**1. Introduction**

32 Chronic Obstructive Pulmonary Disease – Current Concepts and Practice

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The chronic obstructive pulmonary disease (COPD) encompasses two phenotypically related diseases, chronic bronchitis and emphysema [1-2]. Although the hallmark of COPD is inflammation and inability to maintain efficient gas exchange, emphysema is often characterized by atypical over-distension of the alveoli and permanent destruction of the surrounding supporting structures leading to irreversible damage to gaseous exchange. Statistically, it is rapidly approaching a leading cause of mortality in the United States [3], with a morbidity of 4.9 million [4] and mortality rate at 4.2 per 100,000 [5]. Even with a higher prevalence of COPD related incidences in chronic bronchitis, mortality from emphysema (12,790) had exceeded that of chronic bronchitis (667) in pulmonary-related deaths [5] making early diagnosis and treatment of emphysema an alarming and continued cause for concern.
