Re: need help with ansers from laser doc...

July 17, 2002

When a goggle search lists a url, but then you cannot link to it, use

the " CACHED " link next to the actual url. This is the goggle copy of

the document made at the time it was indexed by the search engine.

tom

> Rick, tnx for the tips !

>

> I did a search in Google for " Laser Therapy in the

> Management of cea " but all urls " The page cannot

> be found " . If u find the url please post.

> //Kajsa.

>

> --- rdl000 <Rdl000@a...> skrev: > Kajsa,

> >

> > Geoffrey's book (and its references) are an

> > excellent start. Go to

> > Medline and do a search for lasers, rosacea, and

> > telangiectasia

> > (assuming your spelling is better than mine ...).

> > Also, some time

> > ago, I posted a URL to a special issue of the

> > Journal of Cutaneous

> > Medicine and Surgery, Volume 2, Supplement 4, June,

> > 1998 which is

> > devoted to rosacea. In there is an article on

> > " Laser Therapy in the

> > Management of cea " by Laughlin and Dudley.

> > (BTW, they do not

> > even

> > mention photoderm, perhaps for reasons other than it

> > doesn't fit the

> > 'laser' title.)

> >

> > Also, track down the website for ESC (maker of the

> > photoderm machine)

> > and read their side of the photoderm / pulsed-dye

> > laser debate.

> >

> > If I get a chance, I'll try to get these URLs off my

> > office-machine

> > bookmarks.

> >

> > Rickl

>

> _____________________________________________________

> Gratis e-mail resten av livet på www.yahoo.se/mail

> Busenkelt!

July 17, 2002

When a goggle search lists a url, but then you cannot link to it, use

the " CACHED " link next to the actual url. This is the goggle copy of

the document made at the time it was indexed by the search engine.

tom

> Rick, tnx for the tips !

>

> I did a search in Google for " Laser Therapy in the

> Management of cea " but all urls " The page cannot

> be found " . If u find the url please post.

> //Kajsa.

>

> --- rdl000 <Rdl000@a...> skrev: > Kajsa,

> >

> > Geoffrey's book (and its references) are an

> > excellent start. Go to

> > Medline and do a search for lasers, rosacea, and

> > telangiectasia

> > (assuming your spelling is better than mine ...).

> > Also, some time

> > ago, I posted a URL to a special issue of the

> > Journal of Cutaneous

> > Medicine and Surgery, Volume 2, Supplement 4, June,

> > 1998 which is

> > devoted to rosacea. In there is an article on

> > " Laser Therapy in the

> > Management of cea " by Laughlin and Dudley.

> > (BTW, they do not

> > even

> > mention photoderm, perhaps for reasons other than it

> > doesn't fit the

> > 'laser' title.)

> >

> > Also, track down the website for ESC (maker of the

> > photoderm machine)

> > and read their side of the photoderm / pulsed-dye

> > laser debate.

> >

> > If I get a chance, I'll try to get these URLs off my

> > office-machine

> > bookmarks.

> >

> > Rickl

>

> _____________________________________________________

> Gratis e-mail resten av livet på www.yahoo.se/mail

> Busenkelt!

July 17, 2002

Tom,

tnx, I have never known that, it was a great tip!

//Kajsa.

--- tommy7ro skrev: > When a

goggle search lists a url, but then you

> cannot link to it, use

> the " CACHED " link next to the actual url. This is

> the goggle copy of

> the document made at the time it was indexed by the

> search engine.

>

> tom

>

> > Rick, tnx for the tips !

> >

> > I did a search in Google for " Laser Therapy in the

> > Management of cea " but all urls " The page

> cannot

> > be found " . If u find the url please post.

> > //Kajsa.

> >

> > --- rdl000 <Rdl000@a...> skrev: > Kajsa,

> > >

> > > Geoffrey's book (and its references) are an

> > > excellent start. Go to

> > > Medline and do a search for lasers, rosacea, and

> > > telangiectasia

> > > (assuming your spelling is better than mine

> ...).

> > > Also, some time

> > > ago, I posted a URL to a special issue of the

> > > Journal of Cutaneous

> > > Medicine and Surgery, Volume 2, Supplement 4,

> June,

> > > 1998 which is

> > > devoted to rosacea. In there is an article on

> > > " Laser Therapy in the

> > > Management of cea " by Laughlin and Dudley.

> > > (BTW, they do not

> > > even

> > > mention photoderm, perhaps for reasons other

> than it

> > > doesn't fit the

> > > 'laser' title.)

> > >

> > > Also, track down the website for ESC (maker of

> the

> > > photoderm machine)

> > > and read their side of the photoderm /

> pulsed-dye

> > > laser debate.

> > >

> > > If I get a chance, I'll try to get these URLs

> off my

> > > office-machine

> > > bookmarks.

> > >

> > > Rickl

_____________________________________________________

Gratis e-mail resten av livet på www.yahoo.se/mail

Busenkelt!

July 17, 2002

Tom,

tnx, I have never known that, it was a great tip!

//Kajsa.

--- tommy7ro skrev: > When a

goggle search lists a url, but then you

> cannot link to it, use

> the " CACHED " link next to the actual url. This is

> the goggle copy of

> the document made at the time it was indexed by the

> search engine.

>

> tom

>

> > Rick, tnx for the tips !

> >

> > I did a search in Google for " Laser Therapy in the

> > Management of cea " but all urls " The page

> cannot

> > be found " . If u find the url please post.

> > //Kajsa.

> >

> > --- rdl000 <Rdl000@a...> skrev: > Kajsa,

> > >

> > > Geoffrey's book (and its references) are an

> > > excellent start. Go to

> > > Medline and do a search for lasers, rosacea, and

> > > telangiectasia

> > > (assuming your spelling is better than mine

> ...).

> > > Also, some time

> > > ago, I posted a URL to a special issue of the

> > > Journal of Cutaneous

> > > Medicine and Surgery, Volume 2, Supplement 4,

> June,

> > > 1998 which is

> > > devoted to rosacea. In there is an article on

> > > " Laser Therapy in the

> > > Management of cea " by Laughlin and Dudley.

> > > (BTW, they do not

> > > even

> > > mention photoderm, perhaps for reasons other

> than it

> > > doesn't fit the

> > > 'laser' title.)

> > >

> > > Also, track down the website for ESC (maker of

> the

> > > photoderm machine)

> > > and read their side of the photoderm /

> pulsed-dye

> > > laser debate.

> > >

> > > If I get a chance, I'll try to get these URLs

> off my

> > > office-machine

> > > bookmarks.

> > >

> > > Rickl

_____________________________________________________

Gratis e-mail resten av livet på www.yahoo.se/mail

Busenkelt!

July 17, 2002

Tom,

tnx, I have never known that, it was a great tip!

//Kajsa.

--- tommy7ro skrev: > When a

goggle search lists a url, but then you

> cannot link to it, use

> the " CACHED " link next to the actual url. This is

> the goggle copy of

> the document made at the time it was indexed by the

> search engine.

>

> tom

>

> > Rick, tnx for the tips !

> >

> > I did a search in Google for " Laser Therapy in the

> > Management of cea " but all urls " The page

> cannot

> > be found " . If u find the url please post.

> > //Kajsa.

> >

> > --- rdl000 <Rdl000@a...> skrev: > Kajsa,

> > >

> > > Geoffrey's book (and its references) are an

> > > excellent start. Go to

> > > Medline and do a search for lasers, rosacea, and

> > > telangiectasia

> > > (assuming your spelling is better than mine

> ...).

> > > Also, some time

> > > ago, I posted a URL to a special issue of the

> > > Journal of Cutaneous

> > > Medicine and Surgery, Volume 2, Supplement 4,

> June,

> > > 1998 which is

> > > devoted to rosacea. In there is an article on

> > > " Laser Therapy in the

> > > Management of cea " by Laughlin and Dudley.

> > > (BTW, they do not

> > > even

> > > mention photoderm, perhaps for reasons other

> than it

> > > doesn't fit the

> > > 'laser' title.)

> > >

> > > Also, track down the website for ESC (maker of

> the

> > > photoderm machine)

> > > and read their side of the photoderm /

> pulsed-dye

> > > laser debate.

> > >

> > > If I get a chance, I'll try to get these URLs

> off my

> > > office-machine

> > > bookmarks.

> > >

> > > Rickl

_____________________________________________________

Gratis e-mail resten av livet på www.yahoo.se/mail

Busenkelt!

July 17, 2002

Tom,

tnx, I have never known that, it was a great tip!

//Kajsa.

--- tommy7ro skrev: > When a

goggle search lists a url, but then you

> cannot link to it, use

> the " CACHED " link next to the actual url. This is

> the goggle copy of

> the document made at the time it was indexed by the

> search engine.

>

> tom

>

> > Rick, tnx for the tips !

> >

> > I did a search in Google for " Laser Therapy in the

> > Management of cea " but all urls " The page

> cannot

> > be found " . If u find the url please post.

> > //Kajsa.

> >

> > --- rdl000 <Rdl000@a...> skrev: > Kajsa,

> > >

> > > Geoffrey's book (and its references) are an

> > > excellent start. Go to

> > > Medline and do a search for lasers, rosacea, and

> > > telangiectasia

> > > (assuming your spelling is better than mine

> ...).

> > > Also, some time

> > > ago, I posted a URL to a special issue of the

> > > Journal of Cutaneous

> > > Medicine and Surgery, Volume 2, Supplement 4,

> June,

> > > 1998 which is

> > > devoted to rosacea. In there is an article on

> > > " Laser Therapy in the

> > > Management of cea " by Laughlin and Dudley.

> > > (BTW, they do not

> > > even

> > > mention photoderm, perhaps for reasons other

> than it

> > > doesn't fit the

> > > 'laser' title.)

> > >

> > > Also, track down the website for ESC (maker of

> the

> > > photoderm machine)

> > > and read their side of the photoderm /

> pulsed-dye

> > > laser debate.

> > >

> > > If I get a chance, I'll try to get these URLs

> off my

> > > office-machine

> > > bookmarks.

> > >

> > > Rickl

_____________________________________________________

Gratis e-mail resten av livet på www.yahoo.se/mail

Busenkelt!

July 17, 2002

Really interesting thought, . I don't know if the speed or

intensity of vessel heating has a role in its effectiveness, side

effects, or (and this is most interesting to me) subsequent

compensatory mechanisms. For example, might slooowwwwly destroying a

vessel over many sessions less likely to evoke sudden compensatory

mechanisms that might undo the benefits? Or even more intriguing --

perhaps we don't need to explode or implode a vessel, perhaps

partially paralyzing arterial function and so limiting its blood flow

is enough.

I don't know, I don't know, I don't know...

Marjorie

Marjorie Lazoff, MD

> I've been wondering about the effect of lasers on vessels also,

> in terms of how the vessels respond to the heating. The idea that

> the only way to truly eliminate the vessels is to " cook " them seems

> correct. However, the idea that the only options are to " explode "

a

> vessel (I guess boiling the substances inside so they heat enough

to

> increase pressure on the vessel wall and burst it) and not treat it

> at all seems a bit extreme. One would think this is precisely the

> point of developing a better laser, to avoid this all-or-nothing

> scenario.

> I'm certainly not a doctor and have only a limited knowledge of

> laser treatment, so I'm only throwing this out here, poor analogy

and

> all. Can we compare this situation to cooking? Where if you heat

> too fast with too much energy something explodes (potato in the

> microwave) versus heating it more slowly and consistently (laser

> pulses) to effectively " cook " the vessel proteins (a potato in a

> conventional oven, perhaps?). This has been my understanding of

the

> newer lasers like Photoderm and Vbeam. Of course, after heating

and

> shriveling a vessel more slowly, does it disappear through natural

> disposal processes in the body or where does it go?

> Any opinions on this line of thought?

>

July 17, 2002

Really interesting thought, . I don't know if the speed or

intensity of vessel heating has a role in its effectiveness, side

effects, or (and this is most interesting to me) subsequent

compensatory mechanisms. For example, might slooowwwwly destroying a

vessel over many sessions less likely to evoke sudden compensatory

mechanisms that might undo the benefits? Or even more intriguing --

perhaps we don't need to explode or implode a vessel, perhaps

partially paralyzing arterial function and so limiting its blood flow

is enough.

I don't know, I don't know, I don't know...

Marjorie

Marjorie Lazoff, MD

> I've been wondering about the effect of lasers on vessels also,

> in terms of how the vessels respond to the heating. The idea that

> the only way to truly eliminate the vessels is to " cook " them seems

> correct. However, the idea that the only options are to " explode "

a

> vessel (I guess boiling the substances inside so they heat enough

to

> increase pressure on the vessel wall and burst it) and not treat it

> at all seems a bit extreme. One would think this is precisely the

> point of developing a better laser, to avoid this all-or-nothing

> scenario.

> I'm certainly not a doctor and have only a limited knowledge of

> laser treatment, so I'm only throwing this out here, poor analogy

and

> all. Can we compare this situation to cooking? Where if you heat

> too fast with too much energy something explodes (potato in the

> microwave) versus heating it more slowly and consistently (laser

> pulses) to effectively " cook " the vessel proteins (a potato in a

> conventional oven, perhaps?). This has been my understanding of

the

> newer lasers like Photoderm and Vbeam. Of course, after heating

and

> shriveling a vessel more slowly, does it disappear through natural

> disposal processes in the body or where does it go?

> Any opinions on this line of thought?

>

July 17, 2002

Really interesting thought, . I don't know if the speed or

intensity of vessel heating has a role in its effectiveness, side

effects, or (and this is most interesting to me) subsequent

compensatory mechanisms. For example, might slooowwwwly destroying a

vessel over many sessions less likely to evoke sudden compensatory

mechanisms that might undo the benefits? Or even more intriguing --

perhaps we don't need to explode or implode a vessel, perhaps

partially paralyzing arterial function and so limiting its blood flow

is enough.

I don't know, I don't know, I don't know...

Marjorie

Marjorie Lazoff, MD

> I've been wondering about the effect of lasers on vessels also,

> in terms of how the vessels respond to the heating. The idea that

> the only way to truly eliminate the vessels is to " cook " them seems

> correct. However, the idea that the only options are to " explode "

a

> vessel (I guess boiling the substances inside so they heat enough

to

> increase pressure on the vessel wall and burst it) and not treat it

> at all seems a bit extreme. One would think this is precisely the

> point of developing a better laser, to avoid this all-or-nothing

> scenario.

> I'm certainly not a doctor and have only a limited knowledge of

> laser treatment, so I'm only throwing this out here, poor analogy

and

> all. Can we compare this situation to cooking? Where if you heat

> too fast with too much energy something explodes (potato in the

> microwave) versus heating it more slowly and consistently (laser

> pulses) to effectively " cook " the vessel proteins (a potato in a

> conventional oven, perhaps?). This has been my understanding of

the

> newer lasers like Photoderm and Vbeam. Of course, after heating

and

> shriveling a vessel more slowly, does it disappear through natural

> disposal processes in the body or where does it go?

> Any opinions on this line of thought?

>

July 17, 2002

Really interesting thought, . I don't know if the speed or

intensity of vessel heating has a role in its effectiveness, side

effects, or (and this is most interesting to me) subsequent

compensatory mechanisms. For example, might slooowwwwly destroying a

vessel over many sessions less likely to evoke sudden compensatory

mechanisms that might undo the benefits? Or even more intriguing --

perhaps we don't need to explode or implode a vessel, perhaps

partially paralyzing arterial function and so limiting its blood flow

is enough.

I don't know, I don't know, I don't know...

Marjorie

Marjorie Lazoff, MD

> I've been wondering about the effect of lasers on vessels also,

> in terms of how the vessels respond to the heating. The idea that

> the only way to truly eliminate the vessels is to " cook " them seems

> correct. However, the idea that the only options are to " explode "

a

> vessel (I guess boiling the substances inside so they heat enough

to

> increase pressure on the vessel wall and burst it) and not treat it

> at all seems a bit extreme. One would think this is precisely the

> point of developing a better laser, to avoid this all-or-nothing

> scenario.

> I'm certainly not a doctor and have only a limited knowledge of

> laser treatment, so I'm only throwing this out here, poor analogy

and

> all. Can we compare this situation to cooking? Where if you heat

> too fast with too much energy something explodes (potato in the

> microwave) versus heating it more slowly and consistently (laser

> pulses) to effectively " cook " the vessel proteins (a potato in a

> conventional oven, perhaps?). This has been my understanding of

the

> newer lasers like Photoderm and Vbeam. Of course, after heating

and

> shriveling a vessel more slowly, does it disappear through natural

> disposal processes in the body or where does it go?

> Any opinions on this line of thought?

>

July 18, 2002

> IMHO, there is no such thing as a free

> lunch here: if you want the vessels to disappear, then they have to

> be exploded. Period. Check out the ESC web site and see if you can

> find anything there. Been awhile since I've looked, but Geoffrey

does

> reference a computer simulation they did supporting their claims

for

> photoderm vessel elimination.

Rick, I couldn't find the computer simulation you discussed below,

but here's a question: I understand why a vein needs to be totally

destroyed for the telangiectasia to disappear, but why does an artery

need to explode/implode for flushing to decrease?

> > Is that what you mean by flushing migration?

>

> Actually, I meant flushing mitigation, not migration.

Of course you did. It's just not what I misread. <g>

> But I believe

> you are right, based on what Geoffrey has written, that the vessels

> will return after treatment, possibly to a greater extent since,

> after all, you are a rosacean, and rosaceans do have enhanced

> facial vessel structure (I think) which will ultimately return.

You must be a hammer, because you just nailed what I've been worried

about in these past few posts. <g>

> You ask about permanent decreased flushing. I would suggest no one

> knows, since there are no publications supporting these claims.

> Braverman at Yale, a microcirculation expert, told me he did not

> believe that laser (or IPL) treatments could cause observable

> reduction in flushing mechanisms. He would be the person I would

most

> trust to answer your questions, since he is not a laser surgeon,

and

> hence has no vested interest in the efficacy of these treatments.

Did you ask him *why* he doesn't believe these treatments can work.

Is Braverman (microcirculation expert) involved in any research

rosacea-ish?

Marjorie

Marjorie Lazoff, MD

July 18, 2002

> IMHO, there is no such thing as a free

> lunch here: if you want the vessels to disappear, then they have to

> be exploded. Period. Check out the ESC web site and see if you can

> find anything there. Been awhile since I've looked, but Geoffrey

does

> reference a computer simulation they did supporting their claims

for

> photoderm vessel elimination.

Rick, I couldn't find the computer simulation you discussed below,

but here's a question: I understand why a vein needs to be totally

destroyed for the telangiectasia to disappear, but why does an artery

need to explode/implode for flushing to decrease?

> > Is that what you mean by flushing migration?

>

> Actually, I meant flushing mitigation, not migration.

Of course you did. It's just not what I misread. <g>

> But I believe

> you are right, based on what Geoffrey has written, that the vessels

> will return after treatment, possibly to a greater extent since,

> after all, you are a rosacean, and rosaceans do have enhanced

> facial vessel structure (I think) which will ultimately return.

You must be a hammer, because you just nailed what I've been worried

about in these past few posts. <g>

> You ask about permanent decreased flushing. I would suggest no one

> knows, since there are no publications supporting these claims.

> Braverman at Yale, a microcirculation expert, told me he did not

> believe that laser (or IPL) treatments could cause observable

> reduction in flushing mechanisms. He would be the person I would

most

> trust to answer your questions, since he is not a laser surgeon,

and

> hence has no vested interest in the efficacy of these treatments.

Did you ask him *why* he doesn't believe these treatments can work.

Is Braverman (microcirculation expert) involved in any research

rosacea-ish?

Marjorie

Marjorie Lazoff, MD

July 18, 2002

> IMHO, there is no such thing as a free

> lunch here: if you want the vessels to disappear, then they have to

> be exploded. Period. Check out the ESC web site and see if you can

> find anything there. Been awhile since I've looked, but Geoffrey

does

> reference a computer simulation they did supporting their claims

for

> photoderm vessel elimination.

Rick, I couldn't find the computer simulation you discussed below,

but here's a question: I understand why a vein needs to be totally

destroyed for the telangiectasia to disappear, but why does an artery

need to explode/implode for flushing to decrease?

> > Is that what you mean by flushing migration?

>

> Actually, I meant flushing mitigation, not migration.

Of course you did. It's just not what I misread. <g>

> But I believe

> you are right, based on what Geoffrey has written, that the vessels

> will return after treatment, possibly to a greater extent since,

> after all, you are a rosacean, and rosaceans do have enhanced

> facial vessel structure (I think) which will ultimately return.

You must be a hammer, because you just nailed what I've been worried

about in these past few posts. <g>

> You ask about permanent decreased flushing. I would suggest no one

> knows, since there are no publications supporting these claims.

> Braverman at Yale, a microcirculation expert, told me he did not

> believe that laser (or IPL) treatments could cause observable

> reduction in flushing mechanisms. He would be the person I would

most

> trust to answer your questions, since he is not a laser surgeon,

and

> hence has no vested interest in the efficacy of these treatments.

Did you ask him *why* he doesn't believe these treatments can work.

Is Braverman (microcirculation expert) involved in any research

rosacea-ish?

Marjorie

Marjorie Lazoff, MD

July 18, 2002

> IMHO, there is no such thing as a free

> lunch here: if you want the vessels to disappear, then they have to

> be exploded. Period. Check out the ESC web site and see if you can

> find anything there. Been awhile since I've looked, but Geoffrey

does

> reference a computer simulation they did supporting their claims

for

> photoderm vessel elimination.

Rick, I couldn't find the computer simulation you discussed below,

but here's a question: I understand why a vein needs to be totally

destroyed for the telangiectasia to disappear, but why does an artery

need to explode/implode for flushing to decrease?

> > Is that what you mean by flushing migration?

>

> Actually, I meant flushing mitigation, not migration.

Of course you did. It's just not what I misread. <g>

> But I believe

> you are right, based on what Geoffrey has written, that the vessels

> will return after treatment, possibly to a greater extent since,

> after all, you are a rosacean, and rosaceans do have enhanced

> facial vessel structure (I think) which will ultimately return.

You must be a hammer, because you just nailed what I've been worried

about in these past few posts. <g>

> You ask about permanent decreased flushing. I would suggest no one

> knows, since there are no publications supporting these claims.

> Braverman at Yale, a microcirculation expert, told me he did not

> believe that laser (or IPL) treatments could cause observable

> reduction in flushing mechanisms. He would be the person I would

most

> trust to answer your questions, since he is not a laser surgeon,

and

> hence has no vested interest in the efficacy of these treatments.

Did you ask him *why* he doesn't believe these treatments can work.

Is Braverman (microcirculation expert) involved in any research

rosacea-ish?

Marjorie

Marjorie Lazoff, MD

July 18, 2002

Marjorie,

Good (and tough to answer) questions, as always.

> Rick, I couldn't find the computer simulation you discussed below,

> but here's a question: I understand why a vein needs to be totally

> destroyed for the telangiectasia to disappear, but why does an

artery

> need to explode/implode for flushing to decrease?

My stock answer: I don't know. My speculation: there are many

mediators of flushing (SNS, histamine, possibly NO, ...). One

suggestion could be that, assuming one can only eliminate a small

fraction of the small, shallow, vessels near the surface, these

mediators could well be enough to initiate flusing. One thing I

wonder about is do I flush because I have too many small vessels near

my facial skin, or do I flush because I have an overactive SNS and/or

a defective thermoregulartory function? If it is the former, than

perhaps destruction will produce modest improvement; if the it is the

later, than its seems logical to expect less improvement.

Wilkin (agreed: I will not reopen our debate on his work ...!) did

publish two papers a while ago measuring (separately) impact of

clonidine and nadadol (usual pathetic spelling here) on flushing

induced by having roascean drink hot beverage. His net was that

neither impacted flushing as initated by hot beverage. Yet others

swear by these drugs (antedotially) as helping with stress-induced

flushing. Not sure why I bring this up, other that I think is clear

that flushing mechanisms are very poorly understood even today, and

hence it is difficult (for me) to comment on whether eliminating some

probably small fraction of the surface vessels/capaillaries will make

a difference. My usual soapbox argument: get a laser doppler device

(, to his credit, was determined to rent one - I like his style

....) and measure it like Drummond has done. I have not seen

the similuation - it appears as a reference in Nase book. Renamed

ESC website appears (at quick glance) to have dropped some of its more

technical application notesb.

Did you ask him *why* he doesn't believe these treatments can work.

>

> Is Braverman (microcirculation expert) involved in any research

> rosacea-ish?

Braverman wrote standard text on microcirculation. He is not all

into rosacea research. Indeed, when he examined me, he initially said

that I did not have rosacea because I had no papules, which of course

reflects the view from a few years ago before rosacea was recognized

primarily as a vascular condition removed from acne. I am reluctant

to mention this because clinical medicine is more of a hobby for him -

he is a serious academic, and in no way do I expect him to be up on

clinical aspects of rosacea. (I know a bit about computer

architecture, but am have as much trouble as anyone fixing Windows

problems ...). He spent an amazing amount of time with me (his nurse

was badgering him endlessly to move on) simply because he was very

interested in the IPL physics. I believe his feeling is that

rosaceans have such an excess of facial vessels (capillaries - my

pathetic med bkgd here ...) that it would take a laser-like bulldozer

to nail them, and this could cause other, more serious issues. I will

send you his coordinates privately, since you obviously raise informed

questions that he can address with infinite more authority than I.

Rick

July 18, 2002