Our aims are clarifying the facts on fluid replacement and studying the awareness of fluid replacement for people who exercise at the indoor pool. The investigation was conducted in the form of a questionnaire. The number of subjects was 1005 (56.0±15.3yr). While exercising, the subjects who thought that they had to replace fluid whether they felt thirsty or not in both men and women were most common among the subjects younger than the age of 44 but least common among the subjects older than 65. The subjects who replaced fluid before, after, and during exercise were most common among men younger than the age of 44 in all cases, but women did not differ significantly by age. The subjects who replaced fluid after exercise were 77 to 94% of the total, whereas the subjects during exercise were 15 to 34%. As many as 12.7% of subjects did not replace fluid before, after, and during exercise. The reason the subjects did not replace fluid was to have only a limited knowledge about fluid replacement. At aquatic exercise, the subjects who had experienced subjective symptoms which appeared to be dehydration was 57.1%. When taken together, our study demonstrated the need to educate people who performed aquatic exercise regarding fluid replacement.

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In Japan, nicotine dependence care service has been started under public health insurance coverage since 2006. Varenicline tartrate (Champix^®), an oral agent for smoking cessation therapy, has been prescribed under health insurance coverage since 2008.
From October 2009 to March 2013, we collected 130 smokers (male 97, female 33) who received smoking cessation treatment with varenicline at our clinic. We classified these patients into two groups (successful group and failed group), and analyzed the difference of five variables (age, gender, Brinkman index, Tobacco Dependence Screener score and exhaled carbon monoxide level at first visit) between two groups.
Of 130 patients who received treatment, 93 patients (71.5%) were classified into successful group. A significant difference was observed only in Brinkman index between two groups (p=0.037). Brinkman index of successful group was higher than failed group (619 vs 491).
Of 93 successful patients, 69 patients (74.2%) completed five visits to outpatient clinic during 12 weeks’ therapy program. Of 37 failed patients, only 5 patients (13.5%) completed five visits.
Of 93 successful patients, 24 patients (25.8%) did not complete five visits to outpatient clinic. Continuous abstinence rate of 69 full-visit patients after 2 years from therapy program was 51.1%. In contrast, continuous abstinence rate of 24 incomplete-visit patients was only 31.7%.
Successful smoking cessation at the end of therapy program was associated with the achievement of full five visits to outpatient clinic. Continuous abstinence after smoking cessation therapy was also associated with the achievement of full visits to clinic during the program.

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Sanger’s DNA sequencing method has been widely used for genetic testing. With continued advances in molecular biology this sequencing technique will likely be applied for medical diagnosis and therapy in the near future. The continued development of next-generation sequencing approaches will also allow for clinical sequencing and genetic mapping at the individual level. Despite these technical advances, there are inherent problems with genetic testing. In particular, it is difficult to determine if an identified polymorphism represents an inter-individual difference or is a causal mutation of a genetic disease, and the findings may have ethical and moral implications. In Japan, the genetic testing covered by national health insurance is limited to 36 genetic disorders. However, even with this relatively small number of disorders, there are high costs associated with genetic testing, as suitable facilities and trained personnel are required. Importantly, the results of the genetic screening must be accurate to allow for medical doctors and their clients and patients make informed decisions. To achieve these goals, it is necessary to maintain a database of genomic variations and associated clinical phenotypes, and have qualification standards for personnel. To this end, the Human Genome Variation Society (HGVS) was created as an international standard of genetic variations, and Japan’s National Liaison Council for Clinical Sections of Medical Genetics publishes periodic reports on the condition of genetic testing in Japan. In addition a qualified ‘genetic experts’, who are authorized by the Japanese Society for Gene Diagnosis and Therapy to interpret the results of genetic testing, have been introduced in order to support medical staff. In the present review, recent progress and issues related to genetic testing in Japan, particularly quality assurance and qualification standards for personnel, are summarized and discussed.

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