Summarize the radiology report findings into an impression within 3 sentences.
    INPUT: There is little change in comparison to prior study . The lungs remain hyperinflated consistent with emphysema . The aorta appears tortuous . The lungs are otherwise clear with no evidence of consolidation , effusion , or pneumothorax . Cardiomediastinal silhouette is normal . No acute fractures are noted .
    OUTPUT:
    
No acute cardiopulmonary process . Emphysema is again noted .