TEDMED 2011
Yoav Medan: Ultrasound surgery -- healing without cuts
Joav Medan (Yoav Medan): Operacija ultrazvukom- lečenje bez rezova
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Zamislite operaciju bez ikakvih noževa. Na TEDMED konferenciji, Joav Medan (Yoav Medan) objašnjava tehniku zasnovanu na MRI tehnologiji kojom se dolazi do problematičnih polja i usmerenom ultrazvuku kojim se leče problemi lezija u mozgu, fibroida na materici i nekoliko tipova raka.
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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Poslednjih trinaest godina,
00:17
one, three, 13 years --
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jedna, tri, trinaest godina,
00:19
I've been part of an exceptional team at InSightec in Israel
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sam deo vanrednog tima u "InSightec"-u u Izraelu
00:22
and partners around the world
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i partnera širom sveta, koji su posvećeni tome
00:24
for taking this idea, this concept,
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da ideja, koncept
00:27
noninvasive surgery,
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neinvazivne hirurgije,
00:29
from the research lab to routine clinical use.
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pređe iz faze istraživanja u rutinsku, kliničku praksu.
00:32
And this is what I'll tell you about.
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O tome ću vam pričati.
00:34
13 years --
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Trinaest godina,
00:36
for some of you, you can empathize with that number.
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neki od vas možda saosećaju sa tim brojem.
00:39
For me, today, on this date,
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Ja se danas osećam
00:41
it's like a second bar mitzvah experience.
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kao da sam na svojoj drugoj Bar Micvi.
00:43
(Laughter)
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(smeh)
00:46
So this dream
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Spajanje
00:49
is really enabled
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dve poznate tehnologije
00:51
by the convergence
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je dovelo
00:53
of two known technologies.
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do ostvarivanja ovog sna.
00:55
One is the focused ultrasound,
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Jedna je usmereni 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 sa vizuelnim predstavljanjem.
01:03
So let's first talk about focused ultrasound.
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Prvo ćemo pričati o fokusiranom ultrazvuku.
01:07
And I hold in my hand
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Držim u svojoj ruci fantoma,
01:09
a tissue-mimicking phantom.
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nešto što imitira tkivo.
01:11
It is made out of silicon.
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Napravljen je od silicijuma.
01:13
It is transparent, made just for you.
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Providan je i napravljen samo za vas.
01:16
So you see, it's all intact,
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Vidite, čitav je i
01:19
completely transparent.
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potpuno providan.
01:21
I'll take you now to the acoustic lab.
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Sada idemo na turu kroz akustičnu laboratoriju.
01:24
You see the phantom within the aquarium.
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Uočićete fantoma u akvarijumu.
01:26
This is a setup I put in a physics lab.
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Ovo je konstrukcija koju sam postavio u laboratoriji za fiziku.
01:28
On the right-hand side,
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Sa desne strane
01:30
you see an ultrasonic transducer.
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je provodnik ultrazvuka.
01:32
So the ultrasonic transducer
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Provodnik ultrazvuka
01:35
emits basically an ultrasonic beam
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odašilje ultrazvučni snop
01:37
that focuses inside the phantom.
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koji se fokusira unutar fantoma.
01:40
Okay, when you hear the click,
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Okej, kada čujete klik,
01:44
this is when the energy starts to emit
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to je momenat kada počinje emitovanje energije
01:46
and you see a little lesion form
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i uočićete malu leziju koja se formira
01:49
inside the phantom.
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unutar fantoma.
01:52
Okay, so everything around it
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Okej, sve oko njega je
01:54
is whole and intact.
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čitavo i netaknuto.
01:56
It's just a lesion formed inside.
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Samo je jedna lezija napravljena unutra.
01:58
So think about, this is in your brain.
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Zamislite sada da je to u vašem mozgu.
02:01
We need to reach a target inside the brain.
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Moramo dospeti do ciljne tačke u vašem mozgu.
02:03
We can do it without harming any tissue.
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Možemo to uraditi bez povrede tkiva.
02:06
So this is, I think,
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Smatram da je ovo
02:08
the first kosher Hippocratic surgical system.
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prvi Hipokratov operacioni sistem košer tipa.
02:11
(Laughter)
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(smeh)
02:13
Okay, so let's talk a little bit about ultrasound,
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Okej, sada ćemo pričati malo 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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Znate sve o uslikavanju, zar ne, ultrazvučnom slikanju.
02:20
And you know also about lithotripsy --
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Čuli ste i za litotripsiju (med.)
02:23
breaking kidney stones.
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to je razbijanje kamenja u bubregu.
02:26
But ultrasound can be shaped
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Ultrazvuk se može podesiti da
02:29
to be anything in between,
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bude bilo šta na toj skali
02:32
because it's a mechanical force.
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jer je to mehanička sila.
02:35
Basically, it's a force acting on a tissue
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U suštini, to je sila koja deluje na tkivo
02:37
that it transverses.
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kroz koje prolazi.
02:39
So you can change the intensity, the frequency,
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Možete menjati jačinu, učestalost,
02:42
the duration, the pulse shape of the ultrasound
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trajanje, pulsni oblik ultrazvuka
02:45
to create anything
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kako biste napravili bilo šta
02:47
from an airbrush to a hammer.
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od aerosolne četkice do čekića.
02:50
And I am going to show you
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Pokazaću vam višestruke
02:52
multiple applications in the medical field
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primene toga u medicini
02:54
that can be enabled
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koje su ostvarive
02:56
just by focusing,
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uz pomoć usmerenosti,
02:58
physically focusing.
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fizičke usmerenosti.
03:01
So this idea
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Ova ideja o
03:03
of harnessing focused ultrasound to treat lesions in the brain
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korišćenju usmerenog ultrazvuka pri lečenju lezija u mozgu
03:06
is not new at all.
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uopšte nije nova.
03:08
When I was born, this idea was already conceived
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Kada sam ja rođen, ideja je već sazrela
03:11
by pioneers such as the Fry brothers
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u glavama pionira, npr. Fraj braće
03:14
and Lars Leksell,
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ili Larsa Leksela,
03:16
who is know actually
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koji je poznat
03:18
as the inventor of the gammaknife.
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kao pronalazač gama-noža.
03:20
But you may not know
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Možda ne znate da je
03:22
that he tried to perform lobotomies in the brain,
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on pokušao da uradi neinvazivne
03:24
noninvasively,
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lobotomije mozga,
03:26
with focused ultrasound in the '50s.
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uz pomoć usmerenog ultrazvuka u 50-im.
03:29
He failed,
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Nije uspeo,
03:31
so he then invented the gammaknife.
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pa je potom izumeo gama-nož.
03:33
And it makes you ponder
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To vas navodi da pažljivo razmislite
03:36
why those pioneers failed.
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zašto ti pioniri nisu uspeli.
03:40
And there was something fundamental
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Postoji 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 vizija.
03:46
It wasn't until the invention of the MR
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Tek kada je otkrivena magnetna rezonanca (MR)
03:49
and really the integration of MR
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i kada je došlo do integracije MR tehnologije
03:51
with focused ultrasound
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i usmerenog ultrazvuka
03:53
that we could get the feedback --
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dobili smo povratnu informaciju--
03:56
both the anatomical and the physiological
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i o anatomiji i o fiziologiji
03:59
in order to have a completely noninvasive, closed-loop
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što je omogućilo da dođemo do potpuno neinvazivne
04:03
surgical procedure.
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hirurške metode po tipu zatvorenog kola.
04:06
So this is how it looks, you know,
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Znate, ovako izgleda
04:08
the operating room of the future today.
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operaciona sala budućnosti.
04:11
This is an MR suite with a focused ultrasound system.
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Ovo je MR odeljenje sa sistemom fokusiranog ultrazvuka.
04:14
And I will give you several examples.
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Navešću vam nekoliko primera.
04:16
So the first one is in the brain.
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Prvo ću pričati o mozgu.
04:18
One of the neurological conditions
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Jedni od neuroloških poremećaja
04:21
that can be treated with focused ultrasound
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koji mogu biti lečeni fokusiranim ultrazvukom
04:23
are movement disorders,
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su poremećaji pokreta,
04:25
like Parkinson's or essential tremor.
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kao što je Parkinsonova bolest ili osnovni tremor.
04:28
What is typical to those conditions,
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Ono što je karakteristično za ova stanja,
04:31
to essential tremor for example,
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na primer za osnovni tremor,
04:34
is inability
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jeste nesposobnost
04:37
to drink or eat cereal or soup
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da pijete ili jedete pahuljice ili supu,
04:41
without spilling everything all over you,
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a da ne prospete sve po sebi,
04:44
or write legibly so people can understand it,
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ili da pišete čitko kako bi ljudi to mogli da pročitaju
04:47
and be really independent in your life
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i da budete zaista nezavisni od pomoći drugih
04:50
without the help of others.
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u svom životu.
04:52
So I'd like you to meet John.
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Hoću da vas upoznam sa Džonom.
04:55
John is a retired professor of history
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Džon je penzionisan profesor istorije
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from Virginia.
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iz Virdžinije.
04:59
So he suffered from essential tremor for many years.
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Patio je od osnovnog tremora godinama.
05:02
And medication didn't help him anymore.
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Lekovi mu više nisu pomagali.
05:06
And many of those patients refused to undergo surgery
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Mnogi pacijenti odbijaju da se podvrgnu operaciji
05:09
to have people cut into their brain.
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da ljudi ne bi seckali njihov mozak.
05:11
And about four or five months ago,
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Pre četiri ili pet meseci
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he underwent an experimental procedure.
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se podvrgao eksperimentalnom tretmanu.
05:19
It is approved under an FDAIDE
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Odobren je od strane "FADAIDE"
05:22
at the University of Virginia
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na Univerzitetu u Virdžiniji
05:24
in Charlottesville
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u Šarlotsvilu,
05:26
using focused ultrasound
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a koristi se ultrazvukom
05:28
to ablate a point in his thalamus.
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kojim se uklanja deo u talamusu.
05:33
And this is his handwriting.
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Ovo je njegov rukopis.
05:36
"On June 20th," if you can read it,
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"20. juna," ukoliko možete da pročitate,
05:39
"2011."
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"2011."
05:42
This is his handwriting
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Ovo je njegov rukopis
05:44
on the morning of the treatment
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jutra pre same operacije,
05:46
before going into the MR
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pre odlaska na MR.
05:48
So now I'll take you through
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Sada ću vam pokazati kako
05:50
[what] a typical procedure like that looks like,
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klasična procedura ovog tipa izgleda,
05:53
[what] noninvasive surgery looks like.
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kako neinvazivna hirurgija izgleda.
05:56
So we put the patient on the MR table.
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Postavili smo pacijenta na MR sto.
05:59
We attach a transducer, in this case, to the brain,
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Potom zakačimo provodnik, u ovom slučaju za mozak,
06:01
but if it will be a different organ,
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ali ukoliko bi se radilo o drugom organu,
06:03
it will be a different transducer attached to the patient.
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drugi tip provodnika bismo zakačili za bolesnika.
06:07
And the physician
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Potom će doktor uraditi
06:09
will then take a regular MR scan.
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prvi uobičajeni snimak MR-om.
06:12
And the objective of that?
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Cilj toga?
06:14
I don't have a pointer here,
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Nemam pokazivač sa sobom,
06:16
but you see the green, sort of rectangle or trapezoid?
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ali da li vidite zeleno, nešto kao kvadrat ili trapezoid?
06:21
This is the sort of general area of the treatment.
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Ovo je opšte operativno polje.
06:23
It's a safety boundary
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To je sigurnosna zona
06:25
around the target.
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oko samog ciljnog mesta.
06:27
It's a target in the thalamus.
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Ovo je cilj u talamusu.
06:29
So once those pictures are acquired
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U trenutku kada lekar
06:31
and the physician has drawn
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dobije željenu sliku
06:34
all the necessary safety limits and so on,
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o svim neophodnim granicama bezbednosti i tako dalje,
06:37
he selects basically a point --
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on odabira, u principu, tačku,
06:39
you see the round point in the middle where the cursor is --
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vidite li ovu okruglu tačku u sredini gde se pokazivač nalazi,
06:42
and he presses this blue button called "sonicate."
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i potom pritisne plavo dugme koje se zove "sonikacija".
06:45
We call this instance of injecting the energy,
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Ovaj proces ubrizgavanja energije
06:48
we call it sonication.
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nazivamo sonikacijom.
06:50
The only handwork the physician does here
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Sve što lekar uradi rukama ovde
06:53
is moving a mouse.
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je pomeranje miša.
06:55
This is the only device he needs in this treatment.
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To je jedini instrument koji mu je neophodan za tretman.
06:58
So he presses "sonicate," and this is what happens.
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Kada pritisne dugme za sonikaciju, desi se sledeće.
07:01
You see the transducer, the light blue.
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Vidite provodnik, u svetlo plavoj boji.
07:03
There's water in between the skull and the transducer.
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Između provodnika i lobanje se nalazi voda.
07:06
And it does this burst of energy.
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Dolazi do ove eksplozije energije.
07:08
It elevates the temperature.
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To povišava temperaturu.
07:10
We first need to verify
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Prvo moramo da proverimo
07:12
that we are on target.
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da zaista gađamo ciljanu tačku.
07:14
So the first sonication
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Prva sonikacija se izvodi
07:16
is at lower energy.
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uz manju količinu energije.
07:18
It doesn't do any damage,
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Ne čini nikakvu štetu,
07:20
but it elevates the temperature
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ali povišava temperaturu
07:22
by a few degrees.
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za nekoliko stepeni.
07:24
And one of the unique capabilities
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Jedna od osobenosti
07:26
that we leverage with the MR
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primene MR tehnologije
07:28
is the ability to measure temperature noninvasively.
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jeste mogućnost neinvazivnog merenja temperature.
07:32
This is really a unique capability of the MR.
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Ovo je zaista jedinstvena sposobnost MR tehnike.
07:35
It is not being used
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Ne koristi se za
07:37
in regular diagnostic imaging.
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uobičajeno dijagnostičko uslikavanje.
07:39
But here we can get
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Uz pomoć ovoga možemo
07:41
both the anatomical imaging and the temperature maps in real time.
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doći do slika anatomije i mape temperatura u stvarnom vremenu.
07:44
And you can see the points there on the graph.
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Možete uočiti te tačke na grafikonu.
07:47
The temperature was raised
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Temperatura je privremeno
07:49
to 43 degrees C temporarily.
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povišena na 43 stepena Celzijusa.
07:51
This doesn't cause any damage.
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Ovo ne dovodi ni do kakvih oštećenja.
07:53
But the point is we are right on target.
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Poenta je u tome da gađamo ciljano mesto.
07:55
So once the physician verifies
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U trenutku kada lekar potvrdi
07:58
that the focus spot is on the target he has chosen,
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da je zadata tačka na cilju koji je izabrao,
08:01
then we move to perform
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sledeći korak je
08:04
a full-energy ablation
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amputacija punom energijom
08:06
like you see here.
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kao što ovde možete videti.
08:08
And you see the temperature rises
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Vidite porast temperature do
08:11
to like 55 to 60 degrees C.
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od prilike 55 do 60 stepeni Celzijusa.
08:13
If you do it for more than a second,
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Ukoliko to radite duže od sekunde,
08:15
it's enough to basically destroy
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to je dovoljno da uništi
08:18
the proteins of the cells.
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sve proteine u ćelijama.
08:22
This is the outcome from a patient perspective --
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Ovako rezultat izgleda iz persepktive pacijenta,
08:24
same day after the treatment.
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istog dana nakon tretmana.
08:27
This is an immediate relief.
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Ovo je momentalno olakšanje.
08:29
(Applause)
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(aplauz)
08:34
Thank you.
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Hvala.
08:36
John is one of [about] a dozen
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Džon je jedan od desetak
08:39
very heroic, courageous people
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veoma hrabrih ljudi, heroja,
08:43
who volunteered for the study.
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koji su volontirali za ovu studiju.
08:45
And you have to understand
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Morate razumeti šta je
08:47
what is in people's mind
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u glavi ovih ljudi kada
08:49
when they are willing to take the risk.
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požele da preuzmu takav rizik.
08:52
And this is a quote from John after he wrote it.
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Sada ću citirati Džona nakon što je ovo napisao.
08:55
He said, "Miraculous."
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On je rekao: "Ovo je čudo."
08:57
And his wife said, "This is the happiest moment of my life."
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Njegova žena je rekla: "Ovo je najsrećniji trenutak u mom životu."
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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Znate, jedna od poruka koju želim da prenesem jeste,
09:06
is, what about defending quality of life?
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šta je sa zaštitom kvaliteta života?
09:09
I mean, those people lose their independence.
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Znate, ovi ljudi izgube svoju nezavisnost.
09:11
They are dependent on others.
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Oni zavise od drugih.
09:13
And John today is fully independent.
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Džon je danas potpuno nezavistan.
09:16
He returned to a normal life routine.
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Vratio se uobičajenom stilu života.
09:19
And he also plays golf,
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On takođe igra golf,
09:21
like you do in Virginia
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jer je to ono što radite u Virdžiniji
09:23
when you are retired.
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kada se penzionišete.
09:28
Okay, so you can see here the spot.
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Okej, ovde možete uočiti naznačeni region.
09:32
It's like three millimeters in the middle of the brain.
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U sredini mozga, veličine oko tri mm.
09:34
There's no damage outside.
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Spolja nema oštećenja.
09:36
He suffers from no neurodeficit.
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Ne pati od neurodeficita.
09:39
There's no recovery needed, no nothing.
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Oporavak nije potreban, ništa se ne zahteva.
09:42
He's back to his normal life.
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Vratio se svom uobičajenom životu.
09:44
Let's move now
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Sada ćemo pričati
09:46
to a more painful subject.
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o bolnijem predmetu.
09:48
Pain is something
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Bol je nešto
09:50
that can make your life miserable.
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što može učiniti život nepodnošljivim.
09:52
And people are suffering from all kinds of pain
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Ljudi pate od različith vrsta bola,
09:54
like neuropathic pain, lower-back pain
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kao što je neuropatski bol, bol u donjem delu kičme,
09:58
and cancer pain from bone metastases,
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bol nastao usled koštanih metastaza
10:01
when the metastases get to your bones,
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što se dešava kada rak metastazira u kostima,
10:04
sometimes they are very painful.
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sve to je ponekad neopisivo bolno.
10:07
All those I've indicated
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Za sve ove vrste bola koje sam naveo
10:09
have already been shown
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je već pokazano
10:11
to be successfully treated
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da mogu biti uspešno lečene
10:13
by focused ultrasound
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pomoću usmerenog ultrazvuka
10:16
relieving the pain, again, very fast.
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koji olakšava osećaj bola veoma brzo.
10:19
And I would like to tell you
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Voleo bih da vam pričam
10:21
about PJ.
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o PiDžej.
10:25
He's a 78 year-old farmer
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On je sedamdesetosmogodišnji poljoprivrednik
10:29
who suffered from -- how should I say it? --
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koji je bolovao od - kako bih to nazvao? -
10:32
it's called pain in the butt.
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naziva se bol u guzici.
10:34
He had metastases in his right buttock,
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Rak je kod njega metastazirao na desnom guzu,
10:37
and he couldn't sit
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i nije mogao da sedi
10:39
even with medication.
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čak ni uz pomoć lekova.
10:41
He had to forgo all the farm activities.
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Morao je da ostavi sve poslove na imanju.
10:48
He was treated with radiation therapy,
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Lečen je radio-terapijom,
10:50
state-of-the-art radiation therapy,
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najsavremenijom radio-terapijom,
10:52
but it didn't help.
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ali to nije pomoglo.
10:54
Many patients like that favor radiation therapy.
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Mnogi takvi bolesnici glasaju za radio-terapiju.
10:57
And again, he volunteered
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Ponovo, on je volontirao
10:59
to a pivotal study
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za važnu studiju koju
11:01
that we ran worldwide,
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sprovodimo širom sveta,
11:04
also in the U.S.
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pa i u Sjedinjenim Državama.
11:08
And his wife actually took him.
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Ustvari, njegova žena ga je dovezla.
11:11
They drove like three hours
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Vozili su oko tri sata
11:13
from their farm to the hospital.
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od njihovog imanja do bolnice.
11:16
He had to sit on a cushion,
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Morao je da sedi na jastuku,
11:19
stand still, not move,
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da mirno stoji, da se ne kreće,
11:21
because it was very painful.
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jer je bilo previše bolno.
11:24
He took the treatment,
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Podvrgao se operaciji,
11:26
and on the way back,
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i pri povratku kući
11:29
he drove the truck by himself.
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on je vozio kamion.
11:33
So again, this is an immediate relief.
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Još jednom, ovo je momentalno olakšanje.
11:36
And you have to understand
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Morate razumeti
11:38
what those people feel
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kako se ti ljudi osećaju
11:40
and what their family experiences
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i šta njihove porodice dožive
11:43
when it happens.
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kada se to dogodi.
11:45
He returned again
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On se ponovo vratio
11:47
to his daily routine on the farm.
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svom svakodnevnom ritmu na imanju.
11:49
He rides his tractor.
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Vozi svoj traktor.
11:51
He rides his horse to their mountain cabin regularly.
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Redovno jaše konja do njihove brvnare na planini.
11:55
And he has been very happy.
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Veoma je srećan.
11:58
But now, you ask me,
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Sada ćete me pitati
12:01
but what about war, the war on cancer?
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kakav to uticaj ima na borbu protiv raka?
12:03
Show us some primary cancer.
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Pokaži nam rezultate na primarnom raku.
12:06
What can be done there?
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Šta se tu može uraditi?
12:08
So I have good news and bad news.
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Pa, imam dobre i loše vesti.
12:10
The good news: there's a lot that can be done.
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Dobre vesti su da se svašta može učiniti.
12:13
And it has been shown actually outside of the U.S.
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To je ustvari bilo pokazano van Sjedinjenih Država.
12:16
And doing that in the U.S.
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Veoma je naporno to
12:20
is very painful.
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uraditi u Sjedinjenim Državama.
12:22
I don't see, without this nation
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Ne vidim da će se to desiti ovde,
12:26
taking it as some collective will
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iako je ovo nacija kojoj je zajednički testament,
12:30
or something that is a national goal to make that happen,
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ili gde je nacionalni cilj baš taj
12:33
it will not happen.
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da se pobedi rak.
12:35
And it's not just because of regulation;
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To nije samo zbog regulacija.
12:37
it's because of the amount of money needed
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Ulogu u ostvarenju ovog cilja ima
12:40
under the current evidence-based medicine
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i količina novca koja je danas neophodna
12:44
and the size of trials and so on
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za medicinske dokaze,
12:46
to make it happen.
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i velike studije.
12:48
So the first two applications
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Prve dve primene su u lečenju
12:50
are breast cancer and prostate cancer.
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raka dojke i raka prostate.
12:53
They were the first to be treated by focused ultrasound.
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To su prvi pokušaji lečenja usmerenim ultrazvukom.
12:56
And we have better-than-surgery results in breasts.
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Imamo bolje rezultate nego klasična hirurgija u slučaju raka dojki.
13:01
But I have a message for the men here.
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Takođe imam i poruku za mušarce.
13:03
We heard here yesterday Quyen
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Juče je Kvijen govorila
13:06
talking about the adverse event trait
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o nepoželjnim, sporednim efektima
13:09
in prostate cancer.
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pri lečenju raka prostate.
13:11
There is a unique opportunity now
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Sada imamo jedinstvenu priliku da
13:13
with focused ultrasound guided by MR,
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uz pomoć usmerenog ultrazvuka i MR tehnologije
13:16
because we can actually think about
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razmišljamo o procesu
13:19
prostate lumpectomy --
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lampektomije prostate (med.)
13:21
treating just the focal lesion
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o odstranjivanju samo određenog dela
13:23
and not removing the whole gland,
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a ne cele žlezde,
13:25
and by that, avoiding all the issues
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i na taj način možemo zaobići probleme
13:28
with potency and incontinence.
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potentnosti i inkontinencije (med.).
13:32
Well, there are other cancer tumors in the abdomen --
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Postoje i drugi tipovi raka u stomaku-
13:38
quite lethal, very lethal actually --
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koji su veoma mali, zaista veoma mali--
13:40
pancreas, liver, kidney.
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rak gušterače, jetre, bubrega.
13:43
The challenge there
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Izazov u ovoj proceduri je u tome
13:45
with a breathing and awake patient --
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što pacijent diše i budan je-
13:48
and in all our treatments,
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u svim našim tretmanima
13:50
the patient is awake and conscious
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su pacijenti budni i svesni
13:52
and speaks with the physician --
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i pričaju sa lekarom--
13:56
is you have to teach the MR some tricks
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izazov je u tome da MR treba podučiti nekim trikovima
13:59
how to do it in real time.
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kako sve to uraditi u stvarnom vremenu.
14:02
And this will take time.
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Za ovo je neophodno vreme.
14:04
This will take two years.
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Neophodne su dve 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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Ovo se dešava u 2004.
14:12
the FDA has approved MR-guided focused ultrasounds
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kada je FDA odobrio usmereni ultravuk, navođen MR tehnikom
14:15
for the treatment of symptomatic uterine fibroids.
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za lečenje simptomatskih fibroida materice.
14:20
Women suffer from that disease.
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Žene pate od te bolesti.
14:24
All those tumors
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Ove tumore karakterišu
14:26
have heavy bleeding during periods,
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obilna krvarenja u toku ciklusa,
14:28
abdominal pressure, back pain,
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pritisak u stomaku, bol u leđima,
14:30
frequent urination.
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česti nagoni za mokrenjem.
14:32
And sometimes, they cannot even conceive and become pregnant
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Ponekada ne može doći do začeća i trudnoće
14:36
because of the fibroid.
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usled fibroida.
14:38
This is Frances.
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Ovo je Frensis.
14:40
She was diagnosed with a grapefruit-sized fibroid.
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Uspostavljeno je da ima fibroid veličine grejpfruta.
14:42
This is a big fibroid.
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To je veliki fibroid.
14:44
She was offered a hysterectomy,
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Predložena joj je histerektomija,
14:46
but this is an inconceivable proposition
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ali to je neprihvatljiv predlog
14:48
for someone who wants to keep her pregnancy option.
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za nekoga ko želi i dalje da rađa.
14:51
So she elected to undergo a focused ultrasound procedure
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Odlučila je da se podvrgne tretmanu usmerenim ultrazvukom
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. je postala prvorotka i ima zdravu bebu.
15:01
So new life was born.
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Novi život je rođen.
15:03
(Applause)
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(aplauz)
15:05
So in conclusion,
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Na kraju,
15:08
I'd like to leave you with actually four messages.
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voleo bih da zaključim sa četiri poruke.
15:11
One is, think about the amount
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Prva, razmislite o pacijentima
15:13
of suffering that is saved
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koji su pošteđeni patnje
15:15
from patients undergoing noninvasive surgery,
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uz pomoć neinvazivne hirurgije,
15:19
and also the economical and emotional burden
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a i o značajnom ekonomskom i emocionalnom
15:23
removed from their families and communities
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rasterećenju njihovih familija i zajednica
15:26
and the society at large --
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kao i celog društva-
15:30
and I think also from their physicians, by the way.
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a čini mi se i njihovih lekara, uzgred budi rečeno.
15:36
And the other thing I would like you to think about
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Često razmišljam i o drugoj stvari koja se tiče
15:39
is the new type of relationship
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novog tipa odnosa
15:42
between physician and patients
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između lekara i pacijenata,
15:44
when you have a patient on the table
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kada je pacijent budan na operaciom stolu
15:47
[who] is awake and can even monitor the treatment.
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i može čak da prati 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 ima u rukama dugme za prekid sonikacije.
15:54
He can stop the surgery at any moment.
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Može da stopira operaciju u bilo kom trenutku.
15:58
And with that note,
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Sa tim bih završio.
16:01
I would like to thank you for listening.
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Hvala na pažnji.
16:04
(Applause)
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(aplauz)
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