In Japan, the number of people 65 and over is increasing while the number of children is decreasing. A greater number of senior citizens live by themselves or husband and wife alone than before.
To realize comfortable and independent life for aged people, it is important to prepare housing and environment which have special services for them.
We would like to explain two housing projects which were planned and are being put into execution in Japan. One is ‘Silver Housing’ multiunit dwellings for the aged built by the Ministry of Construction and the Ministry of Health and Welfare since 1987. The other is ‘Silver Peer’ project which has been pushed forward by the Tokyo Metropolitan Government since 1987.

Thirty six patients with post-infarction complications underwent operation, and the postoperative and late follow-up results were analyzed. There were post-infarction ventricular septal perforation (VSP) in 9 patients and left ventricular aneurysm formation in 27 patients. The operative indications were poor physical work capacity in 13, cardiogenic shock or severe congestive heart failure in 10, left ventricular thrombus in 7, severe ventricular arrhythmia in 6, and repeated angina in 6. Left ventricular aneurysmectomy was performed in 14 patients and VSP closure was in 8. Coronary arteries were simultaneously bypassed in 14 patients. Three patients were died of sudden postoperative arrhythmia 10 days, 55 days and four years after operation. All survivors except two patients with preoperative massive cerebral infarction or prolonged heart failure were in New York Heart Association Class I or II in their late postoperative periods. However, five patients in whom the significant coronary lesion had not been bypassed or the bypassed grafts had occluded complained of mild angina after operation. Postoperative arrhythmia was one of major factors in the late results and simultaneous coronary artery bypass grafting was important to improve the symptoms in the late postoperative periods.

The Japanese Society of Hepato-Biliary-Pancreatic Surgery launched the clinical practice guidelines for the management of biliary tract cancers (cholangiocarcinoma, gallbladder cancer, and ampullary cancer) in 2007, then published the 2nd version in 2014. In this 3rd version, clinical questions (CQs) were proposed on six topics. The recommendation, grade for recommendation, and statement for each CQ were discussed and finalized by an evidence-based approach. Recommendations were graded as grade 1 (strong) or grade 2 (weak) according to the concepts of the grading of recommendations assessment, development, and evaluation system. The 31 CQs covered the six topics: (1) prophylactic treatment, (2) diagnosis, (3) biliary drainage, (4) surgical treatment, (5) chemotherapy, and (6) radiation therapy. In the 31 CQs, 14 recommendations were rated strong and 14 recommendations weak. The remaining three CQs had no recommendation. Each CQ includes a statement of how the recommendations were graded. This latest guideline provides recommendations for important clinical aspects based on evidence. Future collaboration with the cancer registry will be key for assessing the guidelines and establishing new evidence.