Summarize the radiology report findings into an impression within 3 sentences.
    INPUT: Sternotomy wires and mediastinal clips are again seen . There is bilateral lower lobe volume loss with a small left pleural effusion . It a superimposed infection ca n't be totally excluded . The right IJ line tip is in the SVC . The mediastinum is not as prominent as on the film from the prior day . This is likely due to differing technique . The right lung is clear
    OUTPUT:
    
Improved appearance to the mediastinum . Left lower lobe volume loss with effusion