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The cutaneous and the ophthalmic reactions in the diagnosis of tuberculosis with notes on 100 cases
Von Pirquet’s cutaneous reaction to tuberculin and Calmette’s
ophthalmoreaction have of late been attracting a considerable degree
of attention, and numerous articles have appeared in the various
medical journals giving the experiences of different writers. I have
collected a number of these articles and have noted the results and
opinions of the various authors.By the kindness of Dr. Philip, whose resident physician I then
was, I have been able to perform one or both tests on 100 of his
patients in the Royal Infirmary, Edinburgh.For Von Pirquet’s cutaneous test I have used either Koch’s pure
Old Tuberculin or the solution advised by Von Pirquet, viz:-Koch’s Old Tuberculin: 1 Part;
Carbolic Glycerine (5%): 1 part;
Solution of Sodium Chloride: (85%) 2 Parts.With either the procedure has been the same. First the skin was
purified with Sulphuric Ether and then scarified just as for vaccination,
drawing no blood if possible; then a small piece of cotton-wool,
soaked in the solution, was laid on the scarification and left on for
five minutes, after which it was removed and the part covered with dry
cotton-wool.The upper arm was the part selected and at the end of twenty-four
hours the cotton wool was removed and the scarified area examined.
If a reaction was present there was redness of the area with more or
less marked infiltration, best appreciated by gently running the
finger over the part and so feeling for any slight raising as compared
with the surrounding skin.For Calmette’s ophthalmic test, I have used Tuberculin prepared by
the “Institut Pasteur” of Lille according to Calmette’s formula. It is
issued in a liquid form (0*5%) or as a dry powder, to 5 milligrammes of
which distilled water is added - 20 drops making the 0.5# solution and
10 drops the 1%. Calmette prepares his tuberculin solution by precipitating
tuberculin with 95# alcohol and then dissolving the dry powder as
above. The directions accompanying the tuberculin supplied are as
follows: -"Let one or two drops fall on the conjunctiva of one eye of the
patient to be tested, by preference towards the inner angle, and keep
the eyelids apart for a moment. The person so treated will feel no pain
or inconvenience. If he is a tuberculous subject no reaction will be
produced.”“If he is afflicted with tuberculosis, no matter how slightly, the
lower conjunctiva palpebrarum and the caruncula of the eye treated will
commence to redden from the third hour. The injection of the vessels
is slowly aocentuated and accompanied by epiphora. After six hours the
caruncula begins to swell and the eye becomes covered by a slight fibrous
exudation, which gathers in filaments in the inferior conjunctival sac.”“The maximum reaction is observed between the 6th and 13th hour.
“It is nob accompanied by any elevation of temperature. Ho chemosis
is produced nor any pain felt; the only unpleasantness is the epiphora
which disappears, and all is again in its usual order after two or three
days. The intensity of the reaction will be realized by a comparative
examination of the eye which has not received the Tuberculin.”On the 19th of June, 1907 Calmette published his first paper on the
ophthalmic reaction, but previously (on the 3rd June) Wolff-Bisner of
Vienna had announced to the Society of Medicine of Berlin that a drop of
diluted tuberculin put into the eye produced an inflammatory reaction.
At the same time, however, he was not able to state anything as to its
diagnostic value, and so Calmette’s name is the one which is now usually
associated with the reaction.Before giving my own results with the tests I think it well to give
some extracts from recent literature on the subject
Developing, implementing, and testing a parent feedback instrument for public school boards and employees
The primary purpose of this study was to identify, implement, and test a parent feedback questionnaire to be used to gain information from parents about the operation of the board of education, the district administration, the programs, policies, and procedures of individual school buildings, the school administration of individual school buildings, the teachers and professional staff of individual school buildings, and the support staffs of individual school buildings. The questionnaire was developed with assistance from a judgment panel;The opportunity sample consisted of two school systems located in the northeastern United States. Custom tailored scanforms were prepared for each district;The questionnaire used was divided into two parts. The first part was specific questions about the various school groups. The second part allowed respondents to rate the importance of the questions in the first part;The data from the questionnaires were analyzed. Mass authorship of the document provided social validity, while the Cronbach coefficient alpha procedure was used to establish the reliability of the instrument. Additionally, confidence intervals were computed for each district and for the survey as a whole;The major findings include: (1) The parents felt all the questionnaire items were important for parents to rate. (2) The highest rated questions were four in the area of programs, policies, and procedures of the individual school building, and one in the area of teachers and professional staff. (3) The lowest rated questions included three from the area of the school board, one from the area of the district administration, and two from the area of programs, policies, and procedures of the individual school building. (4) When the results of both districts were combined, a reliability of 0.97 was computed for the entire instrument. (5) Confidence intervals of +/-4 percent for the entire survey and +/-5 percent at both Stream Harbor and Cotcar were obtained. (6) The instrument and the process proved to be quick, easy, and cost effective
A static investigation of the thrust vectoring system of the F/A-18 high-alpha research vehicle
A static (wind-off) test was conducted in the static test facility of the Langley 16-foot Transonic Tunnel to evaluate the vectoring capability and isolated nozzle performance of the proposed thrust vectoring system of the F/A-18 high alpha research vehicle (HARV). The thrust vectoring system consisted of three asymmetrically spaced vanes installed externally on a single test nozzle. Two nozzle configurations were tested: A maximum afterburner-power nozzle and a military-power nozzle. Vane size and vane actuation geometry were investigated, and an extensive matrix of vane deflection angles was tested. The nozzle pressure ratios ranged from two to six. The results indicate that the three vane system can successfully generate multiaxis (pitch and yaw) thrust vectoring. However, large resultant vector angles incurred large thrust losses. Resultant vector angles were always lower than the vane deflection angles. The maximum thrust vectoring angles achieved for the military-power nozzle were larger than the angles achieved for the maximum afterburner-power nozzle
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