Variations of lipid profile in animals caused by adenosine analogs: N6 (amido-3-propyl) adenosine hydrochloride and (carboxamido-3-propylamino)-6-(triproprionyl) 2',3',5'beta (D-ribosyl)-9-purine.

N6-substituted adenosine analogues are powerful inhibitors of lipolysis in the adipose tissues of animals and humans, because of their agonist effect on A1 purine receptors. Using a model of hypertriglyceridemia provoked by intravenous injection of Triton WR 1339, we observed that Agr 529 [N6(amido-3-propyl)adenosine hydrochloride] at 2 mg.kg-1 intravenous in rabbits, and intraperitoneally and orally in rats led to a return of the levels of circulating triglycerides to normal values. In addition, Agr 529 and its prodrug, Agr 540 [(carboxamido-3-propylamino)-6-(triproprionyl)2', 3',5'beta(D-ribosyl)-9-purine] administered to rats at 3 and 30 mg.kg-1, respectively, returned plasma triglyceride concentrations to normal levels. Intravenous administration of Agr 529 to normal rats led to decreased concentrations of plasma fatty acids, phospholipids, triglycerides and total cholesterol as a function of dose. The decrease began at 0.1 mg.kg-1 and was highly significant at 3 mg.kg-1. In the same conditions, the intraperitoneal administration of Agr 529 caused a dose-dependent hypolipemia. There was no apparent effect on cholesterol and on the triglycerides of high density lipoproteins. A kinetic study showed that the antilipemic effect of Agr 529 intravenously injected at 3 mg.kg-1 began 30 minutes after the injection with a maximum effect at 2 hours. The effect persisted up to 8 hours after injection. The present results show that the administration of Agr 529 and Agr 540 to normal animals causes hypolipemia (decrease in fatty acids, phospholipids, triglycerides and cholesterol) and restores induced hypertriglyceridemia. These effects may be attributed to an interaction of the molecules with A1 purinergic receptors of adipose tissue.

[Continuous monitoring of temperature in anesthesia and intensive care]. / La surveillance continue des températures en anesthésie-réanimation.

Continuous surveillance of both regional and general temperatures is of great interest in anaesthesia and intensive care. After a brief review of temperature regulation and the value of temperature control, the authors suggest a simple and reliable method of surveillance. This uses Chromel/Alumel thermocouples connected to a central device used to store the information. An experimental clinical study involved the assessment of 3 different anaesthetic protocols: Taractan-Palfium; Droleptan-Phenoperidine, Fentanyl only. These measurements were made in 30 young subjects undergoing a maxillofacial surgical procedure under identical conditions. The parameters studied were central temperature (rectal) and skin temperature of the index finger. With regard to peripheral temperature curves the results showed a first phase consisting of fall followed by a second phase characterised by a sudden increase up to a plateau. This plateau (3rd phase) persisted as long as the subject slept. The 4th phase, when peripheral temperature fell suddenly to a level sometimes lower than the initial temperature represented one of the first signs of awakening. As far as central temperature was concerned it fell in a linear fashion for all curves. Comparing the different curves obtained, the authors conclude by noting that the more vasoplegic the anaesthetic protocol, the higher the induction peak of the second phase of peripheral temperature pattern, but also that the fall in central temperature was marked. The authors feel that an anaesthetic which is biologically satisfactory and at the same time produces an overall fall in the production of heat without causing chills avoids the development of vasoconstrictor reactions between the care and the surface which are reflected by a decrease in the gradient between central and peripheral temperatures.

[The Cerebral Function Monitor. Description, functioning and interpretation principles]. / Le Moniteur de Fonction Cérébrale. Description - principe de fonctionnement et d'interprétation.

The Monitor of Cerebral Function enables continuous monitoring of the cerebral electrical activity and this over long periods due to the slow recording speeds. The cerebral electrical signals picked up by the electrodes attached to the scalp are registered in the form of a curve which fluctuates to a greater or lesser extent depending on the recording speed. The examination of the height of the curve with respect to zero and its amplitude indicates the voltage of the cerebral activity and yields information regarding polymorphism. It is thus possible to monitor variations in cerebral activity over a prolonged period during anaesthesia as well as during the revival phase with the Monitor of Cerebral Function, the electroencephalogram being reserved as an aid to precise diagnosis and for localization and close scruting of the anomalies.

[Cerebral Function Monitor (CFM) and electroencephalography (EEG). Experimental study]. / Moniteur de Fonction Cérébrale (MFC) et électro-encéphalogramme (EEG). Etude expérimentale.

This work is an attempt to connect the electro-encephalogram (EEG) and monitor of cerebral function (MCF) recordings during the experimental stimulation of the rabbit brain whether this is in the from of direct central stimulation, by stereotaxic location, or in the form of indirect stimulation via a peripheral nerve. These stimulations, performed under alfadione anaesthesia or under the neuroleptanalgesic sedative effect of chlorprothixine, are compared for every animal with the results of the control stimulations. The cardiovascular responses are recorded simultaneously. It has been found that, in simple narcosis induced by alfadione, there is much variation in the EEG recording and even more so in the MCF recording according to the quantity used and the block of responses to stimuli does not appear until there is deep anaesthesia. However, when chlorprothixine is used, the MCF trace is found to be very closely related to the trace of mild anaesthesia with accompanying block to all of the nociceptive stimulations. It would seem, therefore, if we accept the concept of levels of cerebral activity, that the use of the MCF could well open the way to a better understanding of the pure narcotic phenomena and of the neurovegetative response block to aggression.

[Use of the Cerebral Function Monitor in the study of physiological sleep]. / Utilisation du Moniteur de Fonction Cérébrale dans l'étude du sommeil physiologique.

After a brief description of the different phases of physiological sleep, the reasons for employing a new appatus, the Monitor of Cerebral Function, are discussed. This instrument, the first designed for continual monitoring of cerebral activity may be employed in neurophysiology. The results obtained are presented, i.e. the demonstration of a perfect correlation between the Monitor of Cerebral Function recording and the polygraphic methods. The paradoxal and rapid phases of sleep are easily distinguished. The study of paradoxal sleep, both in physiology and in pharmacology, could profit greatly from the use of the MCF due to the great advantage of its ease of operation.

A study of eye movement for assessing recovery from anaesthesia.

A test for assessing recovery from general anaesthesia is proposed, using electro-oculographic (e.o.g.) measurements. The eyes, when exploring a flat area, progress by "jerking" movements. After general anaesthesia, incomplete recovery is associated with smooth sinusoidal movements. In a series of 16 patients, different e.o.g. patterns were compared with clinical signs of awakening and related to the anaesthetic drugs used. In a further group of 19 patients, assessment of recovery using e.o.g. techniques was made 2 h following the end of operation. In both groups, this simple test appeared to be very reliable. In addition, the test provides a record which can be filed. This may be of value in day-case anaesthesia, where the safety of the patient and medicolegal considerations would be aided by an objective measurement of recovery.

[Monitoring the integrity of saccadic eye movements as a test of post-anaesthetic recovery (author's transl)]. / Controle de l'intégrité des mouvements de positionnement oculaire par saccades comme test du réveil post-anesthésique.

After reviewing various tests of consciousness which can be used during the post-anaesthetic period, the authors chose to analyse the involvement of the visual receptor during different stages between sleep and complete recovery of consciousness, by an electro-oculographic (EOG) method, providing recordings of the displacement of the optical axis. In states of full consciousness the eye explores a static flat surface in saccades separated by pauses. During sleep caused by anaesthesia or by other types of drugs, the integrity of the eye positioning movements by saccades is impaired, and the EOG shows a sinusoidal recording (smooth movements). In one group of patients, regaining of consciousness was monitored throughout and the EOG reording reflected the clinical state of the patient. In a second group, the state of consciousness was monitored 2 hours after the last injection of the anaesthetic drug, so that correlations could be considered with the type of anaesthesia used. Th conclusion concerns the practical interest of the method (short term hospitalisation after general anaesthetic, medico-legal use due to the existence of a recording) and its basic use in the experimental study of new drugs in man.

[Neuroplegia in cranial and cranio-thoracic injuries]. / La neuroplégie chez les traumatisés craniens et cranio-thoraciques

During severe head injuries, the reaction to the cerebral lesion is intense and characterised by a disturbance which is automatic, vasomotor and endocrine. Associated with general ventilatory and nutritional resuscitation, neuroplegia occupies in this pathology, aplace of choice. Cranio-thoracic traumas raise more complex problems owing to different ventilatory requirements, depending on whether the lesion is of the brain or thorax. One must therefore, find a compromise between the depression which necessarily occurs during a too intense autonomic reaction, and the ventilatory requirements created by the thoracic injury. In all cases, the micro-circulatory improvement produced by neuroplegic drugs is probably favourable. The authors report their experience of eighty severe cranio-thoracic traumas, over a period of thirty months, submitted to treatment including neuroplegics.

[Neuroplegia: results of an interdisciplinary approach to its physiopathology]. / La neuroplégie: résultats d'une approche interdisciplinaire de la physio-pathologie

Neuroplegia was born from a physiopathological study of states of shock and research on inhibition of the autonomic reaction to aggression. Over the last 25 years, the experimental facts have become accumulated in favour of the first theory of H. Laborit, i.e. that this so-called defence reaction defended our lives only through conservation of motor activity in the environment. When this motor activity is inefficacious or useless, the neuroendocrine reaction may lead, during the acute phase, to states of shock and to chronic psychosomatic pathology. On this general theme, inhibition of this reaction by neuroplegic drugs, among which the phenothiazine derivatives have played a very important role, has led in numerous surgical and medical disciplines, to basic research and therapeutic consequences. Thus, in anesthetics, it was at the origin of potentialised anesthesia, then neuroleptanalgesia. In general intensive care, it is used in various ways in the study and treatment of states of shock. In psychiatry, it has initiated neuro-psychopharmacology and the neuro-physiological and biochemical study of the nervous system in its response to the psycho-social environment. It has found its place in anesthesia and in obstetric pathology. But above all, has led pharmacologists to the study of metabolic and biochemical activities. The result of an interdisciplinary approach, neuroplegia has on the contrary, often been the origin of an interdisciplinary development of our physiological and physiopathological knowledge. Today this development seems to better understand its mode of action at various levels of organisation of living systems. One may thus say that neuroplegia, apart from its therapeutic interest, has been a good working instrument and led to better understanding of numerous biological disciplines.