Summarize the radiology report findings into an impression within 3 sentences.
    INPUT: Lungs are fully expanded and clear . No pleural abnormalities . Heart size is normal . Cardiomediastinal and hilar silhouettes are unchanged . A portion of the left fifth rib is again absent . The median sternotomy wires , mediastinal clips , and anterior right chest wall clips are again noted .
    OUTPUT:
    
No acute cardiopulmonary abnormality .