Az angol katonai szaknyelv oktatása és módszertani elemei a honvéd középiskolákban

Az angol katonai szaknyelv oktatása, a különböző típusú és szintű angol katonai szaknyelvi nyelvvizsgákra történő felkészítés már komoly hagyományokkal rendelkezik a magyar felsőoktatásban. A középiskolában azonban a múltban nem volt szaknyelvi oktatás az érettségi vizsga megszerzéséig. Ezért okozott kezdetben komoly kihívást, amikor a tantárgyat már az érettségi vizsga előtt is oktatni kellett a középiskolában. A tantárgy oktatóinak nemcsak a szaknyelvi szókészlet megtanítása okozott többletfeladatot, hanem az angol általános nyelv oktatásától eltérő módszertani eszközök kiválasztása is. A katonai középiskolákban tanító civil tanárok folyamatos konzultációt folytattak a katonai oktatókkal, hogy maximálisan tisztában legyenek a tanítandó anyag hátterével. Alkalmanként egy-egy katonai oktató is tartott elméleti foglalkozásokat, illetve projektfeladatokat is összeállított a növendékek számára. Jelen tanulmány az eddigi oktatási, módszertani eszköztárunkat mutatja be civil és katonai nézőpontból. Ismerteti a Campaign 1 angol tankönyv és munkafüzet hazai adaptációjának egy lehetséges modelljét a honvéd kadétképzés során, a kerettanterv alapján összeállított tanmenetnek megfelelően

Mechanisms of ventricular rate adaptation as a predictor of arrhythmic risk.

Background: Protracted QT interval (QTI) adaptation to abrupt heart rate (HR) changes has been identified as a clinical arrhythmic risk marker. This study investigates the ionic mechanisms of QTI rate adaptation and its relationship to arrhythmic risk. Methods and Results: Computer simulations and experimental recordings in human and canine ventricular tissue were used to investigate the ionic basis of QTI and action potential (AP) duration (APD) to abrupt changes in HR with a protocol commonly used in clinical studies. Time for 90% QTI adaptation is 3.5 min in simulations, in agreement with experimental and clinical data in human. APD adaptation follows similar dynamics, being faster in midmyocardial cells (2.5 min) than in endocardial/epicardial cells (3.5 min). Both QTI and APD adapt in two phases following an abrupt HR change: a fast initial phase with time constant 2 min driven by [Na(+)]i dynamics. Alterations in [Na(+)]i dynamics due to Na(+)/K(+) pump (INaK) inhibition result in protracted rate adaptation, and is associated with increased proarrhythmic risk, as indicated by AP triangulation and faster ICaL recovery from inactivation, leading to formation of early afterdepolarizations (EADs). Conclusions: This study suggests that protracted QTI adaptation could be an indicator of altered [Na(+)]i dynamics following INaK inhibition as it occurs in patients with ischemia or heart failure. Increased risk of cardiac arrhythmias in patients with protracted rate adaptation may be due to increased risk of EAD formation. Key words: action potentials, ventricles, ion channels, arrhythmia

Increased Short-Term Beat-To-Beat Variability of QT Interval in Patients with Acromegaly.

Cardiovascular diseases, including ventricular arrhythmias are responsible for increased mortality in patients with acromegaly. Acromegaly may cause repolarization abnormalities such as QT prolongation and impairment of repolarization reserve enhancing liability to arrhythmia. The aim of this study was to determine the short-term beat-to-beat QT variability in patients with acromegaly. Thirty acromegalic patients (23 women and 7 men, mean age+/-SD: 55.7+/-10.4 years) were compared with age- and sex-matched volunteers (mean age 51.3+/-7.6 years). Cardiac repolarization parameters including frequency corrected QT interval, PQ and QRS intervals, duration of terminal part of T waves (Tpeak-Tend) and short-term variability of QT interval were evaluated. All acromegalic patients and controls underwent transthoracic echocardiographic examination. Autonomic function was assessed by means of five standard cardiovascular reflex tests. Comparison of the two groups revealed no significant differences in the conventional ECG parameters of repolarization (QT: 401.1+/-30.6 ms vs 389.3+/-16.5 ms, corrected QT interval: 430.1+/-18.6 ms vs 425.6+/-17.3 ms, QT dispersion: 38.2+/-13.2 ms vs 36.6+/-10.2 ms; acromegaly vs control, respectively). However, short-term beat-to-beat QT variability was significantly increased in acromegalic patients (4.23+/-1.03 ms vs 3.02+/-0.80, P<0.0001). There were significant differences between the two groups in the echocardiographic dimensions (left ventricular end diastolic diameter: 52.6+/-5.4 mm vs 48.0+/-3.9 mm, left ventricular end systolic diameter: 32.3+/-5.2 mm vs 29.1+/-4.4 mm, interventricular septum: 11.1+/-2.2 mm vs 8.8+/-0.7 mm, posterior wall of left ventricle: 10.8+/-1.4 mm vs 8.9+/-0.7 mm, P<0.05, respectively). Short-term beat-to-beat QT variability was elevated in patients with acromegaly in spite of unchanged conventional parameters of ventricular repolarization. This enhanced temporal QT variability may be an early indicator of increased liability to arrhythmia

Transgenic LQT2, LQT5, and LQT2-5 rabbit models with decreased repolarisation reserve for prediction of drug-induced ventricular arrhythmias

Background and Purpose Reliable prediction of pro‐arrhythmic side effects of novel drug candidates is still a major challenge. Although drug‐induced pro‐arrhythmia occurs primarily in patients with pre‐existing repolarisation disturbances, healthy animals are employed for pro‐arrhythmia testing. To improve current safety screening, transgenic long QT (LQTS) rabbit models with impaired repolarisation reserve were generated by overexpressing loss‐of‐function mutations of human HERG (HERG‐G628S , loss of IKr; LQT2), KCNE1 (KCNE1‐G52R , decreased IKs; LQT5), or both transgenes (LQT2‐5) in the heart. Experimental Approach Effects of K+ channel blockers on cardiac repolarisation and arrhythmia susceptibility were assessed in healthy wild‐type (WT) and LQTS rabbits using in vivo ECG and ex vivo monophasic action potential and ECG recordings in Langendorff‐perfused hearts. Key Results LQTS models reflect patients with clinically “silent” (LQT5) or “manifest” (LQT2 and LQT2‐5) impairment in cardiac repolarisation reserve: they were more sensitive in detecting IKr‐blocking (LQT5) or IK1/IKs‐blocking (LQT2 and LQT2‐5) properties of drugs compared to healthy WT animals. Impaired QT‐shortening capacity at fast heart rates was observed due to disturbed IKs function in LQT5 and LQT2‐5. Importantly, LQTS models exhibited higher incidence, longer duration, and more malignant types of ex vivo arrhythmias than WT. Conclusion and Implications LQTS models represent patients with reduced repolarisation reserve due to different pathomechanisms. As they demonstrate increased sensitivity to different specific ion channel blockers (IKr blockade in LQT5 and IK1 and IKs blockade in LQT2 and LQT2‐5), their combined use could provide more reliable and more thorough prediction of (multichannel‐based) pro‐arrhythmic potential of novel drug candidates