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149 results on '"Vargas, Hernan I."'

2. Immunomodulation by Imiquimod in Patients with High-Risk Primary Melanoma

Author

Narayan, Rupa, Nguyen, Hong, Bentow, Jason J, Moy, Lauren, Lee, Diana K, Greger, Stephanie, Haskell, Jacquelyn, Vanchinathan, Veena, Chang, Pei-Lin, Tsui, Shanli, Konishi, Tamiko, Comin-Anduix, Begonya, Dauphine, Christine, Vargas, Hernan I, Economou, James S, Ribas, Antoni, Bruhn, Kevin W, and Craft, Noah

Subjects
Biomedical and Clinical Sciences, Clinical Sciences, Oncology and Carcinogenesis, Immunology, Clinical Research, Immunization, Vaccine Related, Cancer, Clinical Trials and Supportive Activities, 6.1 Pharmaceuticals, Evaluation of treatments and therapeutic interventions, Administration, Topical, Adult, Aminoquinolines, Antineoplastic Agents, Combined Modality Therapy, Female, Humans, Imiquimod, Immunologic Factors, Male, Melanoma, Pilot Projects, Preoperative Care, Prospective Studies, Risk Factors, Skin, Skin Neoplasms, T-Lymphocytes, Toll-Like Receptor 7, Treatment Outcome, Dermatology & Venereal Diseases, Clinical sciences
Abstract

Imiquimod is a synthetic Toll-like receptor 7 (TLR7) agonist approved for the topical treatment of actinic keratoses, superficial basal cell carcinoma, and genital warts. Imiquimod leads to an 80-100% cure rate of lentigo maligna; however, studies of invasive melanoma are lacking. We conducted a pilot study to characterize the local, regional, and systemic immune responses induced by imiquimod in patients with high-risk melanoma. After treatment of the primary melanoma biopsy site with placebo or imiquimod cream, we measured immune responses in the treated skin, sentinel lymph nodes (SLNs), and peripheral blood. Treatment of primary melanomas with 5% imiquimod cream was associated with an increase in both CD4+ and CD8+ T cells in the skin, and CD4+ T cells in the SLN. Most of the CD8+ T cells in the skin were CD25 negative. We could not detect any increases in CD8+ T cells specifically recognizing HLA-A(*)0201-restricted melanoma epitopes in the peripheral blood. The findings from this small pilot study demonstrate that topical imiquimod treatment results in enhanced local and regional T-cell numbers in both the skin and SLN. Further research into TLR7 immunomodulating pathways as a basis for effective immunotherapy against melanoma in conjunction with surgery is warranted.

Published
2012

14. Intraoperative injection of technetium-99m sulfur colloid is effective in the detection of sentinel lymph nodes in breast cancer

Author

Dauphine, Christine E., Khalkhali, Iraj, Vargas, M. Perla, Isaac, Nova M., Haukoos, Jason, and Vargas, Hernan I.

Subjects
Sulfur compounds, Emergency medicine, Breast cancer, Health
Abstract

To link to full-text access for this article, visit this link: http://dx.doi.org/10.1016/j.amjsurg.2006.06.014 Byline: Christine E. Dauphine (a), Iraj Khalkhali (b), M. Perla Vargas (a), Nova M. Isaac (a), Jason Haukoos (c)(d), Hernan I. Vargas (a) Keywords: Sentinel node; Breast cancer; Radiocolloid; Technique Abstract: Our objective was to determine if intraoperative injection of technetium-99m-labeled sulfur colloid is as effective as preoperative injection in the detection of sentinel lymph nodes (SLNs). Author Affiliation: (a) Department of Surgery, Section of Surgical Oncology, 1000 W. Carson St., Box 25, Harbor-UCLA Medical Center, Torrance, CA 90502, USA (b) Division of Breast Imaging, Harbor-UCLA Medical Center, Torrance, CA, USA (c) Department of Emergency Medicine, Denver Health Medical Center, Denver, CO, USA (d) Department of Preventive Medicine and Biometrics, University of Colorado Health Sciences Center, Denver, CO, USA Article History: Received 7 April 2006; Revised 6 June 2006

Published
2006

21. Scintimammographic analysis of nonpalpable breast lesions previously identified by conventional mammography

Author

Tolmos, Jorge, Cutrone, John A., Wang, Benjamin, Vargas, Hernan I., Stuntz, Michael, Mishkin, Fred S., Diggles, Linda E., Venegas, Rose J., Klein, Stanley R., and Khalkhali, Iraj

Subjects
Radioisotope scanning, Breast cancer, Mammography, Health
Abstract

Background: In randomized trials, screening mammography has led to decreased mortality from breast cancer. However, the low positive predictive value of mammography (i.e., the proportion of patients with a positive test result who actually have breast cancer) results in a large number of unnecessary biopsies. We determined whether scintimammography with technetium-99m-sestamibi is a useful supplemental diagnostic tool for women with nonpalpable breast abnormalities identified by conventional mammography. Methods: Scintimammography was performed preoperatively on 70 women who were 31-66 years of age (mean age and median age = 51 years). These women had nonpalpable breast abnormalities identified by conventional mammography; subsequently, a needle-localization excisional biopsy of each suspicious lesion was performed. Scintimammographic images were interpreted independently by two nuclear medicine physicians who were blinded to all clinical and pathologic data, and an interobserver variation analysis was performed. Results: Interobserver variation analysis of the scintimammographic findings showed an agreement for breast diagnosis of 97% and a kappa coefficient of 0.90. Comparison of scintimammographic findings; and histopathologic results revealed that the sensitivity (proportion of patients with breast cancer who had a positive test result), the specificity (proportion of patients without breast cancer who had a negative test result), the positive predictive value and the negative predictive value (proportion of patients with a negative test result who actually did not have breast cancer) of scintimammography were 56% (95% confidence interval [CI] = 23%-85%), 87% (95% CI = 75%94%),38% (95% CI = 15%-68%), and 93% (95% CI = 82%-98%), respectively. Four of nine breast cancers were not detected by scintimammography. Conclusion: Because of excellent interobserver agreement, scintimammography provides an objective way of detecting primary breast carcinoma. In view of its low sensitivity and positive predictive value, however, scintimammography is not currently recommended as a screening test in patients with nonpalpable positive mammographic findings. [J Natl Cancer Inst 1998;90:846-9]

Published
1998

23. Reduction of paclitaxel neuropathy with cryotherapy.

Author

Wilkinson, Mary, primary, Cocilovo, Costanza, additional, Vargas, Hernan I., additional, Cohen, Robert Alan, additional, Bruce, Sara, additional, Edmiston, Kirsten H., additional, Franco, Claudia Yvette, additional, Agra, Maria Gracia, additional, Bayer, Suzanne, additional, Khan, Afifah, additional, Le, Lamvy, additional, Saifollahi, Parisa, additional, Steimer, Mary, additional, Szeremeta, Christopher, additional, and Deeken, John F., additional

Published
2016
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24. Alternative Therapy Use by Breast Cancer Patients

Author

Chou, Joyce C., Horng, Pei-Min, Tolmos, Jorge, and Vargas, Hernan I.

Subjects
Alternative medicine -- Care and treatment -- Research, Transcultural medical care -- Research, Breast cancer -- Care and treatment -- Research, Health, Care and treatment, Research
Abstract

Abstract: To examine the frequency of alternative therapy use by breast cancer patients receiving conventional treatment, we surveyed 45 patients with breast cancer on their experience with alternative therapy. Patients [...]

Published
2000

26. Focused Microwave Thermotherapy for Preoperative Treatment of Invasive Breast Cancer: A Review of Clinical Studies

Author

Lincoln Laboratory, Fenn, Alan J., Dooley, William C., Vargas, Hernan I., Tomaselli, Mary Beth, Harness, Jay K., Lincoln Laboratory, Fenn, Alan J., Dooley, William C., Vargas, Hernan I., Tomaselli, Mary Beth, and Harness, Jay K.

Abstract

Background: Preoperative focused microwave thermotherapy (FMT) is a promising method for targeted treatment of breast cancer cells. Results of four multi-institutional clinical studies of preoperative FMT for treating invasive carcinomas in the intact breast are reviewed. Methods: Externally applied wide-field adaptive phased-array FMT has been investigated both as a preoperative heat-alone ablation treatment and as a combination treatment with preoperative anthracycline-based chemotherapy for breast tumors ranging in ultrasound-measured size from 0.8 to 7.8 cm. Results: In phase I, eight of ten (80%) patients receiving a single low dose of FMT prior to receiving mastectomy had a partial tumor response quantified by either ultrasound measurements of tumor volume reduction or by pathologic cell kill. In phase II, the FMT thermal dose was increased to establish a threshold dose to induce 100% pathologic tumor cell kill for invasive carcinomas prior to breast-conserving surgery (BCS). In a randomized study for patients with early-stage invasive breast cancer, of those patients receiving preoperative FMT at ablative temperatures, 0 of 34 (0%) patients had positive tumor margins, whereas positive margins occurred in 4 of 41 (9.8%) of patients receiving BCS alone (P = 0.13). In a randomized study for patients with large tumors, based on ultrasound measurements the median tumor volume reduction was 88.4% (n = 14) for patients receiving FMT and neoadjuvant chemotherapy, compared with 58.8% (n = 10) reduction in the neoadjuvant chemotherapy-alone arm (P = 0.048). Conclusions: Wide-field adaptive phased-array FMT can be safely administered in a preoperative setting, and data from randomized studies suggest both a reduction in positive tumor margins as a heat-alone treatment for early-stage breast cancer and a reduction in tumor volume when used in combination with anthracycline-based chemotherapy for patients with large breast cancer tumors. Larger randomized studies are requ

Published
2011

30. American Society of Breast Disease Policy Statement on The Use of Breast Magnetic Resonance Imaging

Author

Harms, Steven, primary, Early, Amy, additional, Bevers, Therese B., additional, Giuliano, Armando, additional, Golshan, Mehra, additional, Hertz, Ilona H., additional, Kiel, Krystyna D., additional, Kivitz, Philip B., additional, Leitch, A. Marilyn, additional, Overmoyer, Beth A., additional, Vargas, Hernan I., additional, Silva, Edibaldo, additional, Siziopikou, Kalliopi P., additional, Shriver, Craig D., additional, and Olopade, Olufunmilayo, additional

Published
2008
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36. Laparoscopic colon surgery

Author

Stamos, Michael J. and Vargas, Hernan I.

Subjects
Laparoscopy -- Usage, Laparoscopic surgery -- Usage, Colon (Anatomy) -- Surgery, Endoscopy -- Usage, Surgery -- Usage, Health, Usage
Abstract

In the early 1990s laparoscopic colon surgery was shown to be technically feasible, and it has been applied to the management of malignant conditions and benign diseases of the colon. [...]

Published
1998

47. Laparoscopic adrenalectomy: A new standard of care

Author

Vargas, Hernan I., primary, Kavoussi, Louis R., additional, Bartlett, David L., additional, Wagner, Joseph R., additional, Venzon, David J., additional, Fraker, Douglas L., additional, Richard Alexander, H., additional, Marston Linehan, W., additional, and Walther, McClellan M., additional

Published
1997
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49. Randomized Study of Preoperative Focused Microwave Phased Array Thermotherapy for Early-Stage Invasive Breast Cancer.

Author

Dooley', William C., Vargas, Hernan I., Fenn, Alan J., Tomaselli, Mary Beth, and Jay K.vHarness

Subjects
*MICROWAVES, *MEDICAL lasers, *TUMOR treatment, *BREAST cancer, *CANCER cells, *THERMOTHERAPY
Abstract

Microwave energy is a promising method of tumor ablation, because it can preferentially heat and kill high-water high-ion content breast carcinomas, compared to adipose and glandular tissues. The aim of this study was to investigate the hypothesis that preoperative focused microwave thermotherapy (FMT) kills breast carcinomas prior to surgery and reduces the incidence of positive margins. This is a prospective, randomized multi-center study of preoperative focused microwave phased array thermotherapy for patients with Ti, T2 invasive breast cancer receiving breast conservation therapy. Tumor dose was measured as cumulative thermal equivalent minutes (CEM) of treatment relative to 43°C. Outcomes measured were pathologic margin status, surgical reexcision rates including second incisions, excised tissue volume, pathologic tumor necrosis, focused microwave thermotherapy related side effects. Interim statistical analysis was performed on a study group of 75 patients, consisting of 34 patients (mean age, 59.4 years) treated with thermotherapy prior to surgery and 41 patients (mean age, 58.0 years) that received surgery alone. At enrollment based on ultrasound measurements, mean tumor diameter was 1.7 cm in the thermotherapy arm versus 1.6 cm in the control arm (p=0.49). After treatments were completed, in the thermotherapy arm 0 of 34 (0%) patients had positive margins and in the surgery-alone arm 4 of 41 (9.8%) patients had positive margins (p=0.13). Preoperative focused microwave thermotherapy can be performed safely with minimal morbidity. Confirmatory data from a larger study should be considered to determine whether focused microwave thermotherapy can reduce the rate of positive margins compared with breast conservation surgery alone. [ABSTRACT FROM AUTHOR]

Published
2008

50. Immediate Preoperative Injection of [sup99m]-Tc Sulfur Colloid Is Effective in the Detection of Breast Sentinel Lymph Nodes.

Author

Vargas, Hernan I., Vargas, Maria P., Gonzalez, Katherine D., Burla, Melissa, Venegas, Rose, Diggles, Linda, Mishkin, Fred, Klein, Stanley R., and Khalkhali, Iraj

Subjects
*LYMPH nodes, *COLLOIDS
Abstract

Sentinel lymph node (SLN) biopsy is an accurate technique to determine the metastatic status of lymph nodes. Radionuclide guidance makes the procedure easier and improves the success rate. Coordinating the operating room and nuclear medicine schedules causes delays when same-day radionuclide injection is used. We hypothesized that injection of [sup 99m]-Tc sulfur colloid immediately preoperatively is effective in SLN detection. We analyzed a prospective database of 70 patients treated at Harbor-UCLA Medical Center. The first 39 patients underwent completion axillary dissection (Group A) and subdermal injection of sulfur colloid immediately before surgery. A second group of 31 patients (Group B) had intraparenchymal injection immediately before surgery. We used isosulfan blue in all cases. SLNs were identified in 97 per cent of cases. SLNs were radioactive in 94 per cent and blue in 90 per cent. In Group A the accuracy and the positive and negative predictive values of SLN biopsy were 100 per cent. SLN counts per second ranged from 22 to 1700. The mean count per second was 290 ± 281 (mean ± standard deviation). Subdermal and intraparenchymal injections were equally successful (93% vs 92%). In conclusion injection of radiocolloid and isosulfan blue immediately preoperatively is highly successful and accurate in the detection of SLNs in breast cancer. It avoids operating room schedule delays. [ABSTRACT FROM AUTHOR]

Published
2002
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