{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,2]],"date-time":"2026-10-02T23:12:01Z","timestamp":1790982721506,"version":"4.1.0"},"reference-count":21,"publisher":"SAGE Publications","issue":"3","license":[{"start":{"date-parts":[[2017,3,1]],"date-time":"2017-03-01T00:00:00Z","timestamp":1488326400000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.sagepub.com\/page\/policies\/text-and-data-mining-license"}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["Journal of Endourology"],"published-print":{"date-parts":[[2017,3]]},"abstract":"\n Introduction:<\/jats:title>\n The efficiency of holmium laser lithotripsy for urolithiasis depends upon several factors, including laser pulse energy and frequency and stone composition and retropulsion. This study investigates the complex interplay between these factors and quantifies lithotripsy efficiency using different laser settings in a benchtop kidney and ureter model.<\/jats:p>\n <\/jats:sec>\n \n Materials and Methods:<\/jats:title>\n \n In vitro<\/jats:italic>\n caliceal and\n ex vivo<\/jats:italic>\n porcine ureteral models were constructed. Calcium oxalate monohydrate stones were fragmented using a 200-\u03bcm laser fiber. In the caliceal model, stone fragmentation and vaporization rates at settings of 0.6\u2009J\/5\u2009Hz, 0.2\u2009J\/15\u2009Hz, and 0.2\u2009J\/50\u2009Hz were compared. In the ureteral model, fragmentation time, retropulsion rate, fragmentation rate, and fragmented stone weight were compared at settings of 0.6\u2009J\/5\u2009Hz and 0.2\u2009J\/15\u2009Hz. Retropulsive forces generated at 0.6\u2009J\/5\u2009Hz, 0.2\u2009J\/15\u2009Hz, and 0.2\u2009J\/50\u2009Hz settings were compared. Analysis was performed using Student's\n t<\/jats:italic>\n -test and one-way ANOVA.\n <\/jats:p>\n <\/jats:sec>\n \n Results:<\/jats:title>\n \n In the caliceal model, the 0.6\u2009J\/5\u2009Hz setting fragmented and vaporized stones at a higher rate than the 0.2\u2009J\/15\u2009Hz setting (0.072\n vs<\/jats:italic>\n . 0.049\u2009mg\/s;\n p<\/jats:italic>\n \u2009<\u20090.001). However, when the 0.2\u2009J energy setting was combined with the 50\u2009Hz frequency, the fragmentation rate (0.069\u2009mg\/s) was similar to the fragmentation rate at 0.6\u2009J\/5\u2009Hz (0.072\u2009mg\/s;\n p<\/jats:italic>\n \u2009=\u20090.677). In the ureteral model, the 0.6\u2009J\/5\u2009Hz setting produced higher fragmentation rates (0.089\n vs<\/jats:italic>\n . 0.049\u2009mg\/s;\n p<\/jats:italic>\n \u2009<\u20090.001), but resulted in significantly lower fragmented stone weight overall (16.815\n vs<\/jats:italic>\n . 25.485\u2009mg;\n p<\/jats:italic>\n \u2009=\u20090.009) due to higher retropulsion rates (0.732\n vs<\/jats:italic>\n . 0.213\u2009mm\/s;\n p<\/jats:italic>\n \u2009<\u20090.001). Retropulsive forces decreased significantly when pulse energy decreased from 0.6 to 0.2\u2009J (0.907\n vs<\/jats:italic>\n . 0.223\u2009N;\n p<\/jats:italic>\n \u2009<\u20090.001). Frequency did not affect retropulsive force at 15 and 50\u2009Hz settings (0.223\n vs<\/jats:italic>\n . 0.288\u2009N;\n p<\/jats:italic>\n \u2009=\u20090.509).\n <\/jats:p>\n <\/jats:sec>\n \n Conclusions:<\/jats:title>\n Laser lithotripsy of calcium oxalate monohydrate stones in the ureter should be performed using the low-energy, moderate-frequency dusting setting to minimize retropulsion and maximize efficiency. In the renal calix, the low-energy high-frequency setting performed similarly to the high-energy low-frequency setting.<\/jats:p>\n <\/jats:sec>","DOI":"10.1089\/end.2016.0547","type":"journal-article","created":{"date-parts":[[2016,12,13]],"date-time":"2016-12-13T20:47:15Z","timestamp":1481662035000},"page":"272-277","update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":36,"title":["High-Frequency Dusting Versus Conventional Holmium Laser Lithotripsy for Intrarenal and Ureteral Calculi"],"prefix":"10.1177","volume":"31","author":[{"given":"Roger","family":"Li","sequence":"first","affiliation":[{"name":"Loma Linda University Health"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"David","family":"Ruckle","sequence":"additional","affiliation":[{"name":"Loma Linda University Health"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mohamed","family":"Keheila","sequence":"additional","affiliation":[{"name":"Loma Linda University Health"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jonathan","family":"Maldonado","sequence":"additional","affiliation":[{"name":"Loma Linda University Health"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Michelle","family":"Lightfoot","sequence":"additional","affiliation":[{"name":"Loma Linda University Health"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Muhannad","family":"Alsyouf","sequence":"additional","affiliation":[{"name":"Loma Linda University Health"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Alexander","family":"Yeo","sequence":"additional","affiliation":[{"name":"Loma Linda University Health"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Samuel R.","family":"Abourbih","sequence":"additional","affiliation":[{"name":"Loma Linda University Health"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Gaudencio","family":"Olgin","sequence":"additional","affiliation":[{"name":"Loma Linda University Health"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Javier L.","family":"Arenas","sequence":"additional","affiliation":[{"name":"Loma Linda University Health"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"D. Duane","family":"Baldwin","sequence":"additional","affiliation":[{"name":"Loma Linda University Health"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"179","published-online":{"date-parts":[[2017,3,1]]},"reference":[{"key":"e_1_3_3_2_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.juro.2015.02.2593"},{"key":"e_1_3_3_3_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.juro.2011.10.147"},{"key":"e_1_3_3_4_2","doi-asserted-by":"publisher","DOI":"10.1089\/end.2010.0115"},{"key":"e_1_3_3_5_2","doi-asserted-by":"publisher","DOI":"10.1007\/s00345-015-1504-9"},{"key":"e_1_3_3_6_2","doi-asserted-by":"publisher","DOI":"10.1007\/s00345-007-0162-y"},{"key":"e_1_3_3_7_2","doi-asserted-by":"publisher","DOI":"10.1016\/S0090-4295(98)00239-8"},{"key":"e_1_3_3_8_2","doi-asserted-by":"publisher","DOI":"10.1089\/089277901750161737"},{"key":"e_1_3_3_9_2","doi-asserted-by":"publisher","DOI":"10.1089\/end.1999.13.181"},{"key":"e_1_3_3_10_2","doi-asserted-by":"publisher","DOI":"10.1186\/1756-0500-6-80"},{"key":"e_1_3_3_11_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.juro.2006.11.078"},{"key":"e_1_3_3_12_2","doi-asserted-by":"publisher","DOI":"10.1089\/end.1998.12.183"},{"key":"e_1_3_3_13_2","doi-asserted-by":"publisher","DOI":"10.1016\/S0022-5347(01)63998-3"},{"key":"e_1_3_3_14_2","doi-asserted-by":"publisher","DOI":"10.1089\/end.1999.13.559"},{"key":"e_1_3_3_15_2","doi-asserted-by":"publisher","DOI":"10.1097\/01.ju.0000046367.49923.c6"},{"key":"e_1_3_3_16_2","doi-asserted-by":"publisher","DOI":"10.1089\/end.2005.19.1041"},{"key":"e_1_3_3_17_2","doi-asserted-by":"publisher","DOI":"10.2214\/ajr.182.4.1821039"},{"key":"e_1_3_3_18_2","doi-asserted-by":"publisher","DOI":"10.1089\/end.1996.10.527"},{"key":"e_1_3_3_19_2","doi-asserted-by":"publisher","DOI":"10.1089\/end.2008.0071"},{"key":"e_1_3_3_20_2","doi-asserted-by":"publisher","DOI":"10.1016\/S0022-5347(01)62927-6"},{"key":"e_1_3_3_21_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.juro.2013.02.2964"},{"key":"e_1_3_3_22_2","doi-asserted-by":"publisher","DOI":"10.1089\/end.2014.0175"}],"container-title":["Journal of Endourology"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/journals.sagepub.com\/doi\/full-xml\/10.1089\/end.2016.0547","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/journals.sagepub.com\/doi\/pdf\/10.1089\/end.2016.0547","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/journals.sagepub.com\/doi\/pdf\/10.1089\/end.2016.0547","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,5,25]],"date-time":"2026-05-25T07:01:52Z","timestamp":1779692512000},"score":1,"resource":{"primary":{"URL":"https:\/\/journals.sagepub.com\/doi\/10.1089\/end.2016.0547"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2017,3]]},"references-count":21,"journal-issue":{"issue":"3","published-print":{"date-parts":[[2017,3]]}},"alternative-id":["10.1089\/end.2016.0547"],"URL":"https:\/\/doi.org\/10.1089\/end.2016.0547","relation":{},"ISSN":["0892-7790","1557-900X"],"issn-type":[{"value":"0892-7790","type":"print"},{"value":"1557-900X","type":"electronic"}],"subject":[],"published":{"date-parts":[[2017,3]]}}}