Главные героини германского героического эпоса «Песнь о нибелунгах» — это бургундская принцесса Кримгильда, ставшая женой главного героя Зигфрида, и исландская дева-богатырша Брунгильда, чью руку Зигфрид добывает в жестоком бою, чтобы отдать ее бургундскому королю Гунтеру в обмен на руку Кримгильды. Ревность, спор о социальном статусе, личная неприязнь между обеими героинями выливаются в жестокую ссору у ворот Вормского собора. В этой ключевой сцене одна героиня обвиняет другую в якобы имевшей место добрачной потере девственности и предъявляет сопернице пояс в качестве доказательства. Острый, напряженный конфликт характеров и воль, обрисованный в этой сцене, с давних пор интересовал деятелей искусства. Сцена «ссора королев» послужила сюжетом многочисленных художественных произведений. В настоящей статье рассматриваются особенности визуализации героинь, их тел, одежды, внешнего облика в произведениях литературы, изящного искусства и кинематографа. Статья насыщена иллюстрациями и образными примерами.
{"title":"Ссора королев. Изображения Кримгильды и Брунгильды в искусстве и литературе","authors":"Gunter E. Grimm","doi":"10.46539/CMJ.V2I1.37","DOIUrl":"https://doi.org/10.46539/CMJ.V2I1.37","url":null,"abstract":"Главные героини германского героического эпоса «Песнь о нибелунгах» — это бургундская принцесса Кримгильда, ставшая женой главного героя Зигфрида, и исландская дева-богатырша Брунгильда, чью руку Зигфрид добывает в жестоком бою, чтобы отдать ее бургундскому королю Гунтеру в обмен на руку Кримгильды. Ревность, спор о социальном статусе, личная неприязнь между обеими героинями выливаются в жестокую ссору у ворот Вормского собора. В этой ключевой сцене одна героиня обвиняет другую в якобы имевшей место добрачной потере девственности и предъявляет сопернице пояс в качестве доказательства. Острый, напряженный конфликт характеров и воль, обрисованный в этой сцене, с давних пор интересовал деятелей искусства. Сцена «ссора королев» послужила сюжетом многочисленных художественных произведений. В настоящей статье рассматриваются особенности визуализации героинь, их тел, одежды, внешнего облика в произведениях литературы, изящного искусства и кинематографа. Статья насыщена иллюстрациями и образными примерами.","PeriodicalId":9777,"journal":{"name":"Ceylon Medical Journal","volume":null,"pages":null},"PeriodicalIF":0.4,"publicationDate":"2021-04-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"47290770","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Журнал Playboy с самого момента его основания явился одним из ярчайших примеров культурных изменений, происходивших в США во второй половине ХХ в.. Анализируя важность журнала, автор показывает, как, казалось бы, банальная идея журнала с фотографиями обнаженных красавиц превратилась в весьма успешный коммерческий и культурный проект, оказавший огромное влияние на американское общество, да и на многие страны мира. По сути, Playboy превратился в «мягкую силу» способную генерировать новые ценности и транслировать их не только в американское общество, но и в культурный ландшафт других стран. В качестве иллюстрации этого влияния были взяты международные франшизы журнала Playboy, выходящие в других странах. Для наглядности были выбраны две версии журнала: в Бразилии и на Филиппинах. Анализ контента этих франшизных версий показывает, что в них удивительным образом сочетались традиции, заложенные основателем «Плейбоя» Хью Хефнером, и национальные стереотипы. Вместе с тем, в этом симбиозе во многом превалировали именно американские паттерны. Особенно заметно это отразилось на выборе расового типа моделей, их цвета кожи и т.д.. Кроме этого, журнал привносил в эти страны и новые системы гендерных отношений. Все это стало возможным благодаря тому, что редакция журнала создала уникальный продукт, ставший одним из неотъемлемых символов ХХ в.
{"title":"“Playboy” как мягкая сила: влияние контента журнала на вестернизацию культуры развивающихся стран","authors":"Serguey N. Yakushenkov","doi":"10.46539/CMJ.V2I1.39","DOIUrl":"https://doi.org/10.46539/CMJ.V2I1.39","url":null,"abstract":"Журнал Playboy с самого момента его основания явился одним из ярчайших примеров культурных изменений, происходивших в США во второй половине ХХ в.. Анализируя важность журнала, автор показывает, как, казалось бы, банальная идея журнала с фотографиями обнаженных красавиц превратилась в весьма успешный коммерческий и культурный проект, оказавший огромное влияние на американское общество, да и на многие страны мира. По сути, Playboy превратился в «мягкую силу» способную генерировать новые ценности и транслировать их не только в американское общество, но и в культурный ландшафт других стран. В качестве иллюстрации этого влияния были взяты международные франшизы журнала Playboy, выходящие в других странах. Для наглядности были выбраны две версии журнала: в Бразилии и на Филиппинах. Анализ контента этих франшизных версий показывает, что в них удивительным образом сочетались традиции, заложенные основателем «Плейбоя» Хью Хефнером, и национальные стереотипы. Вместе с тем, в этом симбиозе во многом превалировали именно американские паттерны. Особенно заметно это отразилось на выборе расового типа моделей, их цвета кожи и т.д.. Кроме этого, журнал привносил в эти страны и новые системы гендерных отношений. Все это стало возможным благодаря тому, что редакция журнала создала уникальный продукт, ставший одним из неотъемлемых символов ХХ в.","PeriodicalId":9777,"journal":{"name":"Ceylon Medical Journal","volume":null,"pages":null},"PeriodicalIF":0.4,"publicationDate":"2021-04-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"41648283","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Автор анализирует проблемы изменений представленности тела и метаморфозы телесности в грузинской идентичности. Грузинская идентичность определяется как культурный и интеллектуальный конструкт, вдохновленный и воображенный грузинскими интеллектуалами как часть процессов социальной и политической модернизации. Анализ социальных мутаций и культурных трансформаций визуализации и актуализации грузинского национального / этнического тела и телесности в дискурсе национализма является основой целью статьи. Методологически автор использует положения и идеи, предложенные в междисциплинарных исследованиях национализма. Национальное тело определяется и анализируется как одна из изобретенных традиций грузинского национализма в контекстах модернизации и трансформации интеллектуального дискурса от модерной культуры к массовой культуре общества потребления. Предполагается, что интеллектуалы использовали телесность для актуализации этнической и культурной грузинской идентичности, подчеркивая уникальность грузинской идентичности. Анализируются проблемы сочетания и сосуществования гражданского и этнического национализма в визуализации телесности. Автор изучает, как грузинское «тело» стало политическим фактором, формой визуализации этничности и принципов политического национализма, включая концепты гражданства и лояльности, а также нации как воображаемого политического сообщества граждан с устойчивыми этническими основаниями.
{"title":"Телесность в стране Руставели: злоключения и путешествия грузинского тела между романтическим картвельским национализмом и потреблением массовой культуры","authors":"Maksym W. Kyrchanoff","doi":"10.46539/CMJ.V2I1.36","DOIUrl":"https://doi.org/10.46539/CMJ.V2I1.36","url":null,"abstract":"Автор анализирует проблемы изменений представленности тела и метаморфозы телесности в грузинской идентичности. Грузинская идентичность определяется как культурный и интеллектуальный конструкт, вдохновленный и воображенный грузинскими интеллектуалами как часть процессов социальной и политической модернизации. Анализ социальных мутаций и культурных трансформаций визуализации и актуализации грузинского национального / этнического тела и телесности в дискурсе национализма является основой целью статьи. Методологически автор использует положения и идеи, предложенные в междисциплинарных исследованиях национализма. Национальное тело определяется и анализируется как одна из изобретенных традиций грузинского национализма в контекстах модернизации и трансформации интеллектуального дискурса от модерной культуры к массовой культуре общества потребления. Предполагается, что интеллектуалы использовали телесность для актуализации этнической и культурной грузинской идентичности, подчеркивая уникальность грузинской идентичности. Анализируются проблемы сочетания и сосуществования гражданского и этнического национализма в визуализации телесности. Автор изучает, как грузинское «тело» стало политическим фактором, формой визуализации этничности и принципов политического национализма, включая концепты гражданства и лояльности, а также нации как воображаемого политического сообщества граждан с устойчивыми этническими основаниями.","PeriodicalId":9777,"journal":{"name":"Ceylon Medical Journal","volume":null,"pages":null},"PeriodicalIF":0.4,"publicationDate":"2021-04-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"45838167","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Автор анализирует визуализацию героев немецкого героического эпоса «Песнь о нибелунгах». То, как иллюстраторы изображают тела персонажей, какие позы им придаются, на фоне какого ландшафта происходит действие, сколько действующих лиц на картине и что именно они делают – все это может стать активным семантическим фактором. Намеренное вторжение в сюжет некоторыми художниками не только создает новый контекст для восприятия, но и придает тексту иное или дополнительное значение. Иногда семантика иллюстраций находится в явном противоречии с событиями сюжета – автор показывает, как и почему это происходит, какие смыслы зашифрованы в иллюстрациях к поэме, как изображения влияют на восприятие текста реципиентами.
{"title":"Визуальная конструкция смыслов – новые правила игры в погибель. Об иллюстрациях к «Песни о нибелунгах»","authors":"Sebastian Karnatz","doi":"10.46539/CMJ.V2I1.38","DOIUrl":"https://doi.org/10.46539/CMJ.V2I1.38","url":null,"abstract":"Автор анализирует визуализацию героев немецкого героического эпоса «Песнь о нибелунгах». То, как иллюстраторы изображают тела персонажей, какие позы им придаются, на фоне какого ландшафта происходит действие, сколько действующих лиц на картине и что именно они делают – все это может стать активным семантическим фактором. Намеренное вторжение в сюжет некоторыми художниками не только создает новый контекст для восприятия, но и придает тексту иное или дополнительное значение. Иногда семантика иллюстраций находится в явном противоречии с событиями сюжета – автор показывает, как и почему это происходит, какие смыслы зашифрованы в иллюстрациях к поэме, как изображения влияют на восприятие текста реципиентами.","PeriodicalId":9777,"journal":{"name":"Ceylon Medical Journal","volume":null,"pages":null},"PeriodicalIF":0.4,"publicationDate":"2021-04-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"42012476","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Anuradha Baminiwatta, Shamila De Silva, Aruni Hapangama, Kumarini Basnayake, Charani Abayaweera, Dinithi Kulasinghe, Dewmi Kaushalya, Shehan Williams
Introduction Healthcare workers (HCWs) are at risk of mental health problems during a pandemic. Being stationed at the frontline or not may have implications on their mental health. Objectives The aims of this study were to assess depression, anxiety and stress among HCWs, to explore differences between frontline and non-frontline workers, and to investigate associated factors. Methods In this cross-sectional study, frontline and non-frontline HCWs were recruited from a COVID-19 screening hospital in Sri Lanka. Mental health impact was assessed using Depression, Anxiety and Stress Scale (DASS-21). Sociodemographic data and perceptions of social and occupational circumstances were gathered. Categorical variables were analyzed using Chi square and logistic regression. Odds ratios were calculated for the effect of different perceptions on psychological morbidity. Results A total of 467 HCWs participated, comprising 244 (52.2%) frontline and 223 (47.8%) non-frontline workers, with female preponderance (n=341, 77%). Prevalence of depression, anxiety and stress among HCWs were 19.5%, 20.6%, 11.8%, respectively. Non-frontline group showed a higher prevalence of depression (27% vs. 11%, p<0.001), anxiety (27% vs. 14%, p=0.001) and stress (15% vs. 8%, p=0.026). Being married, having children, living with family and higher income were associated with better psychological outcomes. Perceived lack of personal protective equipment, inadequate support from hospital authorities, greater discrimination, and lack of training to cope with the situation predicted poor mental health outcomes, and non-frontline HCWs were more likely to hold such perceptions. Conclusion Addressing factors leading to negative psychological outcomes in HCWs should be a key concern during this pandemic.
{"title":"Impact of COVID-19 on the mental health of frontline and non-frontline healthcare workers in Sri Lanka.","authors":"Anuradha Baminiwatta, Shamila De Silva, Aruni Hapangama, Kumarini Basnayake, Charani Abayaweera, Dinithi Kulasinghe, Dewmi Kaushalya, Shehan Williams","doi":"10.4038/cmj.v66i1.9351","DOIUrl":"https://doi.org/10.4038/cmj.v66i1.9351","url":null,"abstract":"Introduction\u0000Healthcare workers (HCWs) are at risk of mental health problems during a pandemic. Being stationed at the frontline or not may have implications on their mental health.\u0000\u0000\u0000Objectives\u0000The aims of this study were to assess depression, anxiety and stress among HCWs, to explore differences between frontline and non-frontline workers, and to investigate associated factors.\u0000\u0000\u0000Methods\u0000In this cross-sectional study, frontline and non-frontline HCWs were recruited from a COVID-19 screening hospital in Sri Lanka. Mental health impact was assessed using Depression, Anxiety and Stress Scale (DASS-21). Sociodemographic data and perceptions of social and occupational circumstances were gathered. Categorical variables were analyzed using Chi square and logistic regression. Odds ratios were calculated for the effect of different perceptions on psychological morbidity.\u0000\u0000\u0000Results\u0000A total of 467 HCWs participated, comprising 244 (52.2%) frontline and 223 (47.8%) non-frontline workers, with female preponderance (n=341, 77%). Prevalence of depression, anxiety and stress among HCWs were 19.5%, 20.6%, 11.8%, respectively. Non-frontline group showed a higher prevalence of depression (27% vs. 11%, p<0.001), anxiety (27% vs. 14%, p=0.001) and stress (15% vs. 8%, p=0.026). Being married, having children, living with family and higher income were associated with better psychological outcomes. Perceived lack of personal protective equipment, inadequate support from hospital authorities, greater discrimination, and lack of training to cope with the situation predicted poor mental health outcomes, and non-frontline HCWs were more likely to hold such perceptions.\u0000\u0000\u0000Conclusion\u0000Addressing factors leading to negative psychological outcomes in HCWs should be a key concern during this pandemic.","PeriodicalId":9777,"journal":{"name":"Ceylon Medical Journal","volume":null,"pages":null},"PeriodicalIF":0.4,"publicationDate":"2021-03-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"39784644","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Paksitya Purnama Putra, M. F. Ma'ruf, Muhammad Ari Ridwansyah, Rendra Kurniawan, Celia Nindy Carisa
Expansive soil has a high swelling and shrinkage ability which can damage the buildings above it. Glagahagung Village, Purwoharjo District, Banyuwangi Regency is one of the areas suspected of having this type of soil. Residents often experience problems in their residential buildings every year, such as cracks in floors, walls, columns, and beams. Several methods can be used to improve expansive soil, including physical and mechanical stabilization. In this study, lime and cement were used as physical stabilizers. On the other hand, sand is used as a mechanical stabilizer. Physical and mechanical parameters will be observed in the stabilization process. Based on the three stabilizers, a 5% cement mixture can be the best alternative. Cement stabilizers can increase the maximum dry volume weight, reduce the rate of soil swelling, and change natural soils' classification from high plasticity clay to silty sand.
{"title":"PERUBAHAN POTENSI MENGEMBANG TANAH EKSPANSIF YANG DISTABILISASI SECARA FISIS DAN MEKANIS","authors":"Paksitya Purnama Putra, M. F. Ma'ruf, Muhammad Ari Ridwansyah, Rendra Kurniawan, Celia Nindy Carisa","doi":"10.32722/CMJ.V3I1.3686","DOIUrl":"https://doi.org/10.32722/CMJ.V3I1.3686","url":null,"abstract":"Expansive soil has a high swelling and shrinkage ability which can damage the buildings above it. Glagahagung Village, Purwoharjo District, Banyuwangi Regency is one of the areas suspected of having this type of soil. Residents often experience problems in their residential buildings every year, such as cracks in floors, walls, columns, and beams. Several methods can be used to improve expansive soil, including physical and mechanical stabilization. In this study, lime and cement were used as physical stabilizers. On the other hand, sand is used as a mechanical stabilizer. Physical and mechanical parameters will be observed in the stabilization process. Based on the three stabilizers, a 5% cement mixture can be the best alternative. Cement stabilizers can increase the maximum dry volume weight, reduce the rate of soil swelling, and change natural soils' classification from high plasticity clay to silty sand.","PeriodicalId":9777,"journal":{"name":"Ceylon Medical Journal","volume":null,"pages":null},"PeriodicalIF":0.4,"publicationDate":"2021-03-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"47679439","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Perkembangan dunia konstruksi yang sudah sangat pesat di Indonesia terbukti dengan adanya metode baru untuk konstruksi yaitu Building Information Modelling (BIM). Munculnya BIM ini diklaim dapat membuat pekerjaan menjadi efektif dan efisien. Sebelum adanya BIM, kegiatan engineering dilakukan dengan menggunakan metode konvensional atau yang telah dikenal dengan AutoCAD, SAP, Ms. Project yang sering digunakan untuk pekerjaan perencanaan proyek. Pekerjaan menggunakan aplikasi tersebut memakan lebih banyak waktu karena dari masing-masing aplikasi tersebut harus dikerjakan secara manual. Hal ini berbeda dengan BIM yang antar aplikasinya dapat terintegerasi satu sama lain, sehingga dapat mempercepat proses pekerjaan yang akan menyingkat waktu dan juga membuat sumber daya manusia menjadi lebih sedikit. Dalam penelitian ini akan dijelaskan apa saja perbedaan jelas proses perencaan konstruksi khususnya saat pembuatan metode kerja dan shopdrawing yang ditinjau dari segi biaya, mutu, waktu. Dan juga akan mengetahui apa saja kelebihan dan kekurangan BIM karena ini adalah sesuatu yang baru, maka dari tiu untuk penelitian ini dilakukan dengan metode kueisioner dan wawancara kepada para draftrer dan engineer yang sudah berkecimpung didunia konstruksi dan sudah merasakan menggunakan BIM. Dengan studi kasus perencanaan Jalan Tol Jakarta – Cikampek II Selatan (Paket 3) dilakukan perbandingan efiseiensi biaya dan waktu dengan metode konvensional dan BIM. Penelitian ini menghasilkan kesimpulan bahwa aplikasi BIM dapat mempercepat proses pelaksanaan kerja sebesar 43.82%, tetapi berbeda dengan biaya lebih mahal dari konvensional dikarenakan biaya investasi awal untuk lisensi software yang mahal.
{"title":"PERBANDINGAN METODE KONVENSIONAL DENGAN BIM TERHADAP EFISIENSI BIAYA, MUTU, WAKTU","authors":"Rizal Maulana Rizqy, Nunung Martina, H. Purwanto","doi":"10.32722/CMJ.V3I1.3506","DOIUrl":"https://doi.org/10.32722/CMJ.V3I1.3506","url":null,"abstract":"Perkembangan dunia konstruksi yang sudah sangat pesat di Indonesia terbukti dengan adanya metode baru untuk konstruksi yaitu Building Information Modelling (BIM). Munculnya BIM ini diklaim dapat membuat pekerjaan menjadi efektif dan efisien. Sebelum adanya BIM, kegiatan engineering dilakukan dengan menggunakan metode konvensional atau yang telah dikenal dengan AutoCAD, SAP, Ms. Project yang sering digunakan untuk pekerjaan perencanaan proyek. Pekerjaan menggunakan aplikasi tersebut memakan lebih banyak waktu karena dari masing-masing aplikasi tersebut harus dikerjakan secara manual. Hal ini berbeda dengan BIM yang antar aplikasinya dapat terintegerasi satu sama lain, sehingga dapat mempercepat proses pekerjaan yang akan menyingkat waktu dan juga membuat sumber daya manusia menjadi lebih sedikit. Dalam penelitian ini akan dijelaskan apa saja perbedaan jelas proses perencaan konstruksi khususnya saat pembuatan metode kerja dan shopdrawing yang ditinjau dari segi biaya, mutu, waktu. Dan juga akan mengetahui apa saja kelebihan dan kekurangan BIM karena ini adalah sesuatu yang baru, maka dari tiu untuk penelitian ini dilakukan dengan metode kueisioner dan wawancara kepada para draftrer dan engineer yang sudah berkecimpung didunia konstruksi dan sudah merasakan menggunakan BIM. Dengan studi kasus perencanaan Jalan Tol Jakarta – Cikampek II Selatan (Paket 3) dilakukan perbandingan efiseiensi biaya dan waktu dengan metode konvensional dan BIM. Penelitian ini menghasilkan kesimpulan bahwa aplikasi BIM dapat mempercepat proses pelaksanaan kerja sebesar 43.82%, tetapi berbeda dengan biaya lebih mahal dari konvensional dikarenakan biaya investasi awal untuk lisensi software yang mahal.","PeriodicalId":9777,"journal":{"name":"Ceylon Medical Journal","volume":null,"pages":null},"PeriodicalIF":0.4,"publicationDate":"2021-03-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"43459626","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Retroperitoneal fibrosis (RPF) is a disease that develops following inflammation and fibrosis of the retroperitoneum and other abdominal organs, which manifests with various local and systemic symptoms. It has several entities, namely the idiopathic RPF (IRPF), secondary RPF and Immunoglobulin G4-related disease (IgG4-RD). The role of a gynaecologist in the management of retroperitoneal fibrosis is highlighted in this case of a parametrial tumour causing retroperitoneal fibrosis and hence leading to hydronephrosis and hydroureter as a consequence. A 49-year-old woman presenting with a symptom cluster suggestive of acute pyelonephritis was found to have reduced eGFR. Elevated levels of inflammatory markers indicated an inflammatory nature of the disease, in addition to a normochromic anaemia that could be due to chronic inflammation itself. CECT Neck, Chest, Abdomen and Pelvis revealed mild hydronephrosis with a distal narrowing and a retroperitoneal confluent mass. Investigations led to suspect an invasive left ovarian malignancy or an endometriotic nodule with ureteric compression, which was later thought to be unlikely with a normal CA-125 level. To obtain a better understanding, a cysto-ureteroscopy was performed where she was found to have an obstruction. Although stent placement is a reasonable temporary mode of symptom relief, this was proven unsuccessful. Surgical management was opted for considering the severity of her symptoms and the course of time it would take for medical management to take effect. In addition, laparoscopy would aid in the exclusion of other pelvic pathologies under direct vision and treat any if found concurrently. Consequently, a laparoscopic hysterectomy, bilateral salpingo-oophorectomy, left sided ureterolysis with careful resection of the densely adhered tumour surrounding the left cysto-ureteric junction was performed, followed by retrograde ureteric stenting. Histology revealed retro-peritoneal fibrosis, and further immunohistochemistry pointed towards a diagnosis of IgG4 related sclerosing disease. This was also supported by elevated levels of IgG, especially the IgG4 component. Disseminated RPF was subsequently excluded by CECT. Following surgery, she was started on high dose corticosteroids and the stent was left in place for six weeks. She is being kept on a maintenance dose of low dose corticosteroids without disease relapse. Regular follow-up with inflammatory markers, serum IgG4 levels and imaging demonstrate adequate response to corticosteroid therapy.
{"title":"Parametrial tumour causing hydronephrosis and hydroureter due to IgG4 mediated retroperitoneal fibrosis; A laparoscopic resection.","authors":"Dhammike Silva, Prabath Randombage, Wedisha Gankanda, Rukshani Edirisinghe, Janani Mathanamohan, Chandu De Silva","doi":"10.4038/cmj.v66i1.9360","DOIUrl":"https://doi.org/10.4038/cmj.v66i1.9360","url":null,"abstract":"Retroperitoneal fibrosis (RPF) is a disease that develops following inflammation and fibrosis of the retroperitoneum and other abdominal organs, which manifests with various local and systemic symptoms. It has several entities, namely the idiopathic RPF (IRPF), secondary RPF and Immunoglobulin G4-related disease (IgG4-RD). The role of a gynaecologist in the management of retroperitoneal fibrosis is highlighted in this case of a parametrial tumour causing retroperitoneal fibrosis and hence leading to hydronephrosis and hydroureter as a consequence. A 49-year-old woman presenting with a symptom cluster suggestive of acute pyelonephritis was found to have reduced eGFR. Elevated levels of inflammatory markers indicated an inflammatory nature of the disease, in addition to a normochromic anaemia that could be due to chronic inflammation itself. CECT Neck, Chest, Abdomen and Pelvis revealed mild hydronephrosis with a distal narrowing and a retroperitoneal confluent mass. Investigations led to suspect an invasive left ovarian malignancy or an endometriotic nodule with ureteric compression, which was later thought to be unlikely with a normal CA-125 level. To obtain a better understanding, a cysto-ureteroscopy was performed where she was found to have an obstruction. Although stent placement is a reasonable temporary mode of symptom relief, this was proven unsuccessful. Surgical management was opted for considering the severity of her symptoms and the course of time it would take for medical management to take effect. In addition, laparoscopy would aid in the exclusion of other pelvic pathologies under direct vision and treat any if found concurrently. Consequently, a laparoscopic hysterectomy, bilateral salpingo-oophorectomy, left sided ureterolysis with careful resection of the densely adhered tumour surrounding the left cysto-ureteric junction was performed, followed by retrograde ureteric stenting. Histology revealed retro-peritoneal fibrosis, and further immunohistochemistry pointed towards a diagnosis of IgG4 related sclerosing disease. This was also supported by elevated levels of IgG, especially the IgG4 component. Disseminated RPF was subsequently excluded by CECT. Following surgery, she was started on high dose corticosteroids and the stent was left in place for six weeks. She is being kept on a maintenance dose of low dose corticosteroids without disease relapse. Regular follow-up with inflammatory markers, serum IgG4 levels and imaging demonstrate adequate response to corticosteroid therapy.","PeriodicalId":9777,"journal":{"name":"Ceylon Medical Journal","volume":null,"pages":null},"PeriodicalIF":0.4,"publicationDate":"2021-03-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"39786217","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
We evaluated the accuracy of two anthropometry-based equations, initially developed for middle-aged women for estimating appendicular skeletal muscle mass (ASMM), when applied to a group of older women. Weight (kg), height (m) and triceps skinfold thickness (TrSFT, mm) of 94 randomly selected community-dwelling older women, aged 65–86 years were studied. The equations [ASMM1= 5.366+0.255(Weight)-0.064(Age)-0.078(TrSFT) and ASMM2 = 0.204(Weight) +8.802(Height)-0.045(Age)-7.405] were cross-validated using the ASMM measured by dual energy x-ray absorptiometry (ASMMDXA) as the reference standard. The concordance between ASMMDXA and ASMM estimated by the two equations were, ASMM1=R2:0.93, SEE: 0.51kg and ASMM2=R2:0.94, SEE: 0.48kg, respectively. Mean ASMM estimated by equations were not significantly different from mean ASMMDXA. We conclude that the two equations examined in this study estimate the ASMM of older women with high accuracy.
{"title":"Prediction of Appendicular Skeletal Muscle Mass of older women using anthropometry-based equations.","authors":"Nirmala Rathnayake, Sarath Lekamwasam, Hasanga Rathnayake","doi":"10.4038/cmj.v66i1.9357","DOIUrl":"https://doi.org/10.4038/cmj.v66i1.9357","url":null,"abstract":"We evaluated the accuracy of two anthropometry-based equations, initially developed for middle-aged women for estimating appendicular skeletal muscle mass (ASMM), when applied to a group of older women. Weight (kg), height (m) and triceps skinfold thickness (TrSFT, mm) of 94 randomly selected community-dwelling older women, aged 65–86 years were studied. The equations [ASMM1= 5.366+0.255(Weight)-0.064(Age)-0.078(TrSFT) and ASMM2 = 0.204(Weight) +8.802(Height)-0.045(Age)-7.405] were cross-validated using the ASMM measured by dual energy x-ray absorptiometry (ASMMDXA) as the reference standard. The concordance between ASMMDXA and ASMM estimated by the two equations were, ASMM1=R2:0.93, SEE: 0.51kg and ASMM2=R2:0.94, SEE: 0.48kg, respectively. Mean ASMM estimated by equations were not significantly different from mean ASMMDXA. We conclude that the two equations examined in this study estimate the ASMM of older women with high accuracy.","PeriodicalId":9777,"journal":{"name":"Ceylon Medical Journal","volume":null,"pages":null},"PeriodicalIF":0.4,"publicationDate":"2021-03-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"39786229","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
The purpose of this research is to recalculate the upper structure of the X building of Jakarta State Polytechnic uses SNI-2847-2019 regulations regarding concrete and SNI 1726- 2019regarding earthquakes. This building consists of 3 floors which use concrete as its main structure. Recalculation includes structural elements starting from collar beam, floor plates, beams, and columns, which are expected to withstand the loads who worked on it. Structural analysis was performed using the ETABS 2013 software. Especially for the calculation of the column structure, the SP Column software is used. The results were obtained from the recalculation of the PNJ x Building in the form of dimensional differences and reinforcement against the existing building. Dimension and reinforcement after redesign became more the size of the existing building. The recalculation results indicate that planning re-using SNI 1726-2019 and SNI 2847-2019 are strong to bear the working load after the dimensions and reinforcement are enlarged.
{"title":"EVALUASI GEDUNG ARSIP POLITEKNIK NEGERI JAKARTA SESUAI SNI 1726-2019 DAN SNI 2847-2019","authors":"Yanuar Setiawan, Bima Ryanto, Mikha Geraldine, Rinawati","doi":"10.32722/CMJ.V3I1.3748","DOIUrl":"https://doi.org/10.32722/CMJ.V3I1.3748","url":null,"abstract":"The purpose of this research is to recalculate the upper structure of the X building of Jakarta State Polytechnic uses SNI-2847-2019 regulations regarding concrete and SNI 1726- 2019regarding earthquakes. This building consists of 3 floors which use concrete as its main structure. Recalculation includes structural elements starting from collar beam, floor plates, beams, and columns, which are expected to withstand the loads who worked on it. Structural analysis was performed using the ETABS 2013 software. Especially for the calculation of the column structure, the SP Column software is used. The results were obtained from the recalculation of the PNJ x Building in the form of dimensional differences and reinforcement against the existing building. Dimension and reinforcement after redesign became more the size of the existing building. The recalculation results indicate that planning re-using SNI 1726-2019 and SNI 2847-2019 are strong to bear the working load after the dimensions and reinforcement are enlarged.","PeriodicalId":9777,"journal":{"name":"Ceylon Medical Journal","volume":null,"pages":null},"PeriodicalIF":0.4,"publicationDate":"2021-03-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"42424189","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
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