Summarize the radiology report findings into an impression within 3 sentences.
    INPUT: In comparison with chest radiograph from ___ , there is little overall change . There is no focal consolidation , effusion , or pneumothorax . There is no vascular congestion or pulmonary edema . Heart size is normal . Bullous emphysema in the upper lobes is substantial . Three endobronchial valves to project over the right hilus , most likely in the segmental divisions of the downward displaced right upper lobe bronchus . There has been no loss of volume of the hyperinflated upper lobe .
    OUTPUT:
    
1 . No pneumothorax . 2 . Substantial upper lobe predominant emphysema .