Summarize the radiology report findings into an impression within 3 sentences.
    INPUT: A large hiatal hernia is re - demonstrated . Marked S - shaped scoliosis of the thoracic spine is re - demonstrated . The cardiac and mediastinal contours are unchanged with tortuosity of the thoracic aorta again noted . No focal consolidation , pleural effusion or pneumothorax is identified . Pulmonary vascularity is not engorged . There are no acute osseous abnormalities .
    OUTPUT:
    
No acute cardiopulmonary process . Large hiatal hernia . Severe S - shaped scoliosis .