Recurrent leak

Denileukin diftitox is a combination of the active sections of interleukin 2 and diphtheria toxin. It binds to high-affinity interleukin 2 receptors on the cancer cell (and other cells), and the toxin portion of the molecule inhibits protein synthesis to result in cell death. The pharmacokinetics of denileukin diftitox are best described by a two-compartment model, with an a half-life of 2 to 5 minutes and a terminal half-life of 70 to 80 minutes. Denileukin diftitox is used for the treatment of persistent or recurrent cutaneous T-cell lymphoma whose cells express the CD25 receptor. Side effects include vascular leak syndrome, fevers/chills, hypersensitivity reactions, hypotension, anorexia, diarrhea, and nausea and vomiting. 

The periodic motion of the wavepacket in the potential well naturally shows up in the autocorrelation function S(t) as depicted schematically in Figure 7.3. Each return of (<) to its origin leads to a maximum in the autocorrelation function, a so-called recurrence. Since the part that is temporarily trapped in the inner region gradually diminishes the overall amplitude of S(t) decays in time. Eventually, the entire wavepacket leaks... 

Surgical ligation of all relevant branches is a possible solution for type II leaks. However experience has shown that there are often more vessels involved in these lesions than is initially suspected, and unless they are all clipped the surgical route approach risks failure or recurrence. Ligation can be accomplished by laparoscopic or open technique. 

Covered metallic stents provide effective treatment for malignant flstulas and perforations. The clinical success rates are very high and most patients derive relief from symptoms of aspiration or debilitating thoracic sepsis. Patients with recurrent flstulas or leaks may be treated by additional overlapping stents in most cases. Metallic stents placed in the airways may be useful for some patients with a dilated esophagus, very high fistulas, or airway obstruction due to local invasion by esophageal tumors. 

Biliary complications, ischemic or non-isch-emic, occur in up to 25% of transplant recipients (Letorneau and Castaneda-Zuniga 1990). Complications include leaks, strictures, stones or sludge, dysfunction of the sphincter of Oddi, malposition-ing of the T-tube, and recurrent disease. 

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