http://repub.eur.nl/res/aut/28767/ List of Publications en http://repub.eur.nl/static-eur/img/logo.png http://repub.eur.nl http://repub.eur.nl/res/pub/23410/ 2001-06-20T00:00:00Z Chronic Obstructive Pulmonary Oisease (COPO) is a major cause of morbidity and mortality throughout the world. Approximately 6 % of deaths in men and 4 % of deaths in women are due to COP01. COPO currently ranks as number six in the global impact of disease scale and is expected to rise to number three by the year 20202. In the Netherlands it already is the third cause of death3. The major cause of COPO is cigarette smoking. The percentage of smokers in the Netherlands is among the highest in Europe4 . COPO is defined physiologically as chronic airflow obstruction and may be due to a mixture of emphysema and peripheral airway obstruction from chronic obstructive bronchitis. Emphysema is a pathological diagnosis characterised by destruction of alveolar walls resulting in abnormal and permanent enlargement of airspaces and loss of lung elasticity, with consequent obstruction of peripheral airways1. Chronic obstructive bronchitis is due to obstruction of peripheral airways as a result of an inflammatory response 1. The population of patients studied in this thesis consists of patients in whom loss of elasticity of lung tissue is assumed to be present. However, this assumption is based on clinical and lung function findings, since destruction of elastic tissue is difficult to demonstrate in a living person.