Carin Han - Academia.edu (original) (raw)

Papers by Carin Han

Research paper thumbnail of Prognostic Indicators for Recurrent Symptoms After a Single Corticosteroid Injection for Carpal Tunnel Syndrome

The Journal of bone and joint surgery. American volume, Jan 7, 2015

Corticosteroid injections are commonly used in the treatment of carpal tunnel syndrome in adults.... more Corticosteroid injections are commonly used in the treatment of carpal tunnel syndrome in adults. This study sought to determine success rates early on and at one year postoperatively of a single corticosteroid injection while identifying prognostic indicators for symptom recurrence and repeat intervention. Fifty-four consecutive wrists in forty-nine patients with carpal tunnel syndrome treated with a single corticosteroid injection were prospectively enrolled. Demographic data and information on comorbidities were identified with a study-specific questionnaire. The Boston Carpal Tunnel Questionnaire was administered prior to injection. Patients returned to clinic at six weeks and were contacted at three, six, nine, and twelve months post-injection to determine symptom and intervention status. Kaplan-Meier analysis and Cox regression modeling were used to estimate recurrence rates and to identify predictors of symptom recurrence and repeat intervention. Fifty-four symptomatic wrists...

Research paper thumbnail of Submental Artery Perforator Flap for a Melanoma Defect

A 63-year-old male underwent submental artery perforator transposition flap for reconstruction of... more A 63-year-old male underwent submental artery perforator transposition flap for reconstruction of 4 × 3.5 cm chin defect following wide excision of a malignant melanoma (13-14 mm depth) involving the right lateral aspect of the chin. Sentinel lymph node biopsies from deep ...

Research paper thumbnail of Impact of Complications on Patient Satisfaction in Breast Reconstruction

Plastic and Reconstructive Surgery, 2011

The development of a complication after surgery can be difficult for both patient and surgeon. Wi... more The development of a complication after surgery can be difficult for both patient and surgeon. With a growing body of literature evaluating patient satisfaction after breast reconstruction, few studies directly focus on the impact of surgical complications on satisfaction. This study analyzed the effect of complications on general and aesthetic satisfaction after breast reconstruction. All women at an academic institution undergoing breast reconstruction between 1999 and 2006 were identified. Patient demographics and history of complications were collected. A questionnaire adapted from the Michigan Breast Reconstruction Outcomes Survey was administered examining general and aesthetic satisfaction. Patients with complications were compared with patients with no complications. Overall, 716 women underwent 932 reconstructions; 233 patients had a complication. Patient demographics and response rate were similar between the two groups (overall response rate 75.4 percent). Development of a complication correlated with increased odds of aesthetic dissatisfaction (odds ratio = 1.61, p = 0.047). Other predictors of dissatisfaction were older age, reconstruction with an implant, and a longer time interval between reconstruction and survey, while autologous reconstruction was a predictor of satisfaction. Among patients with a complication, implant reconstruction and mastectomy for prophylaxis were significant predictors of dissatisfaction. Aesthetic satisfaction after breast reconstruction is lower in patients developing a complication, older patients, and those receiving an implant reconstruction. Furthermore, patients with a prophylactic mastectomy are more likely than those with a therapeutic mastectomy to be dissatisfied when complications arise. These relationships are important, as measures to improve quality and decrease complications can directly improve patient satisfaction.

Research paper thumbnail of Submental Artery Perforator Flap for a Melanoma Defect

Otolaryngology - Head and Neck Surgery, 2010

A 63-year-old male underwent submental artery perforator transposition flap for reconstruction of... more A 63-year-old male underwent submental artery perforator transposition flap for reconstruction of 4 × 3.5 cm chin defect following wide excision of a malignant melanoma (13-14 mm depth) involving the right lateral aspect of the chin. Sentinel lymph node biopsies from deep ...

Research paper thumbnail of VEGF, which is elevated in the CSF of patients with hydrocephalus, causes ventriculomegaly and ependymal changes in rats

Experimental Neurology, 2013

Hydrocephalus is a condition characterized primarily by excessive accumulation of fluid in the ve... more Hydrocephalus is a condition characterized primarily by excessive accumulation of fluid in the ventricles of the brain for which there is currently no effective pharmacological treatment. Surgery, often accompanied by complications, is the only current treatment. Extensive research in our laboratory along with work from others has suggested a link between hydrocephalus and vascular function. We hypothesized that vascular endothelial growth factor (VEGF), the major angiogenic factor, could play a role in the pathogenesis of hydrocephalus. We tested this hypothesis by examining two predictions of such a link: first, that VEGF is present in many cases of clinical hydrocephalus; and second, that exogenous VEGF in an animal model could cause ventricular enlargement and tissue changes associated with hydrocephalus. Our results support the idea that VEGF elevation can potentiate hydrocephalus. The clinical relevance of this work is that anti-angiogenic drugs may be useful in patients with hydrocephalus, either alone or in combination with the currently available surgical treatments.

Research paper thumbnail of De quervain tendinopathy: survivorship and prognostic indicators of recurrence following a single corticosteroid injection

The Journal of hand surgery, 2015

To determine short- and long-term success rates of a single corticosteroid injection for de Querv... more To determine short- and long-term success rates of a single corticosteroid injection for de Quervain tendinopathy while identifying prognostic indicators for symptom recurrence and repeat intervention. Fifty consecutive patients with de Quervain tendinopathy treated with corticosteroid injections (lidocaine plus triamcinolone acetonide or dexamethasone) were prospectively enrolled. Patients with inflammatory arthritis, carpometacarpal osteoarthritis, or a previous distal radius fracture affecting the symptomatic wrist were excluded. Demographic data and information on existing comorbidities were recorded. Patients were seen in clinic at 6 weeks after injection and contacted at 3, 6, 9, and 12 months following injection to determine symptom recurrence and further intervention. Medical records were also reviewed for this purpose. Kaplan-Meier survival analysis and Cox regression modeling were used to estimate recurrence rates and identify predictors of symptom recurrence and repeat in...

Research paper thumbnail of Prognostic Indicators for Recurrent Symptoms After a Single Corticosteroid Injection for Carpal Tunnel Syndrome

The Journal of bone and joint surgery. American volume, Jan 7, 2015

Corticosteroid injections are commonly used in the treatment of carpal tunnel syndrome in adults.... more Corticosteroid injections are commonly used in the treatment of carpal tunnel syndrome in adults. This study sought to determine success rates early on and at one year postoperatively of a single corticosteroid injection while identifying prognostic indicators for symptom recurrence and repeat intervention. Fifty-four consecutive wrists in forty-nine patients with carpal tunnel syndrome treated with a single corticosteroid injection were prospectively enrolled. Demographic data and information on comorbidities were identified with a study-specific questionnaire. The Boston Carpal Tunnel Questionnaire was administered prior to injection. Patients returned to clinic at six weeks and were contacted at three, six, nine, and twelve months post-injection to determine symptom and intervention status. Kaplan-Meier analysis and Cox regression modeling were used to estimate recurrence rates and to identify predictors of symptom recurrence and repeat intervention. Fifty-four symptomatic wrists...

Research paper thumbnail of Submental Artery Perforator Flap for a Melanoma Defect

A 63-year-old male underwent submental artery perforator transposition flap for reconstruction of... more A 63-year-old male underwent submental artery perforator transposition flap for reconstruction of 4 × 3.5 cm chin defect following wide excision of a malignant melanoma (13-14 mm depth) involving the right lateral aspect of the chin. Sentinel lymph node biopsies from deep ...

Research paper thumbnail of Impact of Complications on Patient Satisfaction in Breast Reconstruction

Plastic and Reconstructive Surgery, 2011

The development of a complication after surgery can be difficult for both patient and surgeon. Wi... more The development of a complication after surgery can be difficult for both patient and surgeon. With a growing body of literature evaluating patient satisfaction after breast reconstruction, few studies directly focus on the impact of surgical complications on satisfaction. This study analyzed the effect of complications on general and aesthetic satisfaction after breast reconstruction. All women at an academic institution undergoing breast reconstruction between 1999 and 2006 were identified. Patient demographics and history of complications were collected. A questionnaire adapted from the Michigan Breast Reconstruction Outcomes Survey was administered examining general and aesthetic satisfaction. Patients with complications were compared with patients with no complications. Overall, 716 women underwent 932 reconstructions; 233 patients had a complication. Patient demographics and response rate were similar between the two groups (overall response rate 75.4 percent). Development of a complication correlated with increased odds of aesthetic dissatisfaction (odds ratio = 1.61, p = 0.047). Other predictors of dissatisfaction were older age, reconstruction with an implant, and a longer time interval between reconstruction and survey, while autologous reconstruction was a predictor of satisfaction. Among patients with a complication, implant reconstruction and mastectomy for prophylaxis were significant predictors of dissatisfaction. Aesthetic satisfaction after breast reconstruction is lower in patients developing a complication, older patients, and those receiving an implant reconstruction. Furthermore, patients with a prophylactic mastectomy are more likely than those with a therapeutic mastectomy to be dissatisfied when complications arise. These relationships are important, as measures to improve quality and decrease complications can directly improve patient satisfaction.

Research paper thumbnail of Submental Artery Perforator Flap for a Melanoma Defect

Otolaryngology - Head and Neck Surgery, 2010

A 63-year-old male underwent submental artery perforator transposition flap for reconstruction of... more A 63-year-old male underwent submental artery perforator transposition flap for reconstruction of 4 × 3.5 cm chin defect following wide excision of a malignant melanoma (13-14 mm depth) involving the right lateral aspect of the chin. Sentinel lymph node biopsies from deep ...

Research paper thumbnail of VEGF, which is elevated in the CSF of patients with hydrocephalus, causes ventriculomegaly and ependymal changes in rats

Experimental Neurology, 2013

Hydrocephalus is a condition characterized primarily by excessive accumulation of fluid in the ve... more Hydrocephalus is a condition characterized primarily by excessive accumulation of fluid in the ventricles of the brain for which there is currently no effective pharmacological treatment. Surgery, often accompanied by complications, is the only current treatment. Extensive research in our laboratory along with work from others has suggested a link between hydrocephalus and vascular function. We hypothesized that vascular endothelial growth factor (VEGF), the major angiogenic factor, could play a role in the pathogenesis of hydrocephalus. We tested this hypothesis by examining two predictions of such a link: first, that VEGF is present in many cases of clinical hydrocephalus; and second, that exogenous VEGF in an animal model could cause ventricular enlargement and tissue changes associated with hydrocephalus. Our results support the idea that VEGF elevation can potentiate hydrocephalus. The clinical relevance of this work is that anti-angiogenic drugs may be useful in patients with hydrocephalus, either alone or in combination with the currently available surgical treatments.

Research paper thumbnail of De quervain tendinopathy: survivorship and prognostic indicators of recurrence following a single corticosteroid injection

The Journal of hand surgery, 2015

To determine short- and long-term success rates of a single corticosteroid injection for de Querv... more To determine short- and long-term success rates of a single corticosteroid injection for de Quervain tendinopathy while identifying prognostic indicators for symptom recurrence and repeat intervention. Fifty consecutive patients with de Quervain tendinopathy treated with corticosteroid injections (lidocaine plus triamcinolone acetonide or dexamethasone) were prospectively enrolled. Patients with inflammatory arthritis, carpometacarpal osteoarthritis, or a previous distal radius fracture affecting the symptomatic wrist were excluded. Demographic data and information on existing comorbidities were recorded. Patients were seen in clinic at 6 weeks after injection and contacted at 3, 6, 9, and 12 months following injection to determine symptom recurrence and further intervention. Medical records were also reviewed for this purpose. Kaplan-Meier survival analysis and Cox regression modeling were used to estimate recurrence rates and identify predictors of symptom recurrence and repeat in...