Summarize the radiology report findings into an impression within 3 sentences.
    INPUT: Since earlier same day chest radiograph , left chest tube is removed . New left sided subcutaneous emphysema is likely related to chest tube removal . Small left apical pneumothorax is unchanged . Otherwise , the lungs are similar in appearance to earlier same day exam . Mild cardiomegaly is unchanged .
    OUTPUT:
    
1 . Since earlier same day exam , the left chest tube has been removed with new development of left sided subcutaneous emphysema .