Clinical Data Age at Age at time of time of Lobe Estimated Subjects Sex surgery study Height

tomy in infancy and the low expiratory flows which persist after lobectomy for congenital lobar emphysema, 15 subjects with this history were studied at age 8-30 yr. Total lung capacity was normal in all, but higher values (P < 0.05) were observed in nine subjects with upper lobectomy than in five subjects with right middle lobectomy. Ratio of residual volume to total lung capacity was correlated (P < 0.05) with the amount of lung missing as estimated from normal relative weights of the respective lobes. Xe133 radiospirometry in eight subjects showed that the operated and unoperated sides had nearly equal volumes at total lung capacity, but that the operated side was larger than the unoperated side at residual volume. Perfusion was equally distributed between the two sides. Similar findings were detected radiographically in four other subjects. Forced expiratory volume in 1 s and maximal midexpiratory flow rate averaged 72 and 45% of predicted, respectively. Low values of specific airway conductance and normal density dependence ofmaximal flows in 12 subjects suggested that obstruction was not limited to peripheral airways. Pathologic observations at the time of surgery and morphometry ofthe resected lobes were not correlated with any test of pulmonary function. This study was presented in part at the 89th Annual Meeting of the American Pediatric Association, May 1979, Atlanta, Ga., and published in abstract form in 1979. Pediatr. Res. 13: 538. Dr. Jackson's present address is Califomia Primate Respiratory Center, University of California in Davis, Davis, Calif. 95616. Dr. Morton's present address is Prince of Wales Children's Hospital, University ofNew South Wales, Sydney, Australia, Dr. Zwerdling's new address is La Rabida Children's Hospital and Research Center, 65th Street at Lake Michigan, Chicago, Ill. 60649. Dr. Williams' present address is Wadsworth Hospital, University of California at Los Angeles, Los Angeles, Calif. 90073. Received for publication 14 February 1980 and in revised form 20 June 1980. 962 These data show that lung volume can be completely recovered after lobectomy for congenital lobar emphysema in infancy. The volume increase occurs on the operated side, and probably represents tissue growth rather than simple distension. The response to resection is influenced by the particular lobe resected and may be associated with decreased lung recoil near residual volume. Low expiratory flows in these subjects could be explained by several mechanisms, among which a disproportion between airway and parenchymal growth in infancy (dysanaptic growth) is most compatible with our data.