A survey was made of the state of home care for healthy old folks and those elderly patients who have been disabled by illness or injury, and the care provided by institutions in six areas throughout the nation.
The number of healthy old people was larger in women than in men. However, men had the edgeon women in Activity Daily Living (ADL). Compared to the healthy aged people, many ill or disabled elderly patients receiving home care were found to be suffering from anemia, low cholesterol level, hypoproteinemia, and poor glucose-tolerance. The major cause of disability was cerebral apoplexy. Recently, the cases of cerebral hemorrhage have decreased in number, and the rate of death in acute stage has notability declined ; however, the incidence of cerebral infarction is on the increase among the aged.
There are limits to care for disabled elderly patients at home by the family because of the aging of their spouses and the increasing trend toward the nuclear family. Many of those who look after the sick persons are crying for expert help and services capable of coping with a sudden change in the patient's condition. Hence the need to establish a 24-hour home care providing system. It is desirable to establish old people's homes, as residential care institusion, in alignment with hospitals. This system would facilitate hospitalization in case of emergency. To execute care programs more effectively, close collaboration will be necessary among hospital, home care services, clinics, local governments, agricultural cooperatives, and neighborhood associations.

Background/Aims: Intestinal fibrosis is a major complication of Crohn’s disease (CD). The profibrotic protein transforming growth factor-β (TGF-β) has been considered to be critical for the induction of the fibrotic program. TGF-β has the ability to induce not only the expression of extracellular matrix (ECM) including collagen, but also the production of plasminogen activator inhibitor-1 (PAI-1) that prevents enzymatic degradation of the ECM during the onset of fibrotic diseases. However, the significance of PAI-1 in the developing intestinal fibrosis has not been fully understood. In the present study, we examined the actual expression of PAI-1 in fibrotic legion of intestinal inflammation and its correlation with the abnormal ECM deposition. Methods: Chronic intestinal inflammation was induced in BALB/c mice using 8 repeated intrarectal injections of 2,4,6-trinitrobenzene sulfonic acid (TNBS). TM5275, a PAI-1 inhibitor, was orally administered as a carboxymethyl cellulose suspension each day for 2 weeks after the sixth TNBS injection. Results: Using a publicly available dataset (accession number, GSE75214) and TNBS-treated mice, we observed increases in PAI-1 transcripts at active fibrotic lesions in both patients with CD and mice with chronic intestinal inflammation. Oral administration of TM5275 immediately after the onset of intestinal fibrosis upregulated MMP-9 (matrix metalloproteinase 9) and decreased collagen accumulation, resulting in attenuation of the fibrogenesis in TNBS-treated mice. Conclusions PAI-1-mediated fibrinolytic system facilitates collagen degradation suppression. Hence, PAI-1 inhibitor could be applied as an anti-fibrotic drug in CD treatment.