Summarize the radiology report findings into an impression within 3 sentences.
    INPUT: The heart is moderate to markedly enlarged , as before . The mediastinal and hilar contours appear unchanged . Central pulmonary arteries are again mildly enlarged . There are streaky opacities in the right lower and left mid lungs , similar to the prior examination and suggesting minor scarring or atelectasis . There is no definite pleural effusion or pneumothorax . The bones appear demineralized . Degenerative changes appear similar along each shoulder and about along the thoracic spine .
    OUTPUT:
    
Stable appearance of the chest with no definite evidence of superimposed acute disease .