Summarize the radiology report findings into an impression within 3 sentences.
    INPUT: The heart is at the upper limits of normal size . The mediastinal and hilar contours appear unchanged . Bilateral nipple shadows are visualized . There is again a very large hiatal hernia with an air - fluid level projecting primarily to the right of midline . The lungs are hyperinflated but clear . Mild loss in vertebral body height among mid to lower thoracic vertebral bodies is probably unchanged and chronic , associated with demineralization . Several mid to lower thoracic vertebral bodies have mildly biconcave endplate configuration that is typical for compression deformities associated with demineralization .
    OUTPUT:
    
No evidence of acute disease . Large hiatal hernia .