We observed ectopic soft tissue calcification affecting seven patients following orthotopic liver transplantation. The cause of such calcification is unknown, but potential pathogenetic factors include hyperparathyroidism, calcium administered during and following surgery, renal failure, acid-base changes and citrate in fresh frozen plasma. To investigate some of the mechanisms underlying ectopic calcification following liver transplantation, we determined preoperative levels of ionized serum calcium, phosphate, magnesium, parathyroid hormone (midmolecule assay) and 1,25-(OH)2 vitamin D in 20 patients who underwent 24 liver transplants. In addition, these parameters were measured weekly in 15 patients during the first month after liver transplantation. Preoperatively, 5 of the 20 patients had elevated serum levels of parathyroid hormone, and 9 others had low levels of 1,25-(OH)2 vitamin D. After liver transplantation, ectopic calcification was found in seven patients (47%). The organs affected in order of frequency were lungs, liver graft, colon, vascular walls, kidneys, adrenal glands and gastric mucosa. One patient with ectopic calcification of both lungs had markedly restricted pulmonary function as well as radiologic evidence of osteopenia and pathologic fractures of three vertebrae. Postoperatively, increased parathyroid hormone levels were found in all patients who developed soft tissue calcification. Parathyroid hormone levels peaked during the second week after transplantation and were higher at all times compared to subjects without calcification. Five of the seven patients with ectopic calcification had associated renal failure. Individuals who developed calcification had received significantly more fresh frozen plasma, red blood cells and elemental calcium postoperatively, but showed no difference in serum levels of calcium, magnesium, vitamin D, total plasma CO2 or phosphate levels when compared to patients without calcification.(ABSTRACT TRUNCATED AT 250 WORDS)

Organometallics 1982,1, 851-858 851 encing chemistry of these complexes seems to be the most informative and internally consistent method of categorizing these and related compounds.The previous EHMO description of M(HCdH),(dtc); utilized a M-C(a1kyne) distance of 2.03 A and resulted in a calculated barrier to rotation of 40.3 kcal mol-'. The discrepancy between experimental (AG* of 15.3 kcal mol-') and calculated energy barriers for Mo(EtC,Et),(S,CNMez), was much larger than we had found in M(CO)(HC= CH) (dtc), and M(0) (HCECH) (dtc), studies. Although 2.03 A was the M-C distance reported for W(CO)(HC= CH)(det~),,~ structural data for (?r-C,H,)Nb(CO)(PhC= CPh);' and (7r-C5H5)WC1(CF3C4Y2F3)29 suggested that a distance of 2.17 A would be more likely to characterize the bis(alkyne) derivative. The results of such a calculation produced a barrier of 13.2 kcal mol-' for rotation of one alkyne, much nearer the observed value. The variation in calculated barrier as a function of the M-C distance (-2.0 kcal mol-'/O.Ol A) is consistent with a strong dependence of the metal-alkyne 7r-acceptor and a-donor orbital contributions on nuclear separation. Mono-and bis(arene)tricarbonylchromium complexes of (CH3)zE(C6H5)2[Cr(Co)3]x, where E = C, Si, Ge, Sn, and Pb, and (CH3)2Sn(CH2C6H5)2[Cr(C0)3]x and (CH3)zSn(C6H5CH3-p)2[Cr(CO)3]x, where x = 1 (1) (a) Bucknell University. (b) University of Oklahoma.(2) Poeth, T. P.; Harrison, P. G.; Long, T.

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Metastatic choriocarcinoma was suspected in a 39‐year‐old woman who presented 7 months postpartum with fatigue, pelvic pain, a massive pleural effusion, and a positive urine pregnancy test. Subsequent evaluation resulted in discovery of the isolated production of the freeβ‐subunit of chorionic gonadotropin (CG‐β) by a widespread, poorly differentiated epidermoid carcinoma. Chemotherapy was ineffective, the woman died, and at autopsy the primary site of the tumor could not be determined. The patient's serum (185 ng/ml) and a tumor metastasis (720 ng/g) contained large amounts of immunoactive material that diluted in parallel to CG‐β standard, but neither chorionic gonadotropin (CG), its alpha subunit, nor other placental proteins were detected. A monoclonal antibody that recognizes free CG‐β, but not intact CG, was instrumental in implicating an ectopic source of the CG‐β before a tissue diagnosis was obtained. When the patient's serum was chromatographed on a dextran gel, the CG‐β immunoactivity eluted in a position of higher apparent molecular weight than either standard CG or CG‐β, suggesting that this neoplasm secreted an altered molecular form of the CG‐β subunit.