestan
13:52
and speaks with the physician --
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i priča s liječnikom --
13:56
is you have to teach the MR some tricks
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je da moramo naučiti MR neke trikove
13:59
how to do it in real time.
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kako da to napravimo u stvarnom vremenu.
14:02
And this will take time.
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A to zahtjeva vremena.
14:04
This will take two years.
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To traje dvije godine.
14:06
But I have now a message to the ladies.
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Sada imam poruku za dame.
14:09
And this is, in 2004,
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U 2004.
14:12
the FDA has approved MR-guided focused ultrasounds
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FDA je odobrila upotrebu MR-om nadziranog fokusiranog ultrazvuka
14:15
for the treatment of symptomatic uterine fibroids.
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za liječenje simptomatičnih mioma maternice.
14:20
Women suffer from that disease.
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Mnoge žene boluju od ove bolesti.
14:24
All those tumors
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Svi ti tumori
14:26
have heavy bleeding during periods,
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uzrokuju teška krvarenja tijekom menstruacijskog ciklusa,
14:28
abdominal pressure, back pain,
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pritisak u abdomenu, bol u leđima,
14:30
frequent urination.
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učestalo mokrenje.
14:32
And sometimes, they cannot even conceive and become pregnant
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A ponekad, one ne mogu začeti i zatrudnjeti
14:36
because of the fibroid.
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zbog mioma.
14:38
This is Frances.
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Ovo je Frances.
14:40
She was diagnosed with a grapefruit-sized fibroid.
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Diagnosticiran joj je miom veličine grejpa.
14:42
This is a big fibroid.
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To je velik miom.
14:44
She was offered a hysterectomy,
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Ponuđeno joj je uklanjanje maternice,
14:46
but this is an inconceivable proposition
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ali to je neprihvatljiv prijedlog
14:48
for someone who wants to keep her pregnancy option.
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nekomu tko želi zadržati opciju trudnoće.
14:51
So she elected to undergo a focused ultrasound procedure
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Stoga je izabrala podvrći se fokusiranom ultrazvuku
14:55
in 2008.
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u 2008.
14:57
And in 2010, she became a first-time mother to a healthy baby.
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2010. prvi put je postala majka zdravom djetetu.
15:01
So new life was born.
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Tako je rođen novi život.
15:03
(Applause)
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(Pljesak)
15:05
So in conclusion,
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U zaključku
15:08
I'd like to leave you with actually four messages.
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htio bih vas ostaviti zapravo s četiri poruke.
15:11
One is, think about the amount
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Jedna je da razmislite o količini
15:13
of suffering that is saved
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patnje od koje su spašeni
15:15
from patients undergoing noninvasive surgery,
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pacijenti koji se podvrgnu neinvazivnoj operaciji,
15:19
and also the economical and emotional burden
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također i ekonomski i emocijalni teret
15:23
removed from their families and communities
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kojeg su oslobođene njihove obitelji i zajednica
15:26
and the society at large --
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te društvo općenito --
15:30
and I think also from their physicians, by the way.
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usput, također i njihovi liječnici.
15:36
And the other thing I would like you to think about
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Druga stvar o kojoj bih htio da razmislite je
15:39
is the new type of relationship
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novi odnos
15:42
between physician and patients
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između pacijenta i liječnika
15:44
when you have a patient on the table
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kada imate pacijenta na stolu
15:47
[who] is awake and can even monitor the treatment.
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koji je budan i može čak pratiti tretman.
15:50
In all our treatments,
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U svim našim tretmanima,
15:52
the patient holds a stop sonication button.
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pacijent drži gumb za zaustavljanje ozvučivanja.
15:54
He can stop the surgery at any moment.
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On može prekinuti operaciju u bilo kojem trenutku.
15:58
And with that note,
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I s tom porukom
16:01
I would like to thank you for listening.
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htio bih vam zahvaliti na slušanju.
16:04
(Applause)
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(Pljesak)
ABOUT THE SPEAKER
Yoav Medan - Medical inventorWith his team, Yoav Medan is developing a tool for incision-less surgery via focused ultrasound.
Why you should listen
Yoav Medan is the Chief Systems Architect at InSightec Ltd. in Israel, where he works on MRI-guided guided focused ultrasound technology. Before this, he spent 17 years in research and management at the IBM Research Division and was elected to the IBM Academy of Technology. Medan has taught at the EE department at the Technion, Israel Institute of Technology, in addition to serving as a lecturer for Avionic Systems at the Aeronautical Engineering faculty, and mentors young enterpreneurs as part of the Technion Alumni "Technion for Life" program. He plans a 2012 sabbatical as an associate professor at the BioMedical Engineering department of the Technion and its Autonomous Systems Program.
Medan is also the inventor of the QR-code enabled tombstone. Read Adam Ostrow's Q&A with Yoav Medan at TEDGlobal >>
Yoav Medan | Speaker | TED.com