Summarize the radiology report findings into an impression within 3 sentences.
    INPUT: Study is essentially unchanged from prior . Lungs are well expanded and clear bilaterally with no masses , lesions or pleural effusion . There is no pneumothorax . Again visualized is a large hiatal hernia , essentially unchanged from before . Cardiomediastinal silhouette is stable demonstrating normal - sized heart with a tortuous aorta . Pleural surfaces are unremarkable . There is stable moderate multilevel degenerative change seen along the thoracic spine .
    OUTPUT:
    
1 . No evidence of pneumonia or congestive heart failure . 2 . Large hiatal hernia , unchanged .