쉐도잉 연습: Artificial Liver Program: Mayo Clinic Radio - 영상으로 영어 말하기 배우기

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Welcome back to Mayo Clinic Radio.

I'm Dr. Tom Shives.

And I'm Tracy McRae.

Tracy, every year, 40 ,000 people die of liver disease in the U .S.

And the only proven therapy for end -stage liver disease is still a liver transplant.

Unfortunately, there aren't enough organs to go around for those who need them.

In fact, there are more than 150 ,000 people who are on the waiting list for a donor liver.

Now, hopefully, treatment for liver disease is about to change for the better.

Research at Mayo Clinic is focusing on new regenerative liver therapies to help repair diseased livers

and improve the treatment options for liver disease patients.

Here to discuss is Dr. Scott Nyberg, a transplant surgeon at Mayo Clinic.

Dr. Nyberg is the director of the liver program at the Mayo Clinic Center for Regenerative Medicine

and head of Mayo Clinic's artificial liver program.

Welcome to the program, Dr. Nyberg.

It's nice to meet you.

It's great to be here, Tracy and Tom.

Thank you for having me.

Yeah, you bet.

You have been studying the liver and liver disease for a long time, long enough to get all those titles, right?

I started back in the early 80s, probably.

I was both a chemical engineer and then a biomedical engineer.

Had a mentor who said with that engineering background, why don't you build a liver dialysis machine?

I asked him, how should I do that?

That was in 1989, and he said, you figure it out.

You're the engineer.

So I've been working on this for almost 30 years.

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.

What is liver disease?

What causes liver disease?

I mean, there are many causes.

They can range from Tylenol overdose, a common drug like Tylenol, alcohol.

People are familiar with that, along with genetic causes.

In the United States, I would say obesity is becoming a number one cause.

Overweight contributes to a disease called NASH.

It had been hepatitis C.

Now there are pretty effective treatments for hepatitis C, so we're seeing a decrease.

But the number one cause would be NASH, followed by alcohol, and then these others.

Now explain NASH to us.

And you mentioned that obesity is becoming a more common cause of liver disease.

How does obesity cause liver disease?

And I suspect that NASH is the answer.

Right.

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,

there's more liver disease.

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.

Where too many calories cause an inflammatory response and do this over a long period of time,

there becomes scarring and eventually cirrhosis and the manifestations of end -stage liver disease.

And cirrhosis is pretty much just scarring of the liver.

Advanced scarring to a point where the liver isn't able to regenerate.

Fortunately, a healthy liver, if we cut it in half, will grow back to a full size within a couple of weeks.

That's a normal response, but due to the scarring of fibrosis and cirrhosis,

that regenerative response is impaired and the only real treatment for those end -stage livers is a liver transplant currently.

Does NASH stand for something?

Non -alcoholic steatohepatitis.

So it looks pathologically like alcoholic liver injury,

but it's non -alcoholic related presumably to diet and weight.

How long can people live with liver disease before they need a transplant?

well we have a scoring system now

that was developed here at mayo called the meld score initially

it was called the mayo end -stage liver disease score to

predict how long people would survive what's their likelihood of being alive in two months

it's been adopted nationally for organ allocation

because it's very good at predicting the name was changed they took mayo out of the name

and now it's just the model for end -stage liver disease so that's probably the best predictor.

And in transplant, we use that score to determine who has highest priority.

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.

What can make if a patient is not eligible for transplant?

I mean, there's being on the list means that you're eligible, but why would patients not be eligible for transplant?

I mean, there's a variety of reasons.

If you're an alcoholic that continues to drink

and haven't recovered you wouldn't be eligible

that wouldn't be a wise use of an organ

if you have a disease that may involve other organs that's not corrected by a liver transplant

or if you have a cancer that's spread outside of the liver that we wouldn't be able to help you and

transplant an immunosuppressive patient you could actually shorten their life and that

so there are a number

you can be too old though we don't have a cutoff as far as age goes

so you're still doing a lot of liver transplant right and

and a fair number of those are from deceased donors

but also you're using live donors yeah here at mayo

we have a large living donor program one of the largest in the united states

which means we do over 20 per year of the 130 liver transplants that we do.

So that's a living donor, a family member, our friend who donates half of their liver.

Two weeks later, the liver has regenerated, did you say, to its normal size?

Probably two weeks in the donor, we do CAT scans to measure the volume.

And they're within 90 % of the original volume within two weeks.

So it's very rapid.

In my lab, we have a number of animal models studying regeneration

and we see this very quickly also all right what's new

and regenerative medicine

and artificial liver well here at mayo the the biggest problem in transplant is the shortage of organs

so the things we do in regenerative medicine are to address

that shortage of organs one option is a liver dialysis machine to allow the the liver to regenerate

and hopefully avoid a liver transplant so that would be

that would save the liver it could be used for someone else

and avoid big surgery

and all the immunosuppression lifelong immunosuppression for a patient that'd be a patient maybe with a tylenol overdose

we also have a special pig that we've developed a genetically engineered pig

and the goal there is to grow transplantable human livers in this pig sounds science fiction

100

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

104

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

106

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,

108

fuse it with an embryo, and then grow a liver from that human stem cell.

109

Whoa.

110

I got to sit down.

111

Oh, I am sitting down.

112

Good.

113

That's good.

114

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?

116

In this case, you could even take a blood sample, like a white blood cell from just a blood sample.

117

The Nobel Prize for Medicine about four years ago was a way to reprogram cells, adult cells, to become stem cells.

118

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.

120

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

126

If it works using your own cells, you shouldn't need to.

127

We had a paper recently published in one of the science journals, Science Translational Medicine, showing that this concept would work in pigs,

128

and it's a matter of scaling it up to humans.

129

It's all really exciting.

130

Thanks so much for being with us.

131

Thank you very much.

132

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.

135

Thanks, Dr. Nyberg.

136

Yeah, thank you, Tom, Tracy.

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이 레슨의 어휘와 말하기 포인트

이 말하기 레슨은 영상 “Artificial Liver Program: Mayo Clinic Radio”을(를) 바탕으로 합니다. 가장 자주 반복되는 단어는 다음과 같습니다: liver, disease, transplant, cell, mayo. 이 영상에는 섀도잉할 문장 136개와 단어 1533개가 있습니다. 말하는 구간의 길이는 9:08입니다. 화자는 분당 약 168단어로, 일상 대화에 가까운 자연스러운 속도로 말합니다. 영어에서 가장 많이 쓰이는 3,000단어에 속하는 단어가 76%뿐이라 어휘가 어려운 편입니다.

이 영상의 핵심 어휘

영상에 나오는 익혀 둘 만한 단어 15개를 발음, 뜻과 함께 정리했습니다.

단어	발음	뜻
organ 명사	/ˈɔːɡən/	기관
liver 명사	/ˈlɪvɚ/	간장, 간
donor 명사	/ˈdəʊnə/	기부자, 기증자
alcoholic 명사	/ˌæl.kəˈhɔ.lɪk/	알코올 중독자
eligible 형용사	/ˈɛl.ɪ.d͡ʒɪ.bəl/	적격(適格)의, 적임(適任)의
artificial 형용사	/ˌɑː.tɪˈfɪʃ.əl/	인공, 인조
scar 명사	/skɑɹ/	흉터, 반흔
pig 명사	/ˈpɪɡ/	돼지
obesity 명사	/ə(ʊ)ˈbiːsɪti/	비만
surgeon 명사	/ˈsɝd͡ʒən/	외과의사, 외과의
predict 동사	/pɹɪˈdɪkt/	예언하다, 예측하다
shortage 명사	/ˈʃɔː(ɹ)tɪd͡ʒ/	부족, 흠손
overdose 명사	/ˈəʊvə(ɹ)ˌdəʊs/	과다복용
hepatitis 명사	/ˌhɛpəˈtaɪ̯tɪs/	간염
fiction 명사	/ˈfɪkʃən/	소설, 픽션

영상에 나오는 구동사

단어	뜻
sit down 동사	앉다

따라 말해 볼 만한 문장

영상에 나오는 짧고 완결된 문장으로, 일상 대화에서 그대로 쓸 수 있습니다:

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?

이 영상의 문법

화자가 가장 많이 쓰는 문형을 영상 속 실제 표현과 함께 정리했습니다.

문형	영상 속 표현
현재완료진행 have/has been + -ing — 전에 시작해 지금도 계속되는 동작	have been studying · I've been working
수동태 be + 과거분사 — 누가 하는지보다 무슨 일이 일어나는지에 초점	is impaired · was developed · was called
현재완료 have/has + 과거분사 — 과거의 일이 지금도 관련이 있을 때	has been · it's been adopted · haven't recovered
관계절 who / which + 절 — 사람이나 사물에 대한 추가 정보	those who need · people who are · friend who donates

주의할 발음

화자는 you're, we're, wouldn't 같은 축약형과 약화된 형태를 28번 사용합니다. 들리는 대로 짧게 발음하세요.

“sh”와 “zh” 소리: artificial /ˌɑː.tɪˈfɪʃ.əl/, shortage /ˈʃɔː(ɹ)tɪd͡ʒ/, fiction /ˈfɪkʃən/, essentially /ɪˈsɛnʃəli/, tissue /ˈtɪʃ.(j)u/
긴 단어 — 강세 위치에 주의: alcoholic /ˌæl.kəˈhɔ.lɪk/, eligible /ˈɛl.ɪ.d͡ʒɪ.bəl/, artificial /ˌɑː.tɪˈfɪʃ.əl/, obesity /ə(ʊ)ˈbiːsɪti/, hepatitis /ˌhɛpəˈtaɪ̯tɪs/

한국어 화자가 어려워하는 소리:

/f/ — ㅍ(/p/)으로 바꾸지 말고 윗니를 아랫입술에 대기: artificial /ˌɑː.tɪˈfɪʃ.əl/, fiction /ˈfɪkʃən/, fortunately /ˈfɔɹ.t͡ʃə.nɪt.li/, lifelong /ˈlaɪf.lɔːŋ/, inflammatory /ɪnˈflæmət(ə)ɹi/
/v/ — ㅂ(/b/)과 구별하기: liver /ˈlɪvɚ/, overdose /ˈəʊvə(ɹ)ˌdəʊs/, recover /ɹɪˈkʌvɚ/, involve /ɪnˈvɑlv/, overweight /ˌoʊvɚˈweɪt/
/z/ — ㅈ이 아니라 성대를 울리는 /s/: transplant /tɹænzˈplænt/, mechanism /ˈmɛk.ə.nɪ.zəm/, presumably /pɹɪˈzuːməbli/, fuse /fjuːz/, decellularize /diːˈsɛljələɹaɪz/

이 영상으로 연습하는 방법

먼저 말하지 않고 영상을 끝까지 듣고 모르는 단어를 적어 둡니다.
0.75배속으로 한 문장씩 섀도잉을 시작하고, 익숙해지면 보통 속도로 돌아갑니다.
자신의 목소리를 녹음해 원본과 비교하고, organ, liver, donor 같은 단어에 특히 주의합니다.

쉐도잉이란? 영어 실력을 빠르게 키우는 과학적 방법

쉐도잉(Shadowing)은 원래 전문 통역사 훈련을 위해 개발된 언어 학습 기법으로, 다언어 학자인 Dr. Alexander Arguelles에 의해 대중화된 방법입니다. 핵심 원리는 간단하지만 매우 강력합니다: 원어민의 영어를 들으면서 1~2초의 짧은 지연으로 즉시 소리 내어 따라 말하는 것——마치 '그림자(shadow)'처럼 화자를 따라가는 것입니다. 문법 공부나 수동적인 청취와 달리, 쉐도잉은 뇌와 입 근육이 동시에 실시간으로 영어를 처리하고 재현하도록 훈련합니다. 연구에 따르면 이 방법은 발음 정확도, 억양, 리듬, 연음, 청취력, 말하기 유창성을 크게 향상시킵니다. IELTS 스피킹 준비와 자연스러운 영어 소통을 원하는 분들에게 특히 효과적입니다.

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쉐도잉 연습: Artificial Liver Program: Mayo Clinic Radio - 영상으로 영어 말하기 배우기

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