Summarize the radiology report findings into an impression within 3 sentences.
    INPUT: As compared to ___ , there is unchanged . Lower lobe predominant emphysema and hyperinflation is unchanged . Mild biapical pleural scarring . The lungs are otherwise clear . The cardiomediastinal contours are unchanged . No pleural effusions . Multiple wedge compression fractures involving the mid thoracic spine .
    OUTPUT:
    
Severe lower lobe predominant emphysema . No acute cardiopulmonary process .