Summarize the radiology report findings into an impression within 3 sentences.
    INPUT: The 2 lead pacemaker in sternal wires are unchanged . There areas of volume loss / infiltrate in both lower lobes . There are also small effusions , left greater than right . The dual lead pacemaker is again seen with the leads projecting over the expected location . The right IJ Cordis is been removed
    OUTPUT:
    
Overall there is no substantial change compared to prior