Experimental pancreas transplantation: the consequences of the portocaval shunt on the blood glucose, plasma insulin, and glucagon

A proposição foi realizada, no período pós-operatório imediato, em 40 ratos Wistar, distribuídos por sorteio em doi grupos: grupo NC, vinte ratos correspondentes ao grupo controle, não diabético, submetidos a operação simulada e o grupo PT, 20 ratos correspondentes ao grupo diabético que recebeu transplante de pâncreas heterotópico de ratos Wistar normais. Durante sete dias, antes do transplante, e 1, 3, 6, 12, 24, 48, 72, 96 horas após, determinava-se a glicose sanguínea, a insulina plasnática e o glucagon. Estes parâmetros eram obtidos também do grupo NC. Diabetes mellitus experimental era induzida pela administração intravenosa de aloxana. O grupo PT era imunosuprimido com ciclosporina A. O grupo NC apresentou níveis normais de glicose sanguínea, de insulina plásmica e de glucagon, durante todo o experimento. Foi encontrada nítida hiperinsulinemia no sangue venoso periférico do grupo PT. A insulina plasmática era significantemente maior no grupo PT comparada ao grupo NC começando 72 horas após o transplante. O glucagon plasmático, elevado no período pré-transplante, não se alterou após o transplante. Apesar de hiperinsulinemia e hiperglucagonemia, os níveis de glicose sanguínea eram elevados 6 horas após o transplante e mantiveram-se normais após este período. Considerando-se os níveis de glicose sanguínea 12 horas pós-transplante, não houve diferença estatisticamente significante entre os grupos PT e NC, até o sacrifício.

Intravascular US-guided direct intrahepatic portocaval shunt with an expanded polytetrafluoroethylene-covered stent-graft

PURPOSE: To retrospectively evaluate the midterm patency rate of the nitinol (Viatorr, W.L. Gore and Associates, Flagstaff, Ariz) stent-graft for direct intrahepatic portacaval shunt (DIPS) creation. MATERIALS AND METHODS: Institutional Review Board approval for this retrospective HIPAA-compliant study was obtained with waiver of informed consent. DIPS was created in 18 men and one woman (median age, 54 years; range, 45-65 years) by using nitinol polytetrafluoroethylene (PTFE)-covered stent-grafts. The primary indications were intractable ascites (n = 14), acute variceal bleeding (n = 3), and hydrothorax (n = 2). Follow-up included Doppler ultrasonography at 1, 6, and 12 months and venography with manometry at 6-month intervals after the procedure. Shunt patency and cumulative survival were evaluated by using the Kaplan-Meier method and survival curves were plotted. Differences in mean portosystemic gradients (PSGs) were evaluated by using the Student t test. Multiple regression analysis for survival and DIPS patency were performed for the following parameters: Child-Pugh class, model of end-stage liver disease score, pre- and post-DIPS PSGs, pre-DIPS liver function tests, and pre-DIPS creatinine levels. RESULTS: DIPS creation was successful in all patients. Effective portal decompression and free antegrade shunt flow was achieved in all patients. Intraperitoneal bleeding occurred in one patient during the procedure and was controlled during the same procedure by placing a second nitinol stent-graft. The primary patency rate was 100% at all times during the follow-up period (range, 2 days to 30 months; mean, 256 days; median, 160 days). Flow restrictors were deployed in two (11%) of 19 patients. The 1-year mortality rate was 37% (seven of 19). CONCLUSION: Patency after DIPS creation with the nitinol PTFE-covered stent-graft was superior to that after TIPS with the nitinol stent-graft.

Papel do estudo hemodinâmico hepático na avaliação de pacientes com cirrose

O objetivo deste estudo foi avaliar o comportamento do gradiente de pressão venosa hepática (GPVH) em pacientes com cirrose. Foram estudados 83 pacientes portadores de hepatopatia crônica, com média de idade de 52,9 ± 10,1 anos, sendo 71,1% do sexo masculino. Todos realizaram estudo hemodinâmico hepático, sendo determinado o GPVH. Nestes doentes o GPVH foi analisado segundo distintas variáveis clínicas, enfatizando seu papel na avaliação da probabilidade de sangramento a partir de um nível discriminativo. Os pacientes foram seguidos em média por 16,6 ± 16,02 meses e divididos em grupos conforme o desfecho: óbito, realização de cirurgia de “shunt” porto-cava, de transplante hepático e ressangramento por ruptura de varizes de esôfago durante o seguimento, tendo sido realizadas comparações entre as médias do GPVH nos diferentes desfechos. O nível de significância estatística adotado de foi 0,05. Com os dados obtidos foram possíveis os seguintes resultados: - A média do GPVH nos pacientes com hepatopatia crônica foi de 15,26 ± 6,46 mmHg. - Não houve diferença estatística entre as médias do GPVH nos hepatopatas crônicos de etiologia alcoólica e não alcoólica. - O risco relativo para sangramento por varizes de esôfago foi maior nos pacientes com GPVH acima de 10 e 12mmHg, embora tenha havido sangramento em doentes com níveis inferiores a estes. - A média do GPVH foi significativamente maior nos pacientes que apresentaram sangramento durante o seguimento em relação àqueles que estiveram livres desta complicação. - A média do GPVH no grupo de pacientes que sangraram, que foram a óbito, que realizaram “shunt” porto-cava e que foram a transplante hepático foi significativamente maior do que aquela observada nos pacientes que evoluíram sem complicações. - Não foi identificado um nível crítico discriminativo do GPVH que estivesse relacionado ao prognóstico. - A determinação do GPVH, ressalvada uma complicação de seriedade, mostrou-se um método seguro. Dos resultados aqui observados, conclui-se que a determinação do GPVH é útil em predizer qual população de cirróticos está mais suscetível ao sangramento digestivo por ruptura de varizes, bem como em auxiliar na avaliação do prognóstico dos mesmos.

A database ATP simulated waveforms of shunt reactor switching cases with vacuum breakers on motor circuits

This paper presents a database ATP (Alternative Transient Program) simulated waveforms for shunt reactor switching cases with vacuum breakers in motor circuits following interruption of the starting current. The targeted objective is to provide multiple reignition simulated data for diagnostic and prognostic algorithms development, but also to help ATP users with practical study cases and component data compilation for shunt reactor switching. This method can be easily applied with different data for the different dielectric curves of circuit-breakers and networks. This paper presents design details, discusses some of the available cases and the advantages of such simulated data.

An optimization-based algorithm for shunt active filter under distorted supply voltages

When the supply voltages are balanced and sinusoidal, load compensation can give both unity power factor (UPF) and perfect harmonic cancellation (PHC) source currents. But under distorted supply voltages, achieving both UPF and PHC currents are not possible and contradictory to each other. Hence there should be an optimal performance between these two important compensation goals. This paper presents an optimal control algorithm for load compensation under unbalanced and distorted supply voltages. In this algorithm source currents are compensated for reactive, imbalance components and harmonic distortions set by the limits. By satisfying the harmonic distortion limits and power balance, this algorithm gives the source currents which will provide the maximum achievable power factor. The detailed simulation results using MATLAB are presented to support the performance of the proposed optimal control algorithm.

Control schemes for equalization of capacitor voltages in neutral clamped shunt compensator

Voltage imbalance in capacitors is a well-known problem in compensator topologies which use two or more capacitors. This imbalance may exist even if the load does not contain any DC component, due to practical factors. However, when the load contains a DC part, the voltage imbalance problem becomes critical. In this paper, a two-quadrant chopper has been used to regulate the capacitor voltages in a two-capacitor compensator structure. Two different control strategies for the two-quadrant chopper to equalize the voltage of the capacitors have been proposed. The strategies are validated through detailed simulation studies. Experiments have also been carried out to validate the hysteresis control of chopper.

Static shunt and series compensations of an SMIB system using flying capacitor multilevel inverter

The flying capacitor multilevel inverter (FCMLI) is a multiple voltage level inverter topology intended for high-power and high-voltage operations at low distortion. It uses capacitors, called flying capacitors, to clamp the voltage across the power semiconductor devices. A method for controlling the FCMLI is proposed which ensures that the flying capacitor voltages remain nearly constant using the preferential charging and discharging of these capacitors. A static synchronous compensator (STATCOM) and a static synchronous series compensator (SSSC) based on five-level flying capacitor inverters are proposed. Control schemes for both the FACTS controllers are developed and verified in terms of voltage control, power flow control, and power oscillation damping when installed in a single-machine infinite bus (SMIB) system. Simulation studies are performed using PSCAD/EMTDC to validate the efficacy of the control scheme and the FCMLI-based flexible alternating current transmission system (FACTS) controllers.

Performance comparison of VSC-based shunt and series compensators used for load voltage control in distribution systems

In this paper, the performance of voltage-source converter-based shunt and series compensators used for load voltage control in electrical power distribution systems has been analyzed and compared, when a nonlinear load is connected across the load bus. The comparison has been made based on the closed-loop frequency resopnse characteristics of the compensated distribution system. A distribution static compensator (DSTATCOM) as a shunt device and a dynamic voltage restorer (DVR) as a series device are considered in the voltage-control mode for the comparison. The power-quality problems which these compensator address include voltage sags/swells, load voltage harmonic distortions, and unbalancing. The effect of various system parameters on the control performance of the compensator can be studied using the proposed analysis. In particular, the performance of the two compensators are compared with the strong ac supply (stiff source) and weak ac-supply (non-still source) distribution system. The experimental verification of the analytical results derived has been obtained using a laboratory model of the single-phase DSTATCOM and DVR. A generalized converter topology using a cascaded multilevel inverter has been proposed for the medium-voltage distribution system. Simulation studies have been performed in the PSCAD/EMTDC software to verify the results in the three-phase system.

A restrike waveform predictive model for shunt capacitor bank switching with point-on-wave recommendation

Circuit-breakers (CBs) are subject to electrical stresses with restrikes during capacitor bank operation. Stresses are caused by the overvoltages across CBs, the interrupting currents and the rate of rise of recovery voltage (RRRV). Such electrical stresses also depend on the types of system grounding and the types of dielectric strength curves. The aim of this study is to demonstrate a restrike waveform predictive model for a SF6 CB that considered the types of system grounding: grounded and non-grounded and the computation accuracy comparison on the application of the cold withstand dielectric strength and the hot recovery dielectric strength curve including the POW (point-on-wave) recommendations to make an assessment of increasing the CB remaining life. The simulation of SF6 CB stresses in a typical 400 kV system was undertaken and the results in the applications are presented. The simulated restrike waveforms produced with the identified features using wavelet transform can be used for restrike diagnostic algorithm development with wavelet transform to locate a substation with breaker restrikes. This study found that the hot withstand dielectric strength curve has less magnitude than the cold withstand dielectric strength curve for restrike simulation results. Computation accuracy improved with the hot withstand dielectric strength and POW controlled switching can increase the life for a SF6 CB.

Performance issues of distance relays for shunt FACTS compensated transmission lines

In this paper, the performance of distance relays when applied to transmission system equipped with shunt FACTS device, Static Synchronous Compensator (STATCOM) is described. The aim of the proposed study is to evaluate the performance of distance relays when STATCOM is incorporated at the mid point of transmission lines for voltage control. A detailed model of STATCOM and its control strategy is presented. The presence of these devices significantly affects apparent impedance seen by the distance relays due to their rapid response to different power system configurations. The distance relay is evaluated for different loading conditions and for different fault locations. The faults are created during various pre-fault loading conditions. The studies are performed on 400KV and 132KV systems and the results are presented. Simulation studies are carried out using transient simulation software, PSCAD/EMTDC.

Ground-fault-arc suppression on series-and shunt-compensated lines

An extension of Rizk's analysis to cover any type of switching is presented for calculating the residual current and recovery voltage in a singlephase switched transmission system. Equations for the determination of the current and voltage are shown, and the method has been used for the analysis of a series- and shunt-compensated line.Three possible switching methods for the effective control of the recovery voltage and residual current are discussed: normal switching, switching at the ends of the line and switching of the series capacitors.

Control technique for non-linear and unbalance compensation of an integrated magnetics-based three-phase series-shunt-compensated uninterruptible power supply

Handling unbalanced and non-linear loads in a three-phase AC power supply has always been a difficult issue. This has been addressed in the literature by either using fast controllers in the fundamental rotating reference frame or using separate controllers in reference frames specific to the harmonics. In the former case, the controller needs to be fast and in the latter case, besides the need for many controllers, negative-sequence components need to be extracted from the measured signal. This study proposes a control scheme for harmonic and unbalance compensation of a three-phase uninterruptible power supply wherein the problems mentioned above are addressed. The control takes place in the fundamental positive-sequence reference frame using only a set of feedback and feed-forward compensators. The harmonic components are extracted by a process of frame transformations and used as feed-forward compensation terms in the positive-sequence fundamental reference frame. This study uses a method wherein the measured signal itself is used for fundamental negative-sequence compensation. As the feed-forward compensator handles the high-bandwidth components, the feedback compensator can be a simple low-bandwidth one. This control algorithm is explained and validated experimentally.