Summarize the radiology report findings into an impression within 3 sentences.
    INPUT: No evidence of a focal consolidation . No pleural effusion or pneumothorax is seen . The cardiac and mediastinal silhouettes are unchanged . Left pectoral pacemaker with leads terminating in the right atrium and right ventricle are again noted . Fracture of the inferior most sternotomy wire again noted .
    OUTPUT:
    
No acute cardiopulmonary process . Again noted is the fractured inferior most median sternotomy wire .