Summarize the radiology report findings into an impression within 3 sentences.
    INPUT: The lungs are well expanded and clear . The cardiomediastinal silhouette is unchanged from comparison exam . There is a large hiatal hernia which is significantly larger from most recent exam . There is no focal consolidation , pleural effusion or pneumothorax . There is unchanged appearance of scoliosis and significant degenerative changes in the thoracic spine . The thoracic aorta is heavily calcified and tortuous .
    OUTPUT:
    
1 . There is no evidence of pneumonia . 2 . Large hiatal hernia which is significantly larger from prior exam .