Summarize the radiology report findings into an impression within 3 sentences.
    INPUT: PA single chest view has been obtained with patient in upright position . Analysis is performed in direct comparison with the next preceding similar study ___ ___ . Tracheal cannula remains in place . Unchanged position of previously described left - sided PICC line terminating in lower SVC . Mediastinal and cardiac structures unaltered . The pulmonary vasculature is not congested . Bilateral linear basal densities similar as before . No new parenchymal infiltrates can be identified . The on previous examination noted extreme gas dilatation of the stomach has receded moderately .
    OUTPUT:
    
Stable pulmonary appearance after tracheostomy placement . No new discrete parenchymal infiltrates in this patient with apparently advanced findings of COPD .