Summarize the radiology report findings into an impression within 3 sentences.
    INPUT: Since the recent prior radiograph , there has been interval increase in left hydropneumothorax with an air - fluid level seen . Pleural fluid has increased . Again seen is a small left apical pneumothorax . The right lung is clear and there is a small tiny right pleural effusion . There are no focal consolidations . Cardiac silhouette is normal .
    OUTPUT:
    
1 . Interval increase in left hydropneumothorax . Recommend chest tube placement . 2 . Small left apical pneumothorax persists . These findings were reported to ___ , M .D . by Dr . ___ ___ telephone at 11 : 19 a .m .