. Influence of surgery for peptic ulcer on pneumoconiosis and tuberculosis. Simple pneumoconiosis in coal miners who have had a partial gastrectomy has often been observed at this Panel to lead to progressive massive fibrosis (PMF). A series comprising 224 men, who had had either a partial gastrectomy, a gastro-enterostomy with or without vagotomy, or a simple closure of a perforated peptic ulcer, was collected over a period of four years. A control series of 220 men who had originally presented with simple pneumoconiosis at least 10 years previously was also studied.Active pulmonary tuberculosis developed in 13 of 106 men (12-2%) following partial gastrectomy compared with 2 of 68 men (2 9%) in the gastro-enterostomy group, 1 of 50 men (2 %) in the perforated peptic ulcer group, and 4 of 220 men (1 8 %) in the control series. Of those who had had a partial gastrectomy, 48-6% progressed to massive fibrosis subsequently, compared with 16-5% in the gastro-enterostomy group, 22% in the perforated peptic ulcer group, and 37 9 % in the control series. Possible reasons for these differences are discussed as well as the current theories of the aetiology of PMF.In view of the increased incidence of tuberculosis and possibly of massive fibrosis in those men who have had a partial gastrectomy in this series, it is recommended that this operation should be avoided in the treatment of peptic ulcer in coal miners with pneumoconiosis. A series comprising 224 men, who had had surgery for peptic ulceration and had been observed for at least five years after their operation, was collected over a period of four years. These were subdivided into three groups according to the nature of their surgical treatment (see Results). In addition, a control series comprising 220 men, who had originally presented with simple pneumoconiosis at least 10 years previously, was also studied.All radiographs had been categorized by at least two members of this Panel. Simple pneumoconiosis was classified as category 1, 2, or 3 (ILO, 1959), depending on the extent and density of opacities whose greatest diameter was less than 1 cm or as PMF when the opacities had a greatest diameter of at least 1 cm. All these men had worked under approved dust conditions (Bedford and Warner, 1943; National Coal Board,1965) or had left the industry since certification. 45 on 9 May 2018 by guest. Protected by copyright.