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Clinical Chest Utrasound From the ICU to the Bronchoscopy Progress in Respiratory Research, Vol. 37
	Editors: C.T. Bolliger (Cape Town), F.J.F. Herth (Heidelberg), P.H. Mayo (New Hyde Park, N.Y.), T. Miyazawa (Kawasaki), J.F. Beamis (Burlington, Mass.)

Online Supplement Material 51 online videos and 6 online figures

Chapter 3 Transthoracic Ultrasound for Chest Wall, Pleura, and the Peripheral Lung Koegelenberg, C.F.N.; Diacon, A.H.; Bolliger, C.T. (Cape Town)
p. 23	Video 1 (400 KB) A high-frequency US of a normal individual. Video 2 (2,4 MB) A high-frequency US of a normal person. Note the presence of the 'lung sliding' sign.
p. 25	Video 3 (1,7 MB) A low-frequency US of a septated effusion. Video 4 (AVI, 1 MB) A high-frequency US obtained from a patient with pleural thickening. Note the hypoechoic appearance and the absence of mobility with respiration.
p. 26	Video 5a (622 KB) Video 5b (1,6 MB) High-frequency US of a patient with an artificially induced pneumothorax (medical thoracoscopy). a) Prior to pneumothorax – note the sliding sign. b) Pneumothorax – note the reverberation artefacts, and the absence of the lung sliding sign or commit tails.
p. 29	Video 6 (3,2 MB) A low-frequency US was employed to assist with an FNA of this large paracardiac mass. Note how the mass is identified, and how the potential puncture site and safe range are identified. An FNA was subsequently performed ('freehand'), and a diagnosis of adenocarcinoma was made. Video 7 (2,7 MB) A low-frequency US of a patient with a pleural cyst. An FNA was performed, and confirmed an echinococcus cyst.
p. 31	Video 8 (1,7 MB) A low-frequency US was used to assist in making a cytological diagnosis in this patient with a peripheral lung mass. Following adequate patient positioning, the intended site of needle insertion is identified with US and marked, while the direction, the depth of interest and the safety range for the procedure are determined and memorized. An FNA was performed with a 22-gauge spinal needle, and a diagnosis of small cell carcinoma was made.

Chapter 7 Critical Care Echocardiography Mayo, P.H. (New Hyde Park, N.Y.)
p. 61	Video 1 (115 KB) Parasternal long axis view of the heart. Video 2 (789 KB) Parasternal short axis view of the heart. Video 3 (1,1 MB) Apical four chamber view of the heart. Video 4 (1,1 MB) Subcostal long axis view of the heart. There is ascites present. Video 5 (398 KB) Longitudinal view of the inferior vena cava. Video 6 (790 KB) Apical four chamber view of the heart. There is a large pericardial effusion.
p. 62	Video 7 (1,1 MB) Parasternal long axis view of the heart. The aortic valve is heavily calcified with reduced mobility consistent with aortic stenosis. Left ventricular function is severely reduced.
p. 66	Video 8 (792 KB) Parasternal long axis view of the heart. Left ventricular function is severely reduced. There is a tissue valve in the mitral position. Video 9 (1,1 MB) Apical four chamber view of the heart. There is a flail chordal structure. Video 10 (790 KB) Parasternal long axis view of the heart. There is severe aortic regurgitation by color Doppler study. Video 11 (1,5 MB) Apical four chamber view of the heart. The right ventricle is dilated.
p. 67	Video 12 (821 KB) Subcostal long axis view of the heart. Subcostal long axis view of the heart. There is absent cardiac function with opacification of the ventricular cavities.

Chapter 8 Use of Ultrasound for Central Venous Access Garibaldi, B.; Feller-Kopman, D. (Baltimore, Md.)
p. 70	Video 1 (5,4 MB) Distention of right IJ with valsalva maneuver.
p. 72	Video 2 (364 KB) Transverse and longitudinal view of right IJ and carotid.
p. 73	Video 3 (324 KB) Transverse US showing relationship of US plane to advancing needle tip.

Chapter 9 Ultrasound Evaluation of the Lung Pellecchia, C. (New York, N.Y.); Mayo, P.H. (New Hyde Park, N.Y.)
p. 77	Video 1 (362 KB) Standard lung ultrasound image with 3.5-MHz transducer in longitudinal plane showing sliding lung and A lines consistent with normal aeration pattern. Video 2 (1 MB) Sliding lung with 3.5-MHz transducer. Video 3 (1 MB) Sliding lung with 7.5-MHz transducer. Video 4 (363 KB) Lung pulse with 3.5-MHz transducer. Video 5 (719 KB) Lung pulse with 7.5-MHz transducer.
p. 78	Video 6 (1 MB) Absent lung sliding. Video 7 (1 MB) Lung point. Video 8 (1 MB) B lines.
p. 79	Video 9 (1 MB) Alveolar consolidation of the lateral segment of the right lower lobe. B lines are present at the interface of the consolidated and aerated lung. There is a small pleural effusion. Video 10 (1 MB) Alveolar consolidation of the left lower lobe. There is a small pleural effusion. The heart is seen in short axis view as the pleural effusion and consolidation allow transmission of ultrasound. Video 11 (1 MB) Alveolar consolidation of the right lower lobe. There is a large pleural effusion which has caused compressive atelectasis of the lung. There is subdiaphragmatic ascites.

Chapter 11 Abdominal Ultrasonography as Related to Problems of the Chest Beckh, S.; Kirchpfening, K. (Nόrnberg)
p. 90	Video 1 (1 MB) Pleural mesothelioma infiltrating the left diaphragm. Lateral longitudinal view in the axillary line. The spleen serves as an acoustic window for the pleural mesothelioma infiltrating the left diaphragm. There are nearly no respiratory movements of the infiltrated diaphragm. Below the spleen the partly filled stomach is displayed.
p. 91	Video 2a (1,4 MB) Video 2b (1,2 MB) Video 2c (1 MB) a–c) Pleural empyema. A 33-year-old man was admitted to the hospital because of left-sided pneumonia. Despite antibiotics fever and laboratory findings of inflammation did not resolve within the first days. a) Ultrasound in the left lateral view through the spleen shows thickening of the diaphragmatic pleura with several strands surrounding the left lower lobe. Within a few days an encapsulated pleural empyema had developed. b) The inflamed left lower lobe is completely fixed by fibrinous bands. c) Hypervascularization in the inflamed lung. The patient was immediately referred to the surgery department and successfully treated by video-assisted surgery. Video 3a (1,8 MB) Video 3b (482 KB) a, b) Chiari's network in the right atrium. a) Subcostal view from the epigastrium towards the chest. An accidental finding of Chiari's network in the right atrium in the four-chamber apical view. Pay attention to the small pericardial effusion beside the right atrium and right ventricle. b) Enlargement of the right atrium. Chiari's network should not be misinterpreted as thrombi. Figure 1 (JPG, 326 KB) Measurement of the caval vein below diaphragm (arrows). Figure 2 (JPG, 475 KB) Longitudinal section in the epigastrium through the left liver lobe. Thrombus (crosses) in the right atrium near the inlet of the inferior caval vein.
p. 92	Figure 3a (JPG, 333 KB) Figure 3b (JPG, 81 KB) View from the epigastrium towards the chest. a) Small pericardial effusion (depth 1.56 cm) below the right atrium; together with the enlarged right atrium a sign for right heart decompensation. b) Large pericardial effusion (depth 3.13 cm) surrounding the heart.
p. 93	Figure 4a (JPG, 92 KB) Figure 4b (JPG, 111 KB) Figure 4c (JPG, 87 KB) a) Dilated vessels in the liver due to arteriovenous malformations. b) Sagittal CT-scan – done after sonographic examination – showing the pulmonary vessel malformation in the right lower lobe. c) Corresponding sonographic image of the pulmonary malformation. The patient was admitted to hospital under the suspicion of lung carcinoma; the pulmonary formation should be biopsied. After sonography, however, the biopsy was refused.
p. 94	Figure 5 (JPG, 98 KB) Echo-poor granulomas in the spleen with no enhancement in echo-contrast sonography in a patient with known sarcoidosis. Checkups at regular intervals demonstrate that the number and size of the granulomas correlate with the general activity of the disease. Figure 6a (JPG, 60 KB) Figure 6b (JPG, 93 MB) Figure 6c (JPG, 77 KB) a) 64-year-old man admitted to hospital because of pulmonary metastases. b) Sonography of the abdomen revealed a kidney tumor (diameter 5.55 cm) on the left side. c) Diagnosis of renal cell carcinoma was obtained by ultrasound-guided biopsy of a peripheral pulmonary metastasis (diameter 2.80 cm). Video 4 (1,1 MB) Peritoneal tuberculosis. The 46-year-old patient was admitted to hospital because of abdominal pain. Abdominal ultrasound revealed fluid between the bowels and pendulous peristalsis of the small intestine. In the peritoneal fluid Mycobacterium tuberculosis was detected. A 4-fold antituberculous therapy was started and the peritoneal infection slowly resolved.

Chapter 13 Principles and Practice of Endoscopic Ultrasound Nishina, K.; Hirooka, K. (Tokyo); Wiegand, J.; Dremel, H. (Hamburg)
p. 115	Video 1 (12,3 MB) Example for mechanical radial ultrasound: EBUS. This case nicely demonstrates the risk of false-positive diagnosis if based only on imaging. Computer tomography (CT) and a consecutive bronchoscopy (in which a radial ultrasound miniature probe was used) suggest that there is a solitary pulmonary nodule (lung cancer) in the right upper lobe. Using the guide sheath approach, the lesion can be localized by ultrasound. In a consecutive step, the probe is withdrawn – leaving the guide sheath in place – and a biopsy forceps is introduced into the guide sheath. The biopsy of this lesion reveals a mycotic disease. Diagnosis: Actinomycosis. Therapy: Long-term treatment with penicillin cures the patient. Video 2 (7,9 MB) Example for electronic linear scanning endobronchial ultrasound: EBUS-TBNA. The patient was referred to the bronchoscopy department as antibiotics treatment for pneumonia showed no response. Transbronchial lung biopsy (TBLB) showed adenocarcinoma in the left upper lobe. Enlarged lymph nodes in station 7 and 10L were diagnosed with endobronchial ultrasound-guided transbronchial needle aspiration (EBUS-TBNA). Both stations proved positive for adenocarcinoma. The sequence shows a lymph node close to the left pulmonary artery with a central echogenic structure (lymph node station 10L after the Mountain Dressler nomenclature). EBUS-TBNA was performed in station 10L lymph node close to the left atrium. The needle is nicely visualized. Diagnosis: Adenocarcinoma stage 3A. Therapy: Three cycles of neoadjuvant chemotherapy, restaging and eventually operation.

Chapter 14 Short History of the Development of Endobronchial Ultrasound – A Story of Success Becker, H.D. (Heidelberg)
p. 135	Video 1 (11,7 MB)
p. 137	Video 2 (6,8 MB)

Chapter 15 State-of-the-Art Equipment and Procedures Kurimoto, N.; Osada, H.; Miyazawa, T. (Kawasaki)
p. 143	Video 1 (6,5 MB) Video 2 (1,5 MB)

Chapter 18 Endobronchial Ultrasonography for Peripheral Pulmonary Lesions Kurimoto, N.; Osada, H.; Miyazawa, T. (Kawasaki)
p. 162	Video 1 (7,2 MB) Procedure of EBUS-GS. The lesion was located in the left S1+2ai. The ultrasonic probe was advanced to the left B1+2ai? and reached beside the lesion. The bronchoscopist changed to left B1+2ai?. The probe reached within the lesion. Video 2 (2,8 MB) Technique used to select the branch. As the first approach to the lesion was unsuccessful, the probe was withdrawn, curette was inserted into the guide sheath, and the branch was selected by the tip of the curette. After the probe reached the lesion, once again the probe was inserted into the guide sheath and the target lesion was visualized successfully.

Chapter 21 Ultrasound and Medical Thoracoscopy Michaud, G.; Ernst, A. (Boston, Mass.)
p. 182	Video 1 (16,3 MB)

Chapter 22 Endobronchial Ultrasound for Difficult Airway Problems Shirakawa, T.; Ishida, A.; Miyazu, Y.; Kurimoto, N. (Kawasaki); Iwamoto, Y. (Hiroshima); Nobuyama, S.; Miyazawa, T. (Kawasaki)
p. 196	Video 1 (7,7 MB) The first case of relapsing polychondritis. CT shows thickness of the cartilaginous portion of the central airway wall. The membranous portion seems to be intact. EBUS at left basal bronchus seems to be relatively intact. Intermediate bronchus, right main bronchus and left main bronchus are stenotic. The cartilage is thick and has an irregular surface. Its echogenicity is increased and some irregular high echoic parts can be seen in it. In the left main bronchus some lymph nodes are described beside the esophagus. Trachea is not stenotic. Tracheal cartilage is also thick and irregular.

Chapter 24 Ultrasound-Guided Drainage Procedures and Biopsies Wang, J.S.; Doelken, P. (Charleston, S.C.)
p. 210	Video 1 (1 MB) Complex septate pleural effusion adjacent to aerated lung and short axis view of cardiac apex. Video 3 (1 MB) Subpleural lung metastasis.
p. 212	Video 2 (1 MB) Large anechoic pleural effusion with a guide wire and associated reverberation artifact originating from the distal section of the wire. The wire lies against atelectatic lung.

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