1) Six months to 6 years follow-up studies of 33 cases treated by extraperiosteal plombage with polyvinyl formal were reported.
2) Before the operation the mean vital capacity of all cases was 550 of predicted normal value, 6 months after the operation there was little reduction in V. C.. with 530 of predicted normal value, The reduced pulmonary function at the time of immediate posto-perative period recovered more quickly compared to the other operations.
3) Seventy-three % of all positive cases in sputum-culture became negative.
4) In all cases post-operative courses were good and no considerable complication were recognized. In a few cases fluid retentions occured, but they were all sterile and many of them recovered spontaneously.
5) There was 25 discharges (76%), with 23 cases (70%) went back to work; . and 8 cases (240) still remain in the sanatorium.
6) Results of this studies are concluded followingly; Twenty five cases (76%) were successful, seven were considered no change, and one became worse.
7) The reason why this surgical procedure has small influences for the lung function was discussed.
8) The extraperiosteal plombage is r valuable technique to treat the so-called poor-risk patients considering difficultness to perform other operation because of decreased lung function,

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The late results over three years were analysed on 32 out of the cases undertaken bilateral surgical treatment for pulmonary tuberculosis in this sanatorium.
The cases consisted of 31 males and a female. As age at the operation, 16 years old was youngest and 49 years old was oldest, 12 cases were in their twenties and 10 cases were in their thirties; Regarding pulmonary function, none of the cases was under %VC 30, each 5 cases were of VC 30 to 39 and 40 to 49, 22 cases were over %VC 50, they have a majority, All of the cases had positive bacilli in sputum before operation. SM, PAS and INH were used for almost all cases as chemotherapy, and 12 cases showed the complete drug resistance. The cases were classified into two groupes of severe and not severe cases due to three points, extent of pulmonary lesions, pulmonary function and drug resistance; 15 cases belonged to the former group and 17 to the later.
Operations carried out for the above analysed cases consisted of 5 sorts and 10 sorts of their combinations; bilateral thoracoplasty (9 cases), bilateral pulmonary resection (4), bilateral extraperiosteal prombage (4), pulmonary resection-thoracoplasty (3), decortieationpulmonary resection (3), bilateral extrapleural pneumothorax (2), extraperiostal prombagethoracoplasty (2), extrapleural pneumothorax-pulmonary resection (2), and bilateral decortication (1). Collaps therapy was relatively often used for the severe cases.
The results obtained were as follows;
Twenty two cases (68.7) are in light to moderate physical work with inactive disease, 4 cases (12.5%) are still hospitalized, 4 cases (12.5 %) are dead and 2 cases (6.3 ) are uncertain, Bacilli in sputum are combated to negative on 27 cases (90.0%), Postoperative complications were noted on 6 cases (18.7%); 3 cases of bronchopleural fistula, each case of postoperative shock, pulmonary edema and pulmonary failure.
As 9 out of 22 cases in work and all of 4 deaths belonged to the group of severe cases, the severity of cases influences the results definitely, the late results of bilateral operation for severe cases should to be needed further.

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From February to August, 1963, we performed interview test of mental state and adrenocortical function test, to 77 tuberculous patients in above-mentioned 6 sanatoria twice each patient at an interval of 3 months, who seemed to have mental difficulties and some of them were administered tranquilizer for the purpose of mental stabilization.
When we compared the mentally improved group with the unimproved group, the range of 17OHCS-response to ACTH-Z injection of the former group decreased and the rate of eosino-fall (Thorn Test) increased and thus the stabilization or the improvement of adrenocortical function was observed, whereas the range of 17 OHCS-response of the latter decreased and the rate of eosino-fall diminished.
Adrenocortical function seems to be stabilized or improved in accordance with vanishment or decrease of mental stress and consequently this seems to add reserved power to defensive reaction of a living body for another stress and afford favorable influence to the change of clinical symptoms of a tuberculous patient.

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1) Economical Factors
Forty eight of the patients, who were admitted in the national sanatorium, as serious far advanced tbc. patients, was householders and 160 of them was housewives.
Fifty five% of them had been once treated in other hospitals, but 42% of these admitted patients left unfinished by economical reasons.
Fifty five % of causes, which prevented the other patients from admission, was matters of household.
2) Medical Factors
Forty four 9 of the patients was discovered at private clinics and 33% at private and official hospitals. The others by medical examination.
Eighty two % of the discovered patients had been treated with 2-3 combined tuberculostatics direct after discovery, but 50% of men patients and 41% of women patients hadd engaged in some labor or business till admission in the national sanatoria. Seventy five % of these laboring patients had worked as much as healthy householders and housewives.
This is the fact that they rely too much on antibiotics and are apt to ignore to take care of their health itself.
3) Management-factors of Patients
Twenty five % of the far advanced patients, who admitted in the national sanatoria, had Been, from the beginning, only treated in hospitals, 34% of only as out-patients and 41% both.
Fifty two o of the patients, who had, once, admitted in hospitals, , left within 1 year, Leaving idicated by doctors was 23% of all leaving-causes in the case of the national sana toria, 47% at other hospitals and 52% at private clinics. The other cause-percentage of each cases were economical. Thirty eight % of the formers and 66% of the Eaters become serious within years.
Seventy four % of the far advanced patients, who admissed in the national sanatorium had been direct before admission as out-patients of any hospitals and clinics, This fact is very serious from the medical and social point of view.

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