Nasopharyngeal airway has been used as the treatment of upper airway obstruction in children. We studied the ten cases who received nasopharyngeal airway management in our hospital from Jan. 1985 to Jan. 1994.
They were begun the nasopharyngeal airway management at the age from one month to 9-year-5-month-old (median=6 months). The causes of the upper airway obstructions were three microgenias, including one Pierre Robin syndrome, two dyschondroplasias, nasopharyngeal stenosis following operation of cleft palate, congenital nasal stenosis, obstructive sleep apnea, and so on. Eight of ten were effective, two of eight also improved the right ventricular hypertrophy and cor pulmonale. The last two were not effective because both of them had complications: central apnea and tracheobronchomalasia respectively. The durations of nasopharyngeal airway management were from 5 months to 4 years and 8 months (mean=2 years and 4 months). No severe complication was seen.
We conclude nasopharyngeal airway management is effective and convenient treatment for upper airway obstructions caused by many kinds of diseases. It might improve the quality of life of these children.

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This study compared the influence of aerobice xercise with that of continuous anaerobic exercise on exercise-induced bronchospasms (EIB) in asthmatic children.
Seven children with bronchial asthma underwent an incremental anaerobic exercise test to determine their maximal anaerobic power (Pmax.) with a high power cycle ergometer. Then, their maximal duration (100%T) was derermined at 80% of each Pmax. EIB by continuous anaerobic exercise were evaluated at duration levels (25%, 50%, 75%and100% of maximam) at 80% of Pmax. They also performed an aerobic EIB test for 6 min by the standard method.
The following results were obtained.
1. The average maximal duration was 38.3±6.8 second.
2. Lactate increased remarkably in all tests except 25% of maximal duration.
3. There was no significant difference in V_E between aerobic exercise and anaerobic exercise except at 25% of maximal duration.
4. The average max.%fall in FEV_1.0 was 21.8±13.1% on aerobic exercise test. The average max.%fall in FEV_1.0 on anaerobic exercise test was 9.7±11.3% at 100% of maximal dulation, 4.0±6.7% at 75%, 4.0±5.4% at 50% and 5.0±7.2% at 25%.
(%fall in FEV_1.0 at all durations of anaerobic exercise were under 10%)
Max.%fall in FEV_1.0 on 100%T which caused positive EIB was not different from that on aerobic exercise
Based on. these results, it was concluded that the longest continuous anaerobic exercise may cause positive EIB. Because there was less rise of lactate, 25% of maximal duration was recommended for interval anaerobic exercise training.

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A 14-year-boy, who was operated on for a right mediastinal ganglioneuroblastoma at the age of 7-year-old. After surgical treatment he received chemotherapy with cyclophosphamide (CPA) administered orally in daily doses of 45 mg for one year and 7 months. The total doses of CPA was 23g. No other chemotherapy or radiotherapy was performed. Five years after suspension of the chemotherapy, he developed dyspnea while exercising. The chest radiograph showed diffuse interstitial infiltration with diminished lung volume. Pulmonary function testing revealed a severely restricted ability, diagnosed as pulmonary fibrosis. Then he was treated with methylprednisolone pulse therapy and oxygen therapy, but respiratory symptoms did not improve and after 3 years and 6 months he died due to progressive respiratory failure. An autopsy was not performed. We believe that pulmonary fibrosis and severe restrictive lung disease of this patient were due to delayed toxic effect of CPA. We conclude that the care of patients during and after prolonged CPA therapy should include serial assessment of pulmonary function and chest radiogragh to identify lung changes at the earliest possible time.

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