Summarize the radiology report findings into an impression within 3 sentences.
    INPUT: Severe hyperexpansion with flattened diaphragms and a barrel chest is unchanged from prior studies indicating chronic obstructive pulmonary disease . Biapical pleural scarring is also stable since the most recent exams . Vascular clips from right breast surgery are in place . Diffuse osteopenia and resultant height loss of the upper thoracic vertebral bodies is stable since ___ . No focal consolidations , pleural effusions or pneumothoraces are identified .
    OUTPUT:
    
Unchanged hyperexpansion and biapical scarring , but no evidence of acute cardiopulmonary process .