Pratique du Shadowing: Artificial Liver Program: Mayo Clinic Radio - Apprendre l'anglais à l'oral avec la vidéo
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136 phrases
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Welcome back to Mayo Clinic Radio.
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I'm Dr. Tom Shives.
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And I'm Tracy McRae.
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Tracy, every year, 40 ,000 people die of liver disease in the U .S.
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And the only proven therapy for end -stage liver disease is still a liver transplant.
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Unfortunately, there aren't enough organs to go around for those who need them.
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In fact, there are more than 150 ,000 people who are on the waiting list for a donor liver.
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Now, hopefully, treatment for liver disease is about to change for the better.
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Research at Mayo Clinic is focusing on new regenerative liver therapies to help repair diseased livers
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and improve the treatment options for liver disease patients.
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Here to discuss is Dr. Scott Nyberg, a transplant surgeon at Mayo Clinic.
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Dr. Nyberg is the director of the liver program at the Mayo Clinic Center for Regenerative Medicine
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and head of Mayo Clinic's artificial liver program.
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Welcome to the program, Dr. Nyberg.
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It's nice to meet you.
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It's great to be here, Tracy and Tom.
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Thank you for having me.
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Yeah, you bet.
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You have been studying the liver and liver disease for a long time, long enough to get all those titles, right?
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I started back in the early 80s, probably.
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I was both a chemical engineer and then a biomedical engineer.
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Had a mentor who said with that engineering background, why don't you build a liver dialysis machine?
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I asked him, how should I do that?
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That was in 1989, and he said, you figure it out.
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You're the engineer.
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So I've been working on this for almost 30 years.
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Well, I want to learn a lot more about the artificial liver program, but before we go there, we should probably just set the table.
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What is liver disease?
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What causes liver disease?
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I mean, there are many causes.
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They can range from Tylenol overdose, a common drug like Tylenol, alcohol.
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People are familiar with that, along with genetic causes.
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In the United States, I would say obesity is becoming a number one cause.
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Overweight contributes to a disease called NASH.
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It had been hepatitis C.
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Now there are pretty effective treatments for hepatitis C, so we're seeing a decrease.
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But the number one cause would be NASH, followed by alcohol, and then these others.
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Now explain NASH to us.
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And you mentioned that obesity is becoming a more common cause of liver disease.
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How does obesity cause liver disease?
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And I suspect that NASH is the answer.
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Right.
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It's not fully understood as far as the mechanisms, but there has been this association with as Americans and people around the world become heavier,
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there's more liver disease.
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If a pathologist looks at a biopsy of a NASH liver, it looks similar to an alcoholic liver, so it's probably a nutritional problem.
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Where too many calories cause an inflammatory response and do this over a long period of time,
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there becomes scarring and eventually cirrhosis and the manifestations of end -stage liver disease.
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And cirrhosis is pretty much just scarring of the liver.
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Advanced scarring to a point where the liver isn't able to regenerate.
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Fortunately, a healthy liver, if we cut it in half, will grow back to a full size within a couple of weeks.
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That's a normal response, but due to the scarring of fibrosis and cirrhosis,
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that regenerative response is impaired and the only real treatment for those end -stage livers is a liver transplant currently.
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Does NASH stand for something?
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Non -alcoholic steatohepatitis.
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So it looks pathologically like alcoholic liver injury,
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but it's non -alcoholic related presumably to diet and weight.
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How long can people live with liver disease before they need a transplant?
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well we have a scoring system now
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that was developed here at mayo called the meld score initially
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it was called the mayo end -stage liver disease score to
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predict how long people would survive what's their likelihood of being alive in two months
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it's been adopted nationally for organ allocation
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because it's very good at predicting the name was changed they took mayo out of the name
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and now it's just the model for end -stage liver disease so that's probably the best predictor.
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And in transplant, we use that score to determine who has highest priority.
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So it ranges from zero to 40, where if you have a score of 40, it's unlikely you're going to survive more than a few weeks.
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What can make if a patient is not eligible for transplant?
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I mean, there's being on the list means that you're eligible, but why would patients not be eligible for transplant?
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I mean, there's a variety of reasons.
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If you're an alcoholic that continues to drink
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and haven't recovered you wouldn't be eligible
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that wouldn't be a wise use of an organ
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if you have a disease that may involve other organs that's not corrected by a liver transplant
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or if you have a cancer that's spread outside of the liver that we wouldn't be able to help you and
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transplant an immunosuppressive patient you could actually shorten their life and that
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so there are a number
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you can be too old though we don't have a cutoff as far as age goes
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so you're still doing a lot of liver transplant right and
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and a fair number of those are from deceased donors
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but also you're using live donors yeah here at mayo
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we have a large living donor program one of the largest in the united states
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which means we do over 20 per year of the 130 liver transplants that we do.
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So that's a living donor, a family member, our friend who donates half of their liver.
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Two weeks later, the liver has regenerated, did you say, to its normal size?
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Probably two weeks in the donor, we do CAT scans to measure the volume.
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And they're within 90 % of the original volume within two weeks.
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So it's very rapid.
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In my lab, we have a number of animal models studying regeneration
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and we see this very quickly also all right what's new
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and regenerative medicine
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and artificial liver well here at mayo the the biggest problem in transplant is the shortage of organs
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so the things we do in regenerative medicine are to address
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that shortage of organs one option is a liver dialysis machine to allow the the liver to regenerate
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and hopefully avoid a liver transplant so that would be
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that would save the liver it could be used for someone else
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and avoid big surgery
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and all the immunosuppression lifelong immunosuppression for a patient that'd be a patient maybe with a tylenol overdose
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we also have a special pig that we've developed a genetically engineered pig
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and the goal there is to grow transplantable human livers in this pig sounds science fiction
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but in my lab we recently had a pig named eddie who beautiful a little piggy
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if you look at my instagram site
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you'll see a picture of eddie who essentially was created by a stem cell transplant into a day four embryo
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and this is sort of the future i see of organ production
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and then we're also
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so this is hopefully someday eddie's liver can be transplanted into a human eddie will eddie
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and pigs like eddie will be incubators to grow human livers.
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The concept would be to take a cell, reprogram it into a cell from a patient liver disease, reprogram it into a stem cell,
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fuse it with an embryo, and then grow a liver from that human stem cell.
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Whoa.
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I got to sit down.
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Oh, I am sitting down.
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Good.
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That's good.
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How are you using the patient's own liver cell?
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Is that what you're saying when you take a cell to help?
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In this case, you could even take a blood sample, like a white blood cell from just a blood sample.
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The Nobel Prize for Medicine about four years ago was a way to reprogram cells, adult cells, to become stem cells.
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And the theory would be that you could use those stem cells to grow livers.
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Well, hopefully you and Eddie will get the Nobel Prize next year.
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I think we're still a little ways off.
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eddie and pigs like eddie the other option that we're working with a local company is to take
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livers decellularize them and then repopulate them with cells from a patient
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so again you could avoid the need for immunosuppression
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so these would be a tissue engineered liver
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that would be identical to the patient so they wouldn't need an anti -rejection drug after the transplant
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If it works using your own cells, you shouldn't need to.
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We had a paper recently published in one of the science journals, Science Translational Medicine, showing that this concept would work in pigs,
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and it's a matter of scaling it up to humans.
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It's all really exciting.
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Thanks so much for being with us.
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Thank you very much.
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An update on the treatment of liver disease with Dr. Scott Nyberg,
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transplant surgeon and director of the liver program at the Mayo Clinic Center for Regenerative Medicine
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and head of Mayo Clinic's artificial liver program.
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Thanks, Dr. Nyberg.
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Yeah, thank you, Tom, Tracy.
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Vocabulaire et conseils d’expression pour cette leçon
Cette leçon d’expression orale s’appuie sur la vidéo « Artificial Liver Program: Mayo Clinic Radio ». Les mots qui reviennent le plus souvent : liver, disease, transplant, cell, mayo. Cette vidéo contient 136 phrases et 1533 mots à répéter en shadowing. La partie parlée dure 9:08. Le locuteur parle à un rythme naturel d’environ 168 mots par minute, proche d’une conversation courante. Seuls 76 % des mots font partie des 3 000 mots les plus courants en anglais, le vocabulaire est donc exigeant.
Vocabulaire clé de cette vidéo
15 mots de la vidéo à retenir, avec leur prononciation et leur sens :
| Mot | Prononciation | Sens |
|---|---|---|
| transplant verbe | /tɹænzˈplænt/ | transplanter |
| organ nom | /ˈɔːɡən/ | organe |
| liver nom | /ˈlɪvɚ/ | foie |
| donor nom | /ˈdəʊnə/ | donateur, donneur |
| alcoholic nom | /ˌæl.kəˈhɔ.lɪk/ | alcoolique |
| eligible adjectif | /ˈɛl.ɪ.d͡ʒɪ.bəl/ | éligible, admissible |
| artificial adjectif | /ˌɑː.tɪˈfɪʃ.əl/ | artificiel |
| scar nom | /skɑɹ/ | cicatrice, balafre |
| pig nom | /ˈpɪɡ/ | cochon, porc |
| obesity nom | /ə(ʊ)ˈbiːsɪti/ | obésité |
| surgeon nom | /ˈsɝd͡ʒən/ | chirurgien, chirurgienne |
| predict verbe | /pɹɪˈdɪkt/ | prédire |
| shortage nom | /ˈʃɔː(ɹ)tɪd͡ʒ/ | défaut, rareté |
| overdose nom | /ˈəʊvə(ɹ)ˌdəʊs/ | surdose, surdosage |
| hepatitis nom | /ˌhɛpəˈtaɪ̯tɪs/ | hépatite |
Les verbes à particule que vous entendrez
| Mot | Sens |
|---|---|
| sit down verbe | s'asseoir |
Des phrases à répéter
Des phrases courtes et complètes de la vidéo, à réutiliser dans la conversation de tous les jours :
- It's nice to meet you.
- I asked him, how should I do that?
- I mean, there's a variety of reasons.
- How are you using the patient's own liver cell?
- Is that what you're saying when you take a cell to help?
La grammaire de cette vidéo
Les structures que le locuteur utilise le plus, avec les mots exacts de la vidéo :
| Structure | Dans la vidéo |
|---|---|
| Present perfect continu have/has been + -ing — une action commencée avant et toujours en cours | have been studying · I've been working |
| Voix passive be + participe passé — l’accent est mis sur ce qui arrive, pas sur qui le fait | is impaired · was developed · was called |
| Present perfect have/has + participe passé — une action passée qui compte encore maintenant | has been · it's been adopted · haven't recovered |
| Propositions relatives who / which + proposition — une précision sur une personne ou une chose | those who need · people who are · friend who donates |
Prononciation à surveiller
Le locuteur utilise 28 contractions et formes réduites, comme you're, we're, wouldn't. Prononcez-les sous leur forme courte, telles que vous les entendez.
- Les sons « sh » et « zh »: artificial /ˌɑː.tɪˈfɪʃ.əl/, shortage /ˈʃɔː(ɹ)tɪd͡ʒ/, fiction /ˈfɪkʃən/, essentially /ɪˈsɛnʃəli/, tissue /ˈtɪʃ.(j)u/
- Mots longs — placez bien l’accent: alcoholic /ˌæl.kəˈhɔ.lɪk/, eligible /ˈɛl.ɪ.d͡ʒɪ.bəl/, artificial /ˌɑː.tɪˈfɪʃ.əl/, obesity /ə(ʊ)ˈbiːsɪti/, hepatitis /ˌhɛpəˈtaɪ̯tɪs/
Les sons difficiles pour les francophones :
- /h/ — il se souffle, il n’est pas muet: alcoholic /ˌæl.kəˈhɔ.lɪk/, hepatitis /ˌhɛpəˈtaɪ̯tɪs/, likelihood /ˈlaɪklihʊd/
- /tʃ/ et /dʒ/ — à ne pas adoucir en « ch » et « j »: eligible /ˈɛl.ɪ.d͡ʒɪ.bəl/, surgeon /ˈsɝd͡ʒən/, shortage /ˈʃɔː(ɹ)tɪd͡ʒ/, genetic /d͡ʒəˈnɛt.ɪk/, fortunately /ˈfɔɹ.t͡ʃə.nɪt.li/
- /r/ anglais — langue recourbée, sans frotter la gorge: transplant /tɹænzˈplænt/, scar /skɑɹ/, predict /pɹɪˈdɪkt/, shortage /ˈʃɔː(ɹ)tɪd͡ʒ/, overdose /ˈəʊvə(ɹ)ˌdəʊs/
Comment s’entraîner avec cette vidéo
- Écoutez la vidéo en entier une fois sans parler et notez les mots que vous ne connaissez pas.
- Commencez à la vitesse 0,75×, répétez phrase par phrase, puis revenez à la vitesse normale quand cela devient facile.
- Enregistrez-vous et comparez avec l’original, en faisant attention à des mots comme transplant, organ, liver.
Qu'est-ce que la technique du Shadowing ?
Le Shadowing est une technique d'apprentissage des langues fondée sur la science, développée à l'origine pour la formation des interprètes professionnels. Le principe est simple mais puissant : vous écoutez de l'anglais natif et le répétez immédiatement à voix haute — comme une ombre suivant le locuteur avec un décalage de 1 à 2 secondes. Les recherches montrent une amélioration significative de la précision de la prononciation, de l'intonation, du rythme, des liaisons, de la compréhension orale et de la fluidité.