Аналіз фонових знань, необхідних перекладачеві для перекладу текстів у галузі неврології

Наступним є метод смислового розвитку (18%). Поширеність цього способу в перекладанні зумовлена необхідністю відійти від буквалістського перекладу для більшої природності, зберігання змісту та дотримання мовних та культурних норм та в разі відсутності або неточності словникового відповідника. Наступними методами є контекстуальна заміна (9%), адаптивне транс кодування (7%) (частота вживання цього методу зумовлена схожістю багатьох термінів у різних мовах. Перекладач лише мусить у даному випадку адаптувати форму слова у вихідній формі до фонетичної або граматичної структури мови перекладу). Такі трансформації та методи, як описовий переклад (5%), змішане транс кодування (3%), додавання (4%) були застосовані у перекладанні обраного тексту рідше. Метод транскрибування (1%) був застосований лише в єдиному випадку.

Таким чином, найпоширенішими способами є калькування, вибір словникового відповідника та смисловий розвиток, що означає, що у перекладанні медичного тексту у галузі неврології передач однаково часто вдається до простого вибору відповідника у словнику або перекладу терміносполуки поморфемно чи полексемно (вибір словникового відповідника та калькування відповідно), якщо такий спосіб перекладу не викривлює змісту тексту та не порушує норм мови перекладу; та до такого прийому, коли перекладач вимушений шукати інше слово, яке було б логічним розвитком слова, що перекладається (смисловий розвиток).

ВИСНОВОК

Наша робота присвячена труднощам перекладу лексичних одиниць медичного тексту у галузі неврології. Метою нашої роботи є визначення найпоширеніших способів перекладу термінологічних словосполук у галузі неврології та пов'язаних з цим труднощів.

Першим етапом нашого дослідження було визначення обсягу фонових знань. На наш погляд, фонові знання - це соціокультурна інформація, що охоплює національну ментальність, культурні надбання, правильну інтерпретацію проявів іншомовної культури, прогнозування моделей сприйняття мовленнєвих актів носіями мови та їхньої мовленнєвої поведінки, відсутність культурного шоку, здатність толерантно розв'язувати соціокультурні конфлікти, наявність у свідомості індивіда соціокультурного портрета країни, мову якої він вивчає. Оволодіння фоновими знаннями є необхідною умовою перекладацької компетенції.

Обрана нами галузь неврологія, а текст перекладу розглядає захворювання синдрому Вільяма. Для здійснення професіонального перекладу цього тексту, необхідно опанувати фонові знання. Фонові знання у цій галузі перекладу охоплюють розуміння проблем, які розглядає наука неврологія, знання визначення та основних симптомів захворювання, про яке йдеться в тексті, та походження назви цієї хвороби, лікарів, що вперше дослідили її, обізнаність у широкому колі питань та ознайомлення із базовими поняттями хвороби та лексичними одиницями на їх позначення.

Під час перекладу ми стикалися з певними проблемами. Перш за все, це перенасиченість тексту термінами та пошук прийнятних способів їх перекладу. Переклавши текст та зробивши аналіз перекладу, ми дійшли висновку, що найбільш поширеними способами перекладу є калькування (28%), вибір словникового відповідника (25%), смисловий розвиток (18%); контекстуальна заміна (9%), адаптивне транскодування (7%), описовий переклад(5%) також є надзвичайно поширеними способами. Рідше використовувалися такі методи, як транскрибування (4%), змішане транс- кодування (3%), додавання (4%). Таким чином, можнa зробити висновок, що майже усі способи активно застосовуються у перекладанні наукового тексту в галузі медицини. Але жодного разу не застосовувалася формальна негативація та транслітерування.

Розглядана нами проблема є актуальною, особливо в часи розвитку науки, зокрема медицини та її галузей. Перекладач мусить бути обізнаним щодо можливих труднощів перекладу медичних текстів, чітко усвідомлювати головні задачі та етапи роботи. З розвитком медицини ця проблема потребує подальшого вивчення способів перекладу та їх співвідношення у цій галузі, дослідження нових підходів та підготовки кваліфікованих спеціалістів.

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ДОДАТОК А

Англо-український словник

українсько-англійський словник

ДОДАТОК Б

Текст оригіналу

Severe Eating Disorder in a 28-Year-Old Man With William's Syndrome

«Mr. T» was a 28-year-old man with William's syndrome who was admitted to a university-based inpatient psychiatric unit for evaluation and treatment of severe malnutrition and food refusal. Elfin faced, grinning, genial, with limited intellectual functioning, and in the company of his parents, he arrived on the unit carrying a book on drag racing and a magazine for drummers. His parents and primary care physician were deeply concerned and requested in patient evaluation, medical stabilization, and treatment of Mr. T's presumed eating disorder.

History of Present Illness

According to his parents, Mr. T's lifelong struggle with eating adequate amounts of food resulted in his always being exceptionally slim. Over a period of months before admission Mr. T became guarded about meals and ate only single food item for weeks at a time. His parents described him as increasingly preoccupied with food thoughts, becoming distraught when forced to exceed his usual caloric intake boundaries and break his ritualistic eating patterns.

Mr. T's parents believed that his decline in eating resulted from several recent adverse life events affecting the family that disrupted his previous psychological homeostasis.

Mr. T had never been manic or psychotic, had no history of other compulsive behaviors, such as picking or checking, and had never mentioned or displayed obsessional concerns about any specific aspect of his physical appearance other than weight. He never mentioned feeling suicidal and had no history of self-harm. Medically, about 6 months before admission Mr. T started to experience shortness of breath on exertion but reported no chest pain, orthopnea, or pedal edema. Other than the symptom of early satiety and «back-up» described above, he reported no significant constitutional complaints and had not recently been ill. He had no other history of abdominal pains or other subjective gastro-intestinal complaints, diarrhea or constipation, or any other complaints suggesting inflammatory bowel or other gastro-intestinal disease.

Developmental, Medical, Personal, and Social History

Based on characteristic facies, cardiac anomalies, and failure to thrive, Mr. T was diagnosed with William's syndrome. As a toddler, Mr. T. showed a distinct lack of social fear, impaired visuo-spatial construction, and continued failure to thrive.

Medically, by age 19 he required surgical repair of pectus excavatum and supravalvar aortic stenosis, both of which are known to be associated with William's syndrome. Annual echocardiograms consistently demonstrated stable cardiac function until 2 years before admission, when Mr. T. began to show evidence of moderate aortic regurgitation, with an ejection fraction of 50% and normal ankle-brachial indices.

Physical Examination

Upon admission, Mr. T. was cachectic, hypotensive, and tachycardic. He showed the characteristic symmetric microcephaly of William's syndrome, with full lips, a large mouth, and a short upturned nose. His dentition was healthy and without erosion of enamel, although there was increased spacing between the teeth. Jugular venous pulsations were noted over his very thin neck. His scalp hair and beard were thin. Other than diminished breath sounds bilaterally at the lung bases, his pulmonary examination was normal. His heart rate and rhythm were regular with first and second heart sounds present. There was a prominent fourth heart sound and a left-sided diastolic murmur. His abdomen was retracted and scaphoid, with hyperactive bowel sounds following meals. His extremities were strikingly thin, with severely atrophied musculature, and both brachydactyly and clinodactyly were present bilaterally. There was no detectable edema. Mr. T. showed generalized psychomotor slowing, but no focal neurological deficits.

Mental Status Examination

Mr. T. was alarmingly cachectic. He was alert, extremely pleasant, and outgoing, and he greeted the team with a broad smile and a weak handshake, made good eye contact, but cocked his head slightly in order to focus his vision during conversation. In general, he moved slowly, but this seemed natural to him. His stated mood was «good», and he appeared euthymic. His affect was easygoing and reactive, although he seemed almost indifferent to the severity of his physical presentation. His speech was childlike, slow yet enthusiastic, relevant, and responsive. He presented himself as goal directed: but this assertion was clearly contradicted by his inability and frank refusal to consume adequate amounts of food to maintain reasonable body weight. He reported no perceptual disturbances and was not responding to internal stimuli. The nature and origins of his somatic complaints of feeling «backed p» when he ate were unclear, and, at least manifestly, he reported no preoccupying fears of food, weight, or eating.

Іnvestigations and Consultations

There were no electrolyte, hepatic, or thyroid function disturbances. Electrocardiogram demonstrated inverted T waves in inferior leads and pronounced P waves in lead 2, showing previous myocardial changes as a direct result of his supravalvar aortic stenosis, and possible nonspecific atrial changes.

Other examinations obtained during hospitalization were as follows: a T₁-weighted non-contrasted magnetic resonance imaging scan of the brain demonstrated normal anatomy without mass, a midline-shift, hemorrhage, or infarction. The ventricular system and calvarium were unremarkable. A chest X-ray demonstrated a normal cardiac profile, but hyper-inflated lung volumes with flattened diaphragms, suggesting obstructive pulmonary disease. There was a large left-sided pleural effusion, presumed to be due to hypoalbuminemia. Mild thoracic scoliosis, pectus excavatum, and evidence of prior sternotomy were noted. An echocardiogram revealed moderate aortic regurgitation and an ejection fraction of approximately 55%.A computerized tomography scan of the abdomen demonstrated a paucity of intra-abdominal fat and ureteral diverticulum, but no structural anatomic variant of the upper abdomen. An upper endoscopy to the third portion of the duodenum was unremarkable. Barium-contrasted upper gastrointestinal series demonstrated no stricture, hiatal hernia, or inflammatory changes. A gastric emptying study demonstrated markedly delayed and prolonged gastric emptying but no specific outlet obstruction.

Initial Formulation

In our tentative formulation, we hypothesized that psychological, behavioral, and physical processes all interacted in a highly complex manner. Life-event-induced fears and anxieties, in turn, appeared to provoke physiological changes and psychological responses (e.g., a perceived need to exert more personal control through food refusal), and the associated behavioral response of reduced food intake. These processes were superimposed on the pre-existing medical and neuro-developmental challenges of William's syndrome.

Working Diagnoses and Initial Treatment Plan

Mr. T. was given diagnosis of eating disorder not otherwise specified, manifested by food quantity restriction, food selection restriction, food rituals, and the secreting of food. His complete admission diagnostic profile was recorded as follows: 1: eating disorder, rule out obsessive-compulsive disorder; 2: mild mental retardation: severe malnutrition, cachexia, William's syndrome, delayed gastric emptying, supravalvar aortic disease status post repair, osteopenia; 4: changes in primary support systems; 5: Global Assessment of Functioning Scale=18.

Clinical Course

Nutritional rehabilitation, close observation, milieu therapy, and specific behavioral modification protocols to address Mr. T's eating and anxiety issues were developed and implemented. Psychotherapy to provide education and support was conducted with Mr. T. alone and with Mr. T. together with his parents.

Mr. T. struggled with his prescribed oral diet, appearing superficially enthusiastic about eating but actually eating very little. He gained no weight during his first hospital week. On several occasions, he was found to be hiding food in his napkin, in his bathrobe, and in garbage cans.

Understandably, Mr. T's parents were vulnerable to his expressed frustration with the eating protocols in place, and they were unaccustomed to allowing him to endure upsetting situations. As his parents' role in encouraging these behaviors became increasingly clear, visits were restricted to 1 hour daily with supervision by the team therapist and social work staff. Focus during sessions shifted to normalizing Mr. T's natural desire to develop autonomy, and to educating his parents on the importance of discouraging disordered eating behaviors. Time-limited daily visits allowed Mr. T. to participate more autonomously in his nutritional rehabilitation. Close contact and behavioral management then successfully controlled many of these surreptitious behaviors, but his oral nutritional intake remained inadequate.

Having effectively failed a staged oral diet, and consistent with his immediate need to gain weight as evidenced by his symptomatically low serum albumin levels resulting in pulmonary effusion, dyspnea, and fatigue, on the eighth hospital day a nasogastric tube was placed to provide urgently needed supplementary nocturnal feeds, which Mr. T. Tolerated without difficulty. His parents actively supported the nasogastric feedings. By the second hospital week, Mr. T. began to gain weight. Daily physical examinations, serum electrolytes, phosphorus, and liver function tests were monitored for the potential emergence of a refeeding syndrome. Mr. T's father, assigned treatment guardianship, provided informed consent for pharmacotherapy with fluvoxamine (chosen in relation to obsessive-compulsive spectrum symptoms), which was slowly titrated to 100 milligrams daily. Mr. T complied with treatment, albeit reluctantly.

Two weeks after admission, having gained 8 lb, Mr. T and his parents elected to remove the nasogastric tube used for overnight feedings and return home to attempt aftercare with a regular diet. However, within a day or two following discharge, Mr. T. began to experience palpitations, light-headedness, and anxiety, began to lose weight, and within several days returned to the ward with his family for readmission. At that point, upon recommendations of the team, Mr. T. and his family decided to go forward with placement of the percutaneous gastrostomy tube. The goals of psychosocial interventions undertaken by his social worker were to help Mr. T understand and cooperate with nutritional and physical rehabilitation, understand, and change the behaviors and dysfunctional attitudes related to his eating disorder, and improve interpersonal and social functioning. On the fifth day of his rehospitalization, for the first time Mr. T. confided to his treatment team that he felt all along that his dietary intake was one of the few aspects of life over which he exercised any control. This admission was supported by his concurrent acknowledgement that he desired more independence. Family therapy was also included, given the centrality of Mr. T's parents. Conducted by his psychiatrist and social worker, the focus attempted to unite the parents and Mr. T in developing a consistent approach to 1) refeeding, 2) disclaiming «blame» behavior, and 3) addressing his burgeoning wish for autonomy, which conflicted with his parents' concerns for his safety, given his intellectual and physical limitations.

William's syndrome is a neurodevelopmental disorder caused by a hemizygous deletion of approximately 1.6 megabases containing approximately 28 genes on chromosome 7q11.23, resulting in a gene defect associated with elastin (ELN) that is pathognomonic of the syndrome. Clinical characteristics include an «elfin» or «pixie-like» appearance of the ears and face. Microcephaly is often seen. Other physical manifestations include a stellate blue iris (thought to be due to the role of elastin in functional localization of pigment), curly hair, undeveloped dentition, brachydactyly, and clinodactyly. The elastin gene defect accounts for the hallmark  cardiovascular impairment, supravalvar aortic stenosis, which ultimately results in left ventricular hypertrophy and global cardiopulmonary disease. Hypercalcemia, gastrointestinal problems, orthopedical impairments, hypotonia, life expectation approximately 40 years are common.

Nurological problems include hyperreflexia, strabismus, nystagmus, hyperacusis with hypersensitivity to sound, sensori-neural hearing loss, and coordination difficulties. Neuropsychiatrically, William's syndrome is often associated with mild to moderate mental retardation, with impairments of long-term visual and verbal memory, although short-term memory remains intact. As with our patient, individuals with William's syndrome are characteristically absorbed with music, and many are highly musical. Interpersonally, individuals with William's syndrome are ordinarily socially fearless, engaging eagerly in social interactions with both acquaintances and strangers.

Psychiatrically, a variety of anxiety disturbances are often seen related to nonsocial objects. The most prevalent psychiatric disorders are attention deficit hyperactivity disorder and simple phobias. Although patients with William's syndrome are notably constitutionally thin when they are young, their weights typically approach normal ranges for peers in adulthood. Clinically, the life-course of patients with William's syndrome is known to be foreshortened, with patients ordinarily living to their 40s. As with any developmentally, intellectually, and neuropsychologically challenged individuals, the difficulties to be faced by these patients, their families, are considerable. For any given individual, the challenges include establishing appropriate social, educational, and vocational expectations, determining what can be done to maximize the individual's capacity for autonomy and quality of life, and fostering successful and enduring relationships with caregivers.

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