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+/- Laser resurfacing FIGURE 26-4 Treatment algorithm for boxcar scars peels for the treatment of scars, the modified phenol peels are making a comeback DERMABRASION Dermabrasion attempts to level down normal skin so that it is brought close to the depth of the scar; this method is very effective in creating a new contour plane However, the depth of the plane that can be achieved with dermabrasion is limited as extensively deep abrading can cause additional scarring Wounding to the depth of papillary dermis produces tightening while a wound in the upper reticular dermis results in leveling The presence of pinpoint bleeding indicates abrasion to the level of the papillary dermis while continued abrasion reveals the parallel lines of the superficial reticular dermis When frayed white strands of collagen are evident, the mid-reticular dermis is visible and this should be an absolute endpoint as further invasion may lead to additional scarring For a detailed description on the technique of dermabrasion, we refer the reader to articles by Bradley and Park17 as well as Orentreich and Orentreich18 LASERS Both ablative and nonablative laser resurfacing have been effective in treating facial scarring, and these are discussed in detail below19 24 Ablative lasers Ablative laser resurfacing targets and vaporizes water-containing tissue, thereby allowing epidermal renewal as well as the reorientation and regeneration of collagen fibers in the superficial dermis25 27 The CO2 laser has a wavelength of 10,600 nm and primarily targets water in the epidermis and superficial dermis The Er:YAG laser has a wavelength of 2940 nm, which corresponds to the peak absorption coefficient of water This laser produces minimal thermal injury, thereby resulting in faster reepithelialization and an improved side-effect profile, but less vascular coagulation as well as reduced collagen contraction and remodeling28,29 Combined CO2/Er:YAG is a commonly used treatment modality because it avoids many of the side effects encountered with pure CO2 laser treatment while still producing a satisfying result30 Following the procedure, an occlusive dressing is applied for 2 days; for a comprehensive review of occlusive dressings, we refer the reader to a review article by Newman et al31 A postprocedure wound care regimen consists of Domeboro compresses (Bayer Corp, Morristown, NJ) every 4 hours and Aquaphor Healing Ointment or Biafine (OrthoNeutrogena, Skillman, NJ) Re-epithelialization typically occurs in 7 to 10 days If an occlusive dressing is used for more than 48 hours, prophylaxis with a first-generation cephalosporin and fluconazole is recommended for 4 days, starting the day of the procedure3 Fractional photothermolysis To date, there have been few controlled studies regarding the impact of fractional photothermolysis (Fraxel Laser, Reliant Technologies, Inc, Mountain View, CA) for treatment of scars; however, this relatively new modality has had reported success in the treatment of hypertrophic scars32 and atrophic scars33 35 Fractional photothermolysis creates hundreds to thousands of microthermal zones (MTZ), or microscopic columns of thermal injury, sparing the tissue surrounding each zone35 37 Fractional photothermolysis has a 1550-nm wavelength and targets tissue water but not melanin, allowing its use in patients with all skin types; the depth of penetration is approximately 1500 m The fractional heating of the chromophore avoids bulk heating of the skin and reduces the risk of thermal injury to the dermis thereby minimizing the chance of worsening.



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The Get-Process cmdlet returns a list of all of the processes on this computer, and the where cmdlet selects those processes where the StartTime property of the process is greater than or equal to today.

This result holds provided that n 1 The case when n = 1 introduces us to an interesting phenomena or feature of complex integration This is the fact that the contour we select for our integration will determine what the result is First let s do the integral

The where used in the previous example is an alias for the WhereObject cmdlet, which is described in chapter 6.





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This completes our discussion of the behavior of the comparison operators with scalar data. We paid a lot of attention to the role types play in comparisons, but so far we ve avoided discussing collection types lists, arrays and so on. We ll get to that in the next section. 4.3.2 Using comparison operators with collections In this section, we focus on the behavior of the comparison operators when they are used with collections of objects. Basic comparison operations involving collections Here is the basic behavior. If the left operand is an array or collection, then the comparison operation will return the elements of that collection which match the right operand. Let s illustrate the rule with an example:

using Eq (611), choosing the unit circle as our contour and letting 0 t 2 So, (t ) = eit Then we have

This expression searches the list of numbers on the left side and returns those that match the two 2 s. And of course this works with strings as well:

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When processing the array, the scalar comparison rules are used to compare each element. In the next example, the left operand is an array containing a mix of numbers and strings, and the right operand is the string 2 .

Let s look at the integration another way Now, the domain of f ( z ) = 1 / z is the complex plane less the origin We write this formally as \ {0} The antiderivative of f ( z ) is F ( z ) = ln z = ln r + i The domain of the antiderivative is \ ( ,0] We can do the integral avoiding \ ( ,0] by taking the contour shown in Fig 66 (notice it is not a closed contour) To do the integral with this contour, we choose a = re i , b = rei Note that ln(b) = ln(rei ) = ln r + i ln(a) = ln(re i ) = ln r i Using the fundamental theorem of calculus, the integral is

PS (3) > 1,"2",3,2,"1" -eq "2" 2 2

Again, it returns the two 2 s. Let s look at some more examples where we have leading zeros in the operands. In the first example:

PS (4) > 1,"02",3,02,"1" -eq "2" 2

This is the same result we obtained using the unit circle and Eq (611) In both cases, the singularity of f ( z ) , the point z = 0 was included inside the path What if we take a closed contour that does not include z = 0 Such a contour is shown in Fig 67 This time we have a = b and so

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