Fragmentation of uric acid calculi with the holmium: YAG laser produces cyanide

Robin L. Zagone, Todd M. Waldmann, Michael Conlin

    Research output: Contribution to journalArticle

    6 Citations (Scopus)

    Abstract

    Background and Objectives: To independently test previously reported findings of cyanide evolution under holmium:yttrium aluminum garnet (Ho:YAG) (holmium) lithotripsy of uric acid calculi, determine if this occurs with other forms of intracorporeal lithotripsy, and establish if this occurs due to a photothermal, photochemical, or photo-acoustic reaction. Study Design/Materials and Methods: Human uric acid calculi were fragmented in vitro through exposure to holmium, ultrasound, and electrohydraulic (EHL) energy sources. The following parameters were varied: total laser energy, individual laser pulse energy, ultrasonic energies, and EHL energies. Uric acid powder was suspended in solution and exposed to holmium laser energy in vitro. Serum and irrigant samples from a human patient were collected following intrarenal holmium lithotripsy of a uric acid calculus. All samples were analyzed for hydrogen cyanide (HCN) content. Results: Holmium lithotripsy of solid uric acid calculi produces cyanide. The yield is linearly dependent upon total laser energy delivered. Pulse energy does not affect cyanide yield. Photothermal mechanisms coupling laser energy to the solid crystal lattice are responsible for the production of cyanide. Ultrasound and EHL lithotripsy do not produce cyanide. A clinically insignificant level of cyanide was detected in the blood of a single patient following laser lithotripsy of a uric acid calculus. Conclusions: Our study confirms that cyanide is produced by a photothermal mechanism during holmium laser lithotripsy of uric acid calculi, and that the amount produced is clinically insignificant.

    Original languageEnglish (US)
    Pages (from-to)230-232
    Number of pages3
    JournalLasers in Surgery and Medicine
    Volume31
    Issue number4
    DOIs
    StatePublished - Oct 30 2002

    Fingerprint

    Solid-State Lasers
    Calculi
    Holmium
    Cyanides
    Uric Acid
    Lithotripsy
    Lasers
    Laser Lithotripsy
    Hydrogen Cyanide
    Acoustics
    Ultrasonics
    Powders
    Serum

    Keywords

    • Cyanide
    • Lithotripsy
    • Uric acid
    • Urolithiasis

    ASJC Scopus subject areas

    • Surgery
    • Dermatology

    Cite this

    Fragmentation of uric acid calculi with the holmium : YAG laser produces cyanide. / Zagone, Robin L.; Waldmann, Todd M.; Conlin, Michael.

    In: Lasers in Surgery and Medicine, Vol. 31, No. 4, 30.10.2002, p. 230-232.

    Research output: Contribution to journalArticle

    @article{388f96bcffb24729b291caa9367d1882,
    title = "Fragmentation of uric acid calculi with the holmium: YAG laser produces cyanide",
    abstract = "Background and Objectives: To independently test previously reported findings of cyanide evolution under holmium:yttrium aluminum garnet (Ho:YAG) (holmium) lithotripsy of uric acid calculi, determine if this occurs with other forms of intracorporeal lithotripsy, and establish if this occurs due to a photothermal, photochemical, or photo-acoustic reaction. Study Design/Materials and Methods: Human uric acid calculi were fragmented in vitro through exposure to holmium, ultrasound, and electrohydraulic (EHL) energy sources. The following parameters were varied: total laser energy, individual laser pulse energy, ultrasonic energies, and EHL energies. Uric acid powder was suspended in solution and exposed to holmium laser energy in vitro. Serum and irrigant samples from a human patient were collected following intrarenal holmium lithotripsy of a uric acid calculus. All samples were analyzed for hydrogen cyanide (HCN) content. Results: Holmium lithotripsy of solid uric acid calculi produces cyanide. The yield is linearly dependent upon total laser energy delivered. Pulse energy does not affect cyanide yield. Photothermal mechanisms coupling laser energy to the solid crystal lattice are responsible for the production of cyanide. Ultrasound and EHL lithotripsy do not produce cyanide. A clinically insignificant level of cyanide was detected in the blood of a single patient following laser lithotripsy of a uric acid calculus. Conclusions: Our study confirms that cyanide is produced by a photothermal mechanism during holmium laser lithotripsy of uric acid calculi, and that the amount produced is clinically insignificant.",
    keywords = "Cyanide, Lithotripsy, Uric acid, Urolithiasis",
    author = "Zagone, {Robin L.} and Waldmann, {Todd M.} and Michael Conlin",
    year = "2002",
    month = "10",
    day = "30",
    doi = "10.1002/lsm.10094",
    language = "English (US)",
    volume = "31",
    pages = "230--232",
    journal = "Lasers in Surgery and Medicine",
    issn = "0196-8092",
    publisher = "Wiley-Liss Inc.",
    number = "4",

    }

    TY - JOUR

    T1 - Fragmentation of uric acid calculi with the holmium

    T2 - YAG laser produces cyanide

    AU - Zagone, Robin L.

    AU - Waldmann, Todd M.

    AU - Conlin, Michael

    PY - 2002/10/30

    Y1 - 2002/10/30

    N2 - Background and Objectives: To independently test previously reported findings of cyanide evolution under holmium:yttrium aluminum garnet (Ho:YAG) (holmium) lithotripsy of uric acid calculi, determine if this occurs with other forms of intracorporeal lithotripsy, and establish if this occurs due to a photothermal, photochemical, or photo-acoustic reaction. Study Design/Materials and Methods: Human uric acid calculi were fragmented in vitro through exposure to holmium, ultrasound, and electrohydraulic (EHL) energy sources. The following parameters were varied: total laser energy, individual laser pulse energy, ultrasonic energies, and EHL energies. Uric acid powder was suspended in solution and exposed to holmium laser energy in vitro. Serum and irrigant samples from a human patient were collected following intrarenal holmium lithotripsy of a uric acid calculus. All samples were analyzed for hydrogen cyanide (HCN) content. Results: Holmium lithotripsy of solid uric acid calculi produces cyanide. The yield is linearly dependent upon total laser energy delivered. Pulse energy does not affect cyanide yield. Photothermal mechanisms coupling laser energy to the solid crystal lattice are responsible for the production of cyanide. Ultrasound and EHL lithotripsy do not produce cyanide. A clinically insignificant level of cyanide was detected in the blood of a single patient following laser lithotripsy of a uric acid calculus. Conclusions: Our study confirms that cyanide is produced by a photothermal mechanism during holmium laser lithotripsy of uric acid calculi, and that the amount produced is clinically insignificant.

    AB - Background and Objectives: To independently test previously reported findings of cyanide evolution under holmium:yttrium aluminum garnet (Ho:YAG) (holmium) lithotripsy of uric acid calculi, determine if this occurs with other forms of intracorporeal lithotripsy, and establish if this occurs due to a photothermal, photochemical, or photo-acoustic reaction. Study Design/Materials and Methods: Human uric acid calculi were fragmented in vitro through exposure to holmium, ultrasound, and electrohydraulic (EHL) energy sources. The following parameters were varied: total laser energy, individual laser pulse energy, ultrasonic energies, and EHL energies. Uric acid powder was suspended in solution and exposed to holmium laser energy in vitro. Serum and irrigant samples from a human patient were collected following intrarenal holmium lithotripsy of a uric acid calculus. All samples were analyzed for hydrogen cyanide (HCN) content. Results: Holmium lithotripsy of solid uric acid calculi produces cyanide. The yield is linearly dependent upon total laser energy delivered. Pulse energy does not affect cyanide yield. Photothermal mechanisms coupling laser energy to the solid crystal lattice are responsible for the production of cyanide. Ultrasound and EHL lithotripsy do not produce cyanide. A clinically insignificant level of cyanide was detected in the blood of a single patient following laser lithotripsy of a uric acid calculus. Conclusions: Our study confirms that cyanide is produced by a photothermal mechanism during holmium laser lithotripsy of uric acid calculi, and that the amount produced is clinically insignificant.

    KW - Cyanide

    KW - Lithotripsy

    KW - Uric acid

    KW - Urolithiasis

    UR - http://www.scopus.com/inward/record.url?scp=0036398790&partnerID=8YFLogxK

    UR - http://www.scopus.com/inward/citedby.url?scp=0036398790&partnerID=8YFLogxK

    U2 - 10.1002/lsm.10094

    DO - 10.1002/lsm.10094

    M3 - Article

    C2 - 12355566

    AN - SCOPUS:0036398790

    VL - 31

    SP - 230

    EP - 232

    JO - Lasers in Surgery and Medicine

    JF - Lasers in Surgery and Medicine

    SN - 0196-8092

    IS - 4

    ER -