The minimum inhibitory concentrations (MICs) to the fluoroquinolones, ofloxacin (OFLX), ciprofloxacin (CPFX), sparfloxacin (SPFX), norfloxacin (NFLX), balofloxacin (BLFX) and CS-940, were determined in 100 clinical isolates of Mycobacterium tuberculosis. The MICs were determined with 1% egg-based Ogawa or agar -based Middlebrook 7H10 and each of them supplemented with oxidation-reduction color dye, 2, 3-diphenyl 5-thienyl-(2)-tetrazolium chloride (STC) by using the microculture technique. The MICs determined with Ogawa medium were approximately two to four-fold higher when compared to those determined with Middlebrook agar medium. The supplement with STC slightly increased the MICs, probably as a result of easily recognizing small initial colonies. Among the six fluoroquinolones, CS-940 and SPFX showed the greatest antimy cobacterial activities with inhibition of 50% of all the isolates at the concentrations between 0.25 to 0.5μg/ml. OFLX, CPFX and BLFX followed in potency at 0.5 to 2.0μg/ml. NFLX was less potent requiring 8 to 16μg/ml to inhibit 50% of the isolates.

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In vitro antimicrobial activities of the benzoxazinorifamycin derivative KRM -1648 (KRM) against 50 strains of Mycobacterium tuberculosis isolated from patients with mainly intractable pulmonary tuberculosis were studied. MIC ₉₀ values of KRM, rifabutin (RBT) and rifampicin (RFP) for RFP -sensitive strains (27 strains; defined as those with MIC RFP values of <1.56μ g/ml) were 0.013, 0.1 and 0.4μ g/ml, respectively, when determined by the agar dilution method using 7H11 medium. MIC ₉₀ values of KRM, RBT, and RFP for RFP -resistant strains (23 strains; defined as those having MIC RFP values of ≥ 1.56μ g/ml) were 100, 12.5 and > 100μ g/ml/, respectively. MICs of KRM against 50 clinical isolates of M. tuberculosis distributed over a much lower range than those of RFP. KRM showed more potent antimicrobial activity than RBT against the organisms with low MIC values (≥ 1.56μ g/ml/), while it was not so active as RBT against the organisms with high MIC values (pg/m/). Cross-resistance between KRM and RFP or RBT was observed for M. tuberculosis.

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PCR-SSCP method to detect genetic mutations in rpoB gene as a marker of rifampi cin-resistance was developed by Telenti et al., and we have modified it applying nonradioactive PhastSystem for more practical use in the detection of rifampicin-resistance of Mycobacterium tuberculosis.
PCR products amplified with the primers specific to rpoB gene using extracted DNA from 89 strains of M. tuberculosis were sequenced and the amino acid sequences were morphism was determined by the PhastSystem. The bands were stained by silver staining.
Among 89 strains of M. tuberculosis, 43 were confirmed as rifampicin-resistant (RFP^r) and 46 were rifampicin-sensitive (RFP^s) by the culture on the drug-containing media. All of the 43 RFP^r strains had one or more mutations in the DNA sequence of rpoB gene, while none of the RFP^s strains had such mutations. However, by PCR-SSCP, only 20 out of 43 RFP^r strains showed clear differences in the band pattern of electrophoresis from that of RFP^s strains. Other 23 RFP^r strains had only slight differences in the band pattern of the PCR-SSCP from that of RFPs strains. But it was noticed that the main bands of RFP^r strains were distinguishable from the main bands of RFPs strains even their patterns were similar. Thus, it is possible to apply a non-radioactive PCR-SSCP for the detection of rifampicin resistance of M. tuberculosis with further improvement of the condition of gelelectrophoresis or staining techniques.

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A 22 year-old Thai male was admitted to our hospital because of chest pain and dyspnea. In 1989, he met with a traffic accident and was injured his head and the arm, and was given a blood transfusion in Thai.
Laboratory examinations on admission revealed that serolopositivity for HIV, and CD4 +T lymphocyte count was 17/μl. Chest X-ray on admission showed bilateral diffuse nodular shadow, and he was diagnosed as miliary tuberculosis with AIDS. On the chest X-ray, in the right upper middle lung fields, the shadow was rough and partly influent. In the left lung, the nodular shadow were smaller and distributed evenly. As there was a difference in the distribution of nodular shadows between the left and right lung, the chest X-ray findings of this case was atypical of miliary tuberculosis.

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Respiratory infections in Japan have rapidly changed, because pathogenesis has also changed by the increase of compromised hosts and aged people with the development of chemotherapeutic agents and another medical progresses. Various respiratory infections have been accumulated in our clinical department and clinical investig-tions were done for these diseases during almost 20 years. Firstly, pneumonias in adult T cell leukemia have been very severe and these diseases have occured with load from pathogenic orophayngeal bacteria to lower respiratory airway. With another clinical studies, these pathogenesis which firstly pathogenic bacteria attach to orophayngeal epithelial cells and would move to lower respiratory airway to infect were given very clear evidences especially for Branhamella and Pneumococcus infections with chronic respiratory infections.
The exact clearence of pathogenic orophayngeal bacteria using povidon iode solution was very useful for prevention of these acute or chronic respiratory infections.
Although acute bronchitis is very popular, the secondary bacterial pathogens remained to be unknown, in the world. We showed that H.influenzae, S. pneumoniae and B.catarrhalis were common major pathogens as the secondary invading bacteria of acute bronchitis in Japan, Thailand and Bangladesh.
Recently, the pathogenesis of severe chronic respiratory infections such as diffuse panbronchiolitis is focused after the development of erythromycin therapy.
We gave some evidences of macrolides effectiveness which these drugs inhibited IL-8 production. We described the importance of inflammatory cell classification in sputa or bronchial secretions for deep understanding of inflammatory situation in broncho bronchiolar airway.
Finally, the study results of respiratory infections in patients with AIDS in Uganda

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