1. The concentration of hyaluronic acid in synovial fluid was determined by a modification of the Dische carbazole method for the determination of uronic acids. 2. The results of this determination in 80 specimens of normal and abnormal synovial fluid confirmed values reported by other methods. 3. An inverse relationship between the hyaluronic acid in the synovial fluid and the degree of synovitis was suggested.

The distribution of proteins and glyco-proteins in the synovial fluid and serum of normal patients and those with rheumatoid arthritis and other rheumatic diseases is presented. Joint disease tends to result in similar concentrations of protein in both serum and synovial fluid. Of particular interest is the distribution of alphaz glycoprotein. The relative concentration of this high molecular weight substance between serum and synovial fluid seems to be a most sensitive index of the semipermeability of the synovial membrane. Es presentate le distribution de pro-teinas e glycoproteinas in le liquido synovial e in le sero de subjectos normal e de patientes con arthritis rheumatoide e con altere morbos rheumatic. Morbo articular tende a monstrar simile con-centrationes de proteina in le sero e in le liquido synovial. De interesse particular es le distribution de glyco-proteina alphaz. Le concentration relative de iste substantia a alte peso molecular in le sero e in le liquido synovial pare esser un sensibilissime indice del semipermeabilitate del mem-brana synovial. HIS REPORT presents the results of a comparison of the distribution of T P roteins and glycoproteins, determined by zone electrophoresis, of the serum and synovial fluid of 10 patients without rheumatic disease and 71 patients with certain rheumatic diseases. The electrophoretic distribution of protein in the synovial fluid1 and a comparison of serum and synovial fluid proteins have been It has been shown that the synovial fluid in traumatic arthritis in comparison to serum from the same patient has a higher relative concentration of albumin (as a fraction of the total protein) and a lower relative concentration of globulin (as a fraction of the total protein). In rheumatic diseases with systemic reactions the synovial fluid globulins increase relatively more than the synovial fluid albumin; as a result, when expressed as a percentage of the total protein in synovial fluid (relative concentration), albumin decreases while globulins increase. Changes in distribution of proteins in synovial fluid quantitatively exceed any changes in distribution of proteins in serum. From the Mayo Clinic and Mayo Foundotion, Rochester, Minn. Abridgment of portion of thesis submitted by Dr. Decker to the Faculty of the Graduate School of the Uniuersity of Minncsotu in partial fulfillment of the rcquirernents for the degree of Master of Science in Medicine. The Mayo Foundation (Rochester, Minn.) is a part of the Graduate School of the Unioerdty of Minnesota. The authors would like to acknowledgc the technical assktance of Mr. Curtis Dunlap, Mr. Richard Goodwin and Mr. Sanford Ward. Ths authors are also indebted to the Section of Rheumtology and the Section of Orthopedics for their continuous cooperation and interest.

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With the technical assistance of N . €I. CurryFourteen (4 per cent) of 340 blood donors showed the presence of rheumatoid factor and some of these were studied in detail. One young donor with very high titers of rheumatoid factor and a 22s component, followed for over two years, has shown no clinical evidence of disease. The sensitized human cell test compares favorably with latex reagent. Both methods are more sensitive and less specific than the sensitized sheep cell test.Inter 340 donatores de sanguine, 14 (i.e. 4 pro cento) monstrava le presentia de factor rheumatoide, e plures de istes esseva studiate in detalio. Un juvene donator con altissime titros de factor rheumatoide e un componente 22s monstrava nulle sign0 de morbo durante plus que duo annos de abservation. Le test a sensibilisate cellulas human es nullemente minus bon que le test a latex. Ambe iste tests es plus sensibile e minus specific que le test a sensibilisate cellulas ovin.

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Representative "acute phase reactants" and a "clinical index" of synovial inflammation were determined in patients with various rheumatic diseases. The serum hexose-protein (PR) ratio, serum protein-bound hexose and seromucoid determinations were consistently found a more reliable indication of the extent of systemic inflammation than the other tests studied. Systemic inflammation, measured by "acute phase reactants," paralleled the clinically determined synovial reaction only in patients with rheumatoid arthritis.Representative "reactantes de phase acute" e un "indice clinic" de inflammation synovial esseva determinate in patientes con vane morbos rheumatic. Le proportion de hexosa a proteina in le sero, le hexosa ligate a proteina seral, e le seromucoides se provava uniformemente plus fidel como indices del extension de inflammation systemic que le altere parametros studiate. Le inflammation systemic, mesurate per "reactantes de phase acute," esseva parallel a1 clinicamente determinate reaction synovial solmente in patientes con arthritis rheumatoide.HE PURPOSE of this paper is to compare a number of "acute phase T reactants" in the serum of 65 patients with different rheumatic diseases.The two laboratory tests most often used to measure the activity of inflammation are the erythrocyte sedimentation rate and the C-reactive protein tests2 Electrophoresis of serum proteins has yielded additional measures of inflammatory activity including: (1) decrease in serum albumin, ( 2 ) increase in serum alpha-2 globulin2g3 and ( 3 ) increase in the alpha-1 and alpha-2 serum glycopr~teins.~~~ Chemically determined fractions of the serum glycoproteins also have been shown to vary with the degree of inflammati~n.~-~ These are protein-bound hexose, hexosamine, sialic acid and seromucoid. It has been suggested that the ratio of serum protein-bound hexose to total serum protein (PR) more reliably measures the degree of inflammation than do the other variables mentioned.1°The aforementioned diverse tests have been grouped together as "acute phase reactants," since they often parallel each other in their deviation from normal during an inflammatory reaction. Dissimilar behavior may result from the dependence of individual tests upon different aspects of the undefined chemistry of inflammation. METHODSUncorrected erythrocyte sedimentation rates, in millimeters per hour, were determined by the method of Westergren. C-reactive protein was graded 0 to 4 by microprecipitation

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