Summarize the radiology report findings into an impression within 3 sentences.
    INPUT: Dual lead left - sided AICD is again seen , similar position . The lungs remain hyperinflated with relative lucency of the upper lobes , consistent with chronic obstructive pulmonary disease and pulmonary emphysema . Cardiac and mediastinal silhouettes are stable . There is no focal consolidation , pleural effusion , or evidence of pneumothorax . Wet degenerative changes of the spine are again visualized with flowing anterior osteophytes involving the upper and mid thoracic spine
    OUTPUT:
    
No acute cardiopulmonary abnormalities