Summarize the radiology report findings into an impression within 3 sentences.
    INPUT: Left chest wall vagal nerve stimulator is again noted . Where seen , the lungs are clear . There is no consolidation , effusion , or edema . Calcified mediastinal lymph nodes are again noted . No acute osseous abnormalities . Surgical clips in the upper abdomen suggest prior cholecystectomy . Chronic changes of distal right clavicle however likely posttraumatic .
    OUTPUT:
    
No acute cardiopulmonary process .