The removal of hyaluronic acid (HA) from the blood-stream was studied in four normal human subjects after injection of high molecular weight preparations labelled with 3H in the acetyl position. The plasma half-life of the injected material ranged between 2.5 and 5.5 min. The daily turnover of HA in the circulation was estimated to be at least 150 mg. Its elimination was predominantly extrarenal, the upper molecular weight limit for renal excretion being 25 000. Evidence for rapid degradation was provided by the identification of 3H2O in urine. Calculations from the specific activity of urinary 3H2O indicated that approximately 55% of the acetyl content of the injected HA was completely oxidized within 3 h, and 85% within the first day. It is concluded that hyaluronic acid in the amounts currently used for therapeutic purposes should not accumulate significantly in the circulation.

Adult↗

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Three dimensional display of the cardiac blood pool.

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Data Display↗

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Rubella arthritis in adults. Isolation of virus, cytology and other aspects of the synovial reaction.

Rubella virus was isolated from three consecutive samples of synovial fluid after 1 to 4 days of arthritis in adults with typical naturally acquired rubella. In the two samples suitably prepared, cells in the synovial fluid were mononuclear, with numerous monocytes and macrophages. Detailed studies in one case revealed a close similarity in all respects to the illness caused by Ross River virus, another member of the Togaviridae. Cells in the synovial exudate of this patient showed intense phagocytosis. A fine nodular cytoplasmic distribution of virus antigen was detected by immunofluorescence in 45% of the cells. There was no depletion of the complement components C'3 and C'4 in serum or synovial fluid, and no evidence of excessive immune complexes in the circulation or of immune-complex uptake by cells in the synovial exudate or intima. Synovial intima from the suprapatellar region merely showed slight hyperplasia without cellular infiltration, indicating that the lodgement of virus and the inflammatory cellular reaction to it can be confined to limited regions of the synovial lining, at least in the early stages.

Adult↗