Textbook of Medical Biochemistry Textbook of Medical Biochemistry Eighth Edition Dr (Brig) MN Chatterjea BSc MBBS DCP MD (Biochemistry) Ex-Professor and Head, Department of Biochemistry Armed Forces Medical College, Pune, Maharashtra, India Christian Medical College and Hospital, Ludhiana, Punjab, India MGM Medical College, Aurangabad, Maharashtra, India (Specialist in Pathology and Ex-Reader in Pathology) Rana Shinde PhD FACB MRC Path (Chemical Pathology) Professor and Head and Chief, Chemical Pathologist Department of Biochemistry, SSR Medical College Belle Rive, Mauritius Ex-Reader and Consultant, Department of Biochemistry Christian Medical College and Hospital, Ludhiana, Punjab, India Ex-Professor, Department of Biochemistry JN Medical College, Belgaum, Karnataka, India Formerly Wanless Hospital Miraj and Christian Medical College and Hospital, Ludhiana, Punjab, India Forewords T Venkatesh Vijaykant B Kambli C Sita Devi KP Sinha ® JAYPEE BROTHERS MEDICAL PUBLISHERS (P) LTD New Delhi • Panama City • London ® Jaypee Brothers Medical Publishers (P) Ltd Headquarter Jaypee Brothers Medical Publishers (P) Ltd 4838/24, Ansari Road, Daryaganj New Delhi 110 002, India Phone: +91-11-43574357 Fax: +91-11-43574314 Email: jaypee@jaypeebrothers.com Overseas Offices JP Medical Ltd 83 Victoria Street, London SW1H 0HW (UK) Phone: +44-2031708910 Fax: +02-03-0086180 Email: info@jpmedpub.com Jaypee-Highlights Medical Publishers Inc City of Knowledge, Bld 237, Clayton Panama City, Panama Phone: 507-317-0160 Fax: +50-73-010499 Email: cservice@jphmedical.com Website: www.jaypeebrothers.com Website: www.jaypeedigital.com © 2012, Jaypee Brothers Medical Publishers All rights reserved No part of this book may be reproduced in any form or by any means without the prior permission of the publisher Inquiries for bulk sales may be solicited at: jaypee@jaypeebrothers.com This book has been published in good faith that the contents provided by the authors contained herein are original, and is intended for educational purposes only While every effort is made to ensure a accuracy of information, the publisher and the authors specifically disclaim any damage, liability, or loss incurred, directly or indirectly, from the use or application of any of the contents of this work If not specifically stated, all figures and tables are courtesy of the authors Where appropriate, the readers should consult with a specialist or contact the manufacturer of the drug or device Publisher: Jitendar P Vij Publishing Director: Tarun Duneja Editor: Richa Saxena Cover Design: Seema Dogra Textbook of Medical Biochemistry First Edition Second Edition Third Edition Fourth Edition Fifth Edition Sixth Edition Seventh Edition Eighth Edition : : : : : : : : 1993 1995 1998 2000 2002 2005 2007 2012 ISBN 978-93-5025-484-4 Printed at FOREWORD “Today’s Biochemistry is Tomorrow’s Medicine” rightly said by many is truly justified by Dr (Brig) MN Chatterjea and Dr Rana Shinde in their Textbook of Medical Biochemistry Authors’ sincere efforts are appreciated both by students and faculty who have been using this book, which is meeting most of the requirements of MCI regulations I have found lot of appreciation and greater acceptance in India and abroad for which authors have put in special efforts to cover wide spectrum of current topics in medical biochemistry through constant review and changes from time-totime This popular book itself is a good guide and a tool to both undergraduate students and teachers in medical biochemistry Prof T Venkatesh PhD FACBI Director National Referral Centre for Lead Poisoning in India Professor, Department of Biochemistry and Biophysics Past President, ACBI St John’s National Academy of Health Sciences Bengaluru, Karnataka, India FOREWORD I am very happy to write the foreword for this edition of the Textbook of Medical Biochemistry In keeping with its prior editions, the authors have given full attention to include the advancements occurred in the field of clinical biochemistry I am a practicing clinical chemist in community hospital who used tools in basic concepts of the subject, when teaching students the art and science of clinical biochemistry I encourage the teachers in medical schools in India and abroad to use the book for teaching the subject of clinical biochemistry I am a strong advocate of teaching the fundamental concepts in biochemistry to medical students, clinical laboratory technologists and clinical pathologists to advance their understanding of the subject The authors are well-known teachers and have spent decades in this field This edition is enriched with relevant subject information for those who are seeking to understand medical biochemistry I recommend the book for medical students at undergraduate as well as postgraduate levels I am sure the medical college community in India and abroad will welcome this edition of Textbook of Medical Biochemistry Dr Vijaykant B Kambli PhD MBA FACB DABCC Director Quality Assurance and Point of Care Testing Former Director, Clinical Biochemistry Department of Pathology Norwalk Hospital Norwalk, Connecticut, USA FOREWORD The discipline of biochemistry has expanded by leaps and bounds It is an independent subject with a separate examination in almost all medical colleges Though there are a few books on biochemistry written by Indian authors, there is need for a comprehensive yet simplified textbook I am happy that the Textbook of Medical Biochemistry, written by Dr (Brig) MN Chatterjea and Dr Rana Shinde, fulfils this need Both authors have long experience in teaching biochemistry to undergraduate and postgraduates They have tried their best to make the text simple and lucid and at the same time have also incorporated the recent developments in the subject The textbook is useful not only for undergraduates but also for postgraduates in biochemistry and others registering for diplomate examination of the National Board of Examinations I hope the book will receive appreciation as well as encouragement from all biochemists Dr C Sita Devi MD FAMS FIMSA Vice President-Lab Services Retd Principal and Professor Department of Biochemistry Andhra Medical College Vishakhapatnam, Andhra Pradesh, India FOREWORD I am pleased to go through the Textbook of Medical Biochemistry written by Dr (Brig) MN Chatterjea and Dr Rana Shinde The book makes a lucid reading, is full of necessary facts for medical students, and the text is clinically oriented Both the authors are well-known teachers of repute and have really tried to make the book simple as well as useful for medical students at undergraduate and postgraduate levels The book though similar to many other such textbooks, is unique for its clarity and comprehension I am sure students and teachers will gladly accept the book Dr KP Sinha MD PhD (Lond) Ex-Professor and Head Department of Biochemistry Patna Medical College Patna, Bihar, India PREFACE TO THE EIGHTH EDITION It is a great pleasure to present the Eighth Edition of Textbook of Medical Biochemistry to our beloved teachers and students The main framework of the book has been retained, without much changes, new additions have been made, some portions rewritten in certain chapters Few teachers wanted that the university question types and MCQs be added at the end of each chapter which were in existence in first three editions but later removed to reduce pages To quote, "I suggest that short type of questions and multiple choice questions should be included at the end of each chapter in future edition of the book." We have included the same in the topics pertaining to MBBS We feel confident that this edition will fulfil the requirement of the undergraduate students as per MCI recommendations and also meet the needs and expectations of postgraduate students of Biochemistry As the book is clinically oriented, it will be of much help to PG students of other disciplines, viz Pathology/medicine/pediatrics, etc Colour printing has been used to make the book more attractive, easy recording and highlighting the important portions like Clinical Aspects/Significance and Biochemistry Importance The overall objective of the book has been to provide concise yet authoritative coverage on the basics of Biochemistry with clinical approach to understand the disease processes The important points in the text to be remembered by the students have been highlighted in bold and italicised prints We not claim to the perfect Errors/mistakes may creep-up due to oversight/or printing errors We shall look forward for any valuable comments and useful suggestions from teachers and students so that errors are rectified and suggestions are taken into account for future We sincerely thanks Shri Jitendar P Vij (Chairman and Managing Director), Mr PG Bandhu (Director-Sales), and Mr Tarun Duneja (Director-Publishing) for their untiring work and keen efforts to bring out the new revised edition of the book Dr (Brig) MN Chatterjea Rana Shinde INDEX 862 Textbook of Medical Biochemistry desulfhydrases 476 glycine 511 in blood 471 in urine 665 pool 471 sequence of glucagon 587f human calcitonin 580f serine 423 tryptophan 181 Amino peptidases 467 sugar 32 acids 32 Aminoaciduria 372 Aminophylline and theophylline 220 Aminopterin 118, 195 Ammonia tolerance test 667 Ammonium sulphate solution 97 Amphipathic lipids 62 Amylodextrin 35 Amyloid liver 40 precursor protein 92 Amylopectin 35 Amylopectinosis 354 Anaemia 623 Anaemic hypoxia 207 Anaerobic dehydrogenases 136 oxidative reactions 343 Andersen’s disease 354 Androgens 600 Angina pectoris 440 Angiotensins 88 Anilides 556 Ankyrin 15 Anserine 515 Anterior pituitary gland 376 Antibiotics 89, 802 Antibody functions of IgA molecule 113 Anticancer substances 801 Antidiuretic hormone 625, 699 Antigen binding site 116 Antigenic determinants of vibrio cholerae 312 Antiketogenic 201 Antiobesity vaccine 770 Antioncogenesis 798 Antioxidants 211 Antiport system 16 Antipyrine breath test 668 Antiretroviral therapy 847 Anuria 611 Aplastic anaemia 739 Appearance of cerebrospinal fluid 726 Aquaporins 15 Arachidonic acid series 47 Arginine 79, 526 Argininosuccinic aciduria 483 Aromatic amino acids 78, 495 hydrocarbons 556 nitrocompounds 557 Arsenite 330 Aryl sulphatase Ascorbic acid 163, 174, 363, 801 Asiatic cholera 311 Asparagine 78 Aspartate transaminase 475, 730 transcarbamoylase 91, 130 Aspartic acid 78 Asphyxia 377 Aspirin 130 Asymmetric carbon 24f Atherosclerosis 172, 453, 627, 776 Atractyloside 145 Atrial natriuretic hormone 699 natriuretic peptide 699, 700 Atypical CPK isoenzymes 647 retinitis pigmentosa 453 Augmented histamine test 679 Azacytidine 220 Azapurine 220 Azathiopurine 220 B Bacterial plasmids 282 Bacteriophages 282, 283 Balance of dietary amino acids 756 Barometric pressure 749 Basement membrane 807 Basic amino acids 79 food groups 763 lipid structure 11f Basis of chemotherapy 220 B-complex vitamins 177 Bence-Jones’ protein 103 Benedict’s qualitative reagent 31 Benedict-Roth spirometer 747f Beryllium 785 Bicarbonate 730 buffer system 711 Bile acid 438 pigments in faeces 662 urine 662 Bilirubin albumin binding 550 tolerance test 666 Bilirubinuria 662 Biochemistry of AIDS 838 cancer 790 cholera 310 Biogenic amines 490t Biosynthesis of aldosterone 594f bile acids 438 carnitine 408 catecholamines 497, 498f cholesterol 431 creatine 526 lactose 371 long-chain fatty acids 416f phosphatidyl choline 420 inositol 421 phospholipids 420 plasmalogen 422f porphyrins 541 purines 229 sphingomyelin 423 thyroid hormones 571, 574f triacyl glycerols 419 Biotin 122, 163, 190, 415 carboxyl carrier protein 415 carboxylase 415 Bitot’s spots 166 Biuret reaction 87 Blockers of histamine 492 Blood 408, 501, 502, 520 and blood products 842 and plasma level 526 brain barrier 725 buffers 710 coagulation 58, 173 level of glutamine 485 pressure 770 sugar level 377 Bloor’s classification 46 criteria 45 Blot transfer techniques 284f Blunt ends 283 Boeck’s sarcoidosis 170 Bone and teeth formation 166 diseases 669 disorder 623 isoenzyme 648 marrow syndrome 736 Boron neutron irradiation 741 Bound polyribosomes 269 Boyer’s hypothesis 145 Bracken disease 178 Bradykinin 88, 699 Brain natriuretic peptide 699, 700 peptides 89 scanning 740 tumors 740 Branched structure of glycogen 36f Breast cancer 170, 798 Bromohydroxyacetone 329 Bromsulphthalein test 666 Bronchial muscle 70 Bronchopulmonary dysplasia 211 Brown adipose tissue 404 Brown-Schilder’s disease 414 Bruton’s agammaglobulinaemia 107 BSP retention test 666 Buffers of RB cells 711 Burkitt’s lymphoma 794 Butylated hydroxy anisole 211 toluene 211 C Cadmium 785 Caffeine 218 stimulation 679 Calcification of bones and teeth 614 Calcitonin 580, 613 Index hypoproteinaemia 107t orotic aciduria 237 rancidity 53 Caveolae 13 Cell derived enzymes 637 disease membrane 10 migration in embryonic tissues 41 mixture 118 organelles Cellular oxidation-reduction 175 Cellulose 37 Central nervous system syndrome 736 Centrifugal analyzers 836 Cephalin 56f Cerebral infarction 740 Cerebrocuprein 622 Cerebron 59 Cerebrosides 46, 59 Cerebrospinal fluid 725, 731t Certain aldehydes 557 miscellaneous tests 652 Ceruloplasmin 101 Cervical cancer 795 Chain elongation system 414 synthesis 152f Characteristics of cancer cells 791 enzyme 330 genetic code 263 ideal tumour marker 809 individual plasma proteins 98 lipoprotein lipase 403 liposomes 64 muscle phosphorylases 349 peptide bond 88 promoter sequence 261 tryptophan pyrrolase 517 Chastek paralysis 178 Chaulmoogric acid 47 Chemical stress and pollution 782 Chemistry of carbohydrates 23 colonisation of small intestine 313 enzymes 121 haemoglobin and haemoglobinopathies 149 lipids 45 nucleotides 215 prostaglandins 66 proteins and amino acids 76 respiration and free radicals 204 thyroid hormones 571 Chenodeoxy cholic acid 438 Chloramphenicol 270 Chlorine 612 Chlorocarbonyl cyanide phenylhydrazone 146 Chlorofluorocarbons 786 Chlorophenoxy acids 785 Cholelithiasis 440 Cholera 310, 311 toxin 312, 316 Cholesterol 11, 50, 51 cholesteryl ester ratio 665 crystals 50f esterase 393 stones 440 Cholesteryl ester transfer protein 448 Cholic acid 438 Cholinesterases 641 Chondroitin 38 sulphates 38 Chondrosamine 32 Chorionic somatomammotropin 605 Chromatin 3, Chromatography 94, 827 Chromium 629 Chromoproteins 85 Chronic aspirin ingestion 620 gastritis 678 glomerulonephritis 108 granulomatous diseases 18, 18f, 212 hepatitis 671 infections including tuberculosis 620 tyrosinosis 502 Chylomicrons 395, 445 density lowest-floats 444 fate of labelled chylomicrons 447 Chylothorax 396 Chymotrypsin 465 Cirrhosis 101 of liver 668, 670, 792 Citrate synthase 342 Citric acid cycle 336, 339f Citrous fruits 175 Citrullinemia 483 Class switching 117, 276 Classification of amino acids 77 coenzymes 122 eicosanoids 67f hormones 563 jaundice 661 lipoproteins 444 phospholipids 55 proteins 83 quality of proteins 754 renal function tests 652 tumour markers 809 Cleavage of argininosuccinate 481 Closed-circuit method 747 Clotting time 48 CO2 fixation reactions 191 Coagulated proteins 85 Coated vesicles and endosomes 18 Cobalophilin-bound vitamin B12 198 Cobalt 629 Cobamide coenzyme 122 Coccal meningitis 727 Coconut water 777 Cohn’s fractions 97 Cold bathing 107 Collagen diseases 108 Colloid 822 osmotic pressure of blood and plasma 819 Colloidal state 822 Colostrum 773 INDEX Calcium 146, 612, 730, 773 binding proteins 174 intake 625 Calculation of caloric requirements 749 Calmodulin 351 Campylobacter jejuni 310 Campylobacteriaceae 310 Cancer 108, 487, 791 chemotherapy 802 of colon 776 of stomach 681 phototherapy 546 suppressor genes 798 therapy 327 Carbamoyl phosphate 226 Carbohydrate 12, 23, 325, 533, 773, 775 antigens 809 component 810 tolerance 385 Carbomycin 32 Carbon monoxide 143 poisoning 150 tetrachloride 459 Carbonic acid 710 anhydrase 714 Carboxy peptidase 466 Carboxylation 523 Carcinoembryonic antigen 810 Carcinogenesis 792 Carcinoid 519 syndrome 184 Carcinoma in situ of cervix 792 of stomach 678 Cardiac diseases 108 troponin T 641 Cardiolipin 57 Cardiovascular diseases 776 disorders 632, 767 Carnitine-palmitoyl transferase deficiency 414 Carnosine 88, 515 Carotene 50 Carrier protein and transport of glucose 321f Castor oil 54 Catabolism of carnosine 515 insulin 583 lecithin 424 purines 233, 235f pyrimidines 228 serotonin 519 Catalyses transfer of electrons 142 Catalytic activity of enzymes 121 Catecholamines 376 Causes of alterations in intracranial pressure 727 fatty liver 459 fibrin clot 727 hyperglycaemia 377 hyperproteinaemia 106t hypoglycaemia 374, 377 863 INDEX 864 Textbook of Medical Biochemistry Colour reactions of proteins 87 sterols 51 Combined hyperlipidaemias 453 Complement fixation test 689 Complications of diabetes mellitus 384 Composition and nutritive value of common foodstuffs 772 Composition of diet 619 element constant 400 variable 400 extracellular matrix 807 matrix normal CSF 726 proteins 77 starch granule 35 Compound lipids 46, 55 Conalbumin 774 Concanavalin 12 Concentration of ketone bodies 425 tests 655 Congenital erythropoietic porphyrias 544 pernicious anaemia 200 Congestive heart failure 610 Conjugated proteins 83, 84 Conjugation with amino acids 559 D-glucuronic acid 559 glutamine 560 glutathione 560 sulphuric acid 558 Consequences of protein deficiency 758 Constitutive genes 273 Continuous flow analysers 836 Contractile proteins 83 Control of cholesterol biosynthesis 434 enzyme degradation 131 secretion 566 Copper 544, 622 deficiency manifestations 623 Coprostanol 52 Cori cycle 369f Cornea 166 Corneal transparency 43 Coronary thrombosis 440 Cosmids 282, 283 Co-transport system 16 Creatine kinase 730 phosphokinase 639 Creatinine 526 Creatinuria 527 Creutzfeldt-Jakob disease 92 Crigler-Najjar syndrome 552 Cross-section of mitochondrion 5f Cryoglobulins 104 Cryptococcal meningitis 727 Crystallisable protein 152 CSF copper 730 glutamine 486, 730 phosphate 730 C-type natriuretic peptide 699, 700 Cyanide nitroprusside test 508 poisoning 150 Cyanogenic glycosides 788 Cyclic AMP 222 fatty acids 47 GMP 224 nucleotides 222 structures 25 Cyclisation of squalene 431 Cycloheximide 270 Cyclo-oxygenase enzyme system 68 Cyclopentanoperhydrophenanthrene nucleus 50f Cysteine formation 505 Cystic fibrosis 10, 19 transmembrane protein 19 Cystinosis 508 Cystinuria 508 Cytarabine 220 Cytidine nucleotides 220, 222 Cytochrome 85, 137 B 137 C 137 oxidase 139 C1 137 oxidases 138 Cytogenetic map 294 Cytoplasm Cytos antiobesity vaccine 770 Cytosine 216, 217, 228 Cytoskeleton D De novo synthesis 414 Deacylation 524 Deamination of histidine 476 Decarboxylase 226 Decarboxylation 490 of amino acids lysine and arginine 491 reaction and biogenic amines 490 Decreased glucose tolerance 385 serum levels 638 Decreases gluconeogenesis 584 glycogenolysis 585 lipolysis 585 Defence proteins 83 Deficiency manifestations beriberi 178 scurvy 176 Deficiency of vitamin D 169 E 172 K 174 Definition of calorie 746 hormones 563 Degradation of lecithin 424f polyamines 493 Dehydration 701 Dehydroepiandrosterone 600 Dehydrogenase 226 Dehydrogenation 523, 524 De-iodinase 80 Dementia 184 Denaturation of DNA 242 proteins 92 Dengue 304 Deoxy sugars 31 Deoxycholic acid 438 Deoxyribonucleic acid 239 Deoxyribonucleoproteins 84 Derepression of lac operon 273f Derivatives of haemoglobin 152 Derived lipids 46 proteins 83, 85 Dermatitis 184, 628 Details of enzymes 414 Determination of antimicrosomal antibodies 689 antithyroid autoantibodies 688 peroxidase antibody 689 blood NH3 667 pH of unknown buffer solution 816 serum bilirubin 661 enzyme activities 660 surface tension 821 thyrotropin-receptor antibodies 689, 690 viscosity 822 Determination prothrombin time 666 Detoxication 555 of drugs 560 Development of fatty liver 184 Dextrans 37 D-fructose 27 D-galactose 27 D-glucose 27 D-glucuronic acid 327 Diabetes insipidus 610 mellitus 345, 377, 382f, 459, 425, 440, 611, 621, 767, 750 Diabetic cataract 384 gangrene 385 nephropathy 384 retinopathy 384 Diacyl glycerol lipase 401 Diarrhoea 184 Dicarboxylate transporter 139f Dicarboxylic acid shuttle 366f Dichlororiboflavin 180 Dicoumarol 128, 146 Dictyosomes Diet in pregnancy and lactation 770 Dietary carbohydrates 435 cholesterol 435 deficiencies of vitamin B1 336 fats 435 fibres 436 hepatic necrosis 172 proteins 753 role of trans fatty acids 761 Index sources of fructose 372 iron 618 lipids 392 Different glucose tolerance curves 386f Digestion and absorption of cholesterol 396 lipids 391 phospholipids 396 Digestion in duodenum 320, 464 intestinal lumen 393f mouth 320, 464 and stomach 392 small intestine 320, 392, 466 stomach 320, 464 Digestion of carbohydrates 320 lipids 392 proteins 463 Di-isopropyl fluorophosphate 130 Dioxide transport 208 Dioxygenases 136 Dipalmityl lecithin 59 Dipeptides 86 Diphosphatidyl glycerol 58f Diphtheria toxin 270 Disacchariduria 323 Discovery of HIV 838 Diseases of genetic origin 298 renal tubules 379 Dissimilation of amino acids 473 Distribution of body water and electrolytes 694 carnosine and anserine 515 iron in body 618t Disulfide bonds 91 Disulfiram 130 Disulphide bonds 89 Dithiopropanol 560 Diverticulosis 776 DNA-double helix 241f Docosahexaenoic acid DHA 49 Dolichol 412 Douglas method 747 Drosophila melanogaster 293 Drug related orotic aciduria 237 Drug-induced hypercalcaemia 614 Dry beriberi 178 Dubin-Johnson syndrome 552 Duodenal ulcer 678, 679, 681 Dynamic function tests 737 state of adipose tissue 400 E Ergotoxin 788 Erythrocuprein 622 Erythrodextrin 36 Erythromycin 32, 270 Erythropoietin 544 Escherichia coli 293 Essential amino acids 80, 472, 473 fatty acids 46, 48 pentosuria 362 Esterification of cholesterol 51 Estimation of bile acids and bile salts in blood 440 chloride content of urine 703 chlorides in CSF 728 creatinine 528 CSF proteins 728 lecithin 59 plasma fibrinogen 664 water loss 702 Estrogens 601, 605 Eukaryotic cells 3, 4t Evans blue dye 695 Ewald test meal 677 Excess of vitamin A 167 Excretion of bile pigments 553 Excretory function 660 Exocytosis 17 Exogenous obesity 767 Exonucleases 281 Experimental carcinogenesis 793 hyperglycaemic glycosurias 379 observations 535 porphyrinuria 546 Extracorporeal irradiation of blood 741 Extramitochondrial synthesis of fatty acids 414 system 414 F Fabry’s disease 61 Facilitative bidirectional transporters 322 Factors affecting absorption 613, 624 bicarbonate reabsorption 715 carbondioxide transport 208 enzyme action 126 determining magnitude of ketogenesis 428 of dissociation of oxyhaemoglobin 205 regulating hormone action 563 Fad linked enzymes 137 Faecal urobilinogen 662 Familial dys-beta lipoproteinaemia 451 hypercholesterolaemia 451 hypertriglyceridaemia 452 lipoprotein lipase deficiency 451 methaemoglobinaemia 153 Fanconi syndrome 94 Fantus’s test 703 Fate of acetone 428 cholesterol 438 in body 437f INDEX Eadie-Hofstee transform 126f Ectopia lentis 509 Edelman-Gally model 115 Edman reaction 82 Egg-white injury 190 Ehrlich’s Diazo-reagent 661 Eicosanoids 47 Elaidic acid 48 Elastins 84 Electrical gradient of ions 817 Electrolytes of ICF 696t plasma 695t and tissue fluid 695 Electron transport chain 143 system 176 of respiratory chain 140f Electrophoresis 93, 98, 399, 647, 729, 830 pattern of serum proteins 99f Electrostatic interactions 91 ELISA and RIA methods 689 techniques 689 Elongation of fatty acids 418 Embden-Meyerhof pathway of glycolysis 328 Embryonal stem cells 305 Emotional glycosuria 379 Empirical uses of vitamin C 177 Endemic ascites 789 Endocrine diseases 749 rhythms 566 theory 851 Endocytosis 17f Endogenous ceruloplasmin 210 creatinine clearance 652 inhibitor 523 obesity 767 source 49 Endometrial carcinoma 767 Endonucleases 281 Endoplasmic reticulum 6, Endothelial cell 522 injury 455 Endotoxin 312 Enediols formation 31f Energy requirements in protein synthesis 269 Enterobacteriaceae 310 Enterohepatic circulation 553, 663 Enterokinase 466 Enzyme deficiency 61, 146, 500 arginase 483 glucose-6-phosphatase 353 estimation in serum and body fluids 132 linked immunoabsorbent assay 688 Epiandrosterone 600 Epidemic cholera 311 dropsy 788 Epigallocatectin gallate 211, 802 Epimer of glucose 27 Epinephrine 379, 472 tolerance test 663 Epsilonproteobacteria 310 family helicobacteriaceae 310 Epstein-barr virus 794 Ergastoplasm Ergometrine 788 Ergosterol 52 Ergotamine 788 Ergothioneine 515 865 INDEX 866 Textbook of Medical Biochemistry EFA 49 FFA in liver 429f lactic acid in body 369 methylmalonate semialdehyde 524 pyruvic acid 334 undigested fat 396 Fat-soluble vitamins 162, 163 Fatty acid 11, 46, 399, 412 oxidation promotes gluconeogenesis 369 synthase multienzyme complex 415f synthesis 341 uptake 407 liver 49, 457 Favism 360, 788 Fearon’s test 33 Fehling’s solution 31 Female hormones 600 sex hormones 601 Ferricytochrome 210 Ferritin 617 Ferrodoxin 168 Feto-placental function 605 Fevers 108 Fibrinogen 104 Fibrocystic breast disease 172 Fibrous proteins 83, 84 Figlu’ test 196 Filtration fraction 654 Fishberg concentration test 655 Five types of hyperlipoproteinaemias 454t Flavin adenine nucleotide 179 linked dehydrogenases 137 mononucleotide 179 ribityl-PO4 179 Flavoprotein 85 Flexible protein 351 Flocculation tests 664 Fluid balance 609 mosaic model of membrane structure 12 of dense connective tissue 694 phase pinocytosis 18 Fluorescence of porphyrins 546 Fluoride 130 toxicity fluorosis 626 Fluorine 625 Folate coenzymes 122 trap 199 Folic acid 195, 772 and hyperhomocysteinaemia 197 and inositol prevents birth defects 197 group 163, 192 reductases 193 Folinic acid 193 Follicle stimulating hormone 569 Follicular cells 571 Food borne diseases 789t Forbe’s disease 354 Formation and fate of pyruvic acid 333, 338f Formation of acetoacetyl-CoA 342 acetone 427 active acetate 189 succinate 189 sulphate 616 acyl derivatives 81 adrenocortical hormones 438 amine 81f androgens 438 bile acids 439f bilirubin from biliverdin 550 calcitriol 168 carbamoyl aspartic acid 227 carnitine 176 catecholamines 176 CTP 228 deoxyuridine diphosphate 228 dihydro-orotic acid 227 endorphins 570 esters 81 estrogens 438 ferritin 176 formylglycinamide ribotide 231 free radicals 209 fructose from glucose 327 furfural derivative 30f glucose 341 glutathione 507 glycinamide ribotide 231 guanylate 486 haem 543f and haemoproteins 543 pockets 151 initiation complex 266 inosinic acid 232 isoprenoid units 432 kinins 699f kynurenic acid 518 L-gulonic acid 362 lipid bilayer 12 malic acid from fumaric acid 340 mercaptoethanolamine 508 methyl mercaptan 505 n-formyl glycinamidine ribonucleotide 486 orotic acid 227 orotidylic acid 227 oxalosuccinic acid 338 phenol and cresol 497, 499 phosphodiester bond 240f progesterone 438 prothrombin 660, 666 pyruvic acid in body 334 replication fork 252 ribose and deoxyribose 326 squalene 431 superoxide anion in metabolic pathways 209 taurine 507 transcription complex 260 tryptamine 518 tyramine 497, 499 tyrosine-o-sulphate 497, 500 uridylic acid 227 xanthurenic acid 518 Four complexes of electron transport chain 141f Fractional test meal 678f Fractionation of plasma proteins 97 Free and total acidity 677 cholesterol 399 fatty acids 399 glycerol 394 radicals 209, 852 Froin’s syndrome 726 Fructose tolerance test 663 Fruit sugar 27 Fumarate forming amino acids 341 Functions of albumin 98 amino acids 79 apolipoproteins 445 bile salts 439 carnosine and anserine 515 ceruloplasmin 101 cyclic AMP 224 GMP 224 dietary proteins 753 EFA 48 fluoride 331 GABA 492 glucuronic acid 363 glutamine 485 glutathione 509 haemopexin 102 haptoglobin 101 lipoxins 74 liver 660 melatonin 520 nitric oxide 523 nitrogen in plasma 208 orosomucoid 100 PGS 71 phospholipids 58 plasma proteins 105 polyamines 494 porin prostaglandins 70 proteoglycans 40 T-piece 113 transferrin 102, 617 vitamin A 164 D 169 E 171 K 173 Furfural phloroglucide 30 G Galactokinase deficiency 371 Galactosaemia 371 Galactosamine 32 Galactose 327 index 663 tolerance test 663 Galactosyl transferase 371 Gallbladder bile 439 Gangliosides 46, 60 Gas liquid chromatography 829 Gastric carcinoma 678 Index Glycogen 36 storage diseases 353, 354t, 378 Glycogenolysis of muscle 351 Glycolipids 46, 59 Glycolysis 327 Glycolytic cycle 147 Glycophorin 12, 14 integral protein 14f Glycoproteins 38, 85 Glycosamine 32 Glycosaminoglycans 37 Glycosides 32 Glycosphingosides 59 Glycosuria 378 Glycosylamine 32 Glyoxylic acid reaction 87 Goitrogens 788 Golgi apparatus body complexes Gonadal hormones 599 Granular pneumocytes 59 Granulocytopaenia 196 Granulomatous diseases 614 Graves’ disease 691 Growth hormone 402, 624, 625, 855 suppressor genes 798 GTP guanosine triphosphate 221 Guanine 217 deaminase 234 nucleotide catabolism 234 Guanosine deaminase 234 nucleotides 220 Gynaecological disorders 767 H Haem haem interaction 149, 155 linked groups 149, 155 synthesis 189, 342 Haematin 543 Haematoidin 153 Haematopoietic derived diseases 302 Haematoporphyrin 153 Haemochromatosis 621 Haemochrome 153 Haemochromogen 153 Haemodilution 107 Haemoglobin 85, 150, 152 Haemoglobinopathies 157 Haemolytic anaemia 327, 360 jaundice 662 Haemopexin 102 Haemoproteins 85 Haemosiderin 617 Haemosiderosis 621 Halofenate 236 Hapten 110 Haptoglobin 101 Hartnup disease 184, 520 Haworth projection 26f Hay’s test for bile salts 820 Healing phase of bone disease 615 Heart ailments 170 muscle 201, 327 Heat balance 782 coagulation of proteins 86 exhaustion 782 hyperpyrexia 782 inactivation 647 shock proteins 269, 855 stability 647 stress 782 stroke 782 test 103 Heavy chain classes 115 metal ions 130 pollutants 785 particles 740 Helix-turn helix 277 Haemolytic anaemia 172 Henderson-Hasselbalch equation 815, 816 Heparanase 807 Heparin 39 antagonist 40 Hepatic aldosterone 596 bile 439 diseases 627 isoenzyme 648 jaundice 661 porphyrias 545 Hepatitis A virus 304 B virus 795 C virus 304 virus affecting liver cells 19 Hepatocellular jaundice 662 Hepatocuprein 622 Hepatolenticular degeneration 623 Heptaglutamate 192 Her’s disease 354 Hereditary fructose intolerance 374 porphyrias 544 tyrosinaemia 502 Heterocyclic amino acids 78 Heteropolysaccharides 24, 37 High density lipoproteins 444 Higher fatty acids 47 polymer 113 Hinge’ region 116 Hippuric acid test of quick 665 Histaminase 641 Histamine stimulation test 679 Histidinaemia 516 Histidinuria in normal pregnancy 516 Histones 83, 240 Histotoxic hypoxia 207 HIV genome 840f life cycle 841f vaccine 848 virion 839f INDEX function tests 675 juice 675, 698 lipase 53, 392 ulcer 678, 681 Gastriscin 464 Gastroferrin 618 Gastrointestinal loss 610 tract syndrome 736 Gaucher’s disease 59, 644 Gelatin 84 Gene amplification 797 expression in eukaryotes 275 prokaryotes 273 silencing 303 therapy 298 transfer vehicle 301 Genetic control of chain synthesis 152 Genome mapping 294 Geometric isomers 48 Germline gene therapy 305 Gestogens or progestational hormones 600 GI somatostatin 589 tract 563 Gibbs-Donnan membrane equilibrium 819 Gilbert’s syndrome 552 Gingivitis 184 Globular protein 83 Globulins 84, 99, 729 Glomerular filtration 41 tests 652 function 651 Glomerulonephritis 654 Glucagon 368, 377, 379, 402 hyperglycaemic-glycogenolytic factor 587 Glucocorticoids 69, 368, 376, 402, 472, 590, 613 Glucogenic amino acids 364 Gluconeogenesis 363, 364 Glucosamine 32 Glucosazone crystals 28 Glucose 332, 543 alanine cycle 483, 484f crosslinking 853 nitrogen ratio 487 oxidase 133 tolerance test 345, 385, 663 transporters 321 Glucosinolates 801 Glutamine synthetase 485 Glutathione 88, 509 peroxidase 80, 210 Glutelins 84 Glycaemic index 760 Glycerol 49, 364, 394, 399 therapy 50 Glycerophosphate shuttle 143, 343 Glycerophosphatides 55 Glycerophospholipids 11 Glycine 363, 526, 559 reductase 80 Glycinuria 512 867 INDEX 868 Textbook of Medical Biochemistry Hollander’s test 680 Holy grail of human genetics 294 Homeostasis of body fluids 698 Homopolysaccharides 24, 35 Hopkins-cole reaction 87 Hormones 83, 322, 358, 371, 802, 855 in gluconeogenesis 368 of anterior pituitary 567 of middle lobe of pituitary 570 of posterior pituitary lobe 570 sensitive triacyl glycerol lipase 401 used as tumour markers 810 Human chorionic gonadotrophin 605, 811 deficiency 49 medullary carcinoma of thyroid 67 milk 773 papillomavirus 795 plasma lipoproteins 446f T-cell leukaemia virus 795 Humanisation of cow’s milk 773 Hyaluronic acid 38 Hyaluronidase 7, 38 Hydnocarpic acid 47 Hydration 523, 524 Hydrogen bond 89, 91 ion concentration 815 Hydrolases 123 Hydrolysis of neutral fat 53 Hydroperoxidases 136 Hydrophobic tail 11 Hydrostatic pressure gradient 16 Hydroxylases 136 Hydroxymethyl furfural formation 30f Hydroxyperoxidases 136 Hydroxyproline 78, 175 Hyperactivity of anterior pituitary 379 thyroids 377 Hyperammonaemia 478 Hyperargininemia 483 Hypercalcaemia 614, 687 Hyperchlorhydria 678 Hypercholesterolaemia 186, 443 Hyperglycaemia 382 Hyperglycaemic glycosuria 378, 379 Hyperkalaemia 611 Hyperlipidaemias 451 Hyperlipoproteinaemias 451 Hypermagnesaemia 625 Hypernatraemia 610 Hyperphenylalaninaemias 501t Hyperphosphataemia 615 Hyperplasia chief cells 614 Hyperplastic orange yellow tonsils 453 Hyperthyroidism 387, 749 Hypertonic contraction 706 expansion 705 Hypervitaminosis 177 Hypocalcaemia 580, 614 Hypochloraemic alkalosis 715 Hypochlorhydria 678 Hypoglycaemia 377, 414, 536 Hypokalaemia 611, 719 Hypolipoproteinaemias 451, 453 Hypomagnesaemia 625 Hyponatraemia 610 Hypoparathyroidism 614 Hypophosphataemia 580, 615 Hypothalamic hormone 567 injuries 768 releasing factors 567 somatostatin 589 Hypothermia 782 Hypothyroidism 387, 749 Hypotonic contraction 705 expansion 705 Hypoxanthine 118 nucleotide 232 Hypoxia 206, 543 Hypoxic hypoxia 207 Hyterozygous 158 I Iatrogenic 615 Idiopathic hypercalcaemia of children 170 hypoglycaemia 377 pulmonary haemosiderosis 622 Imino acids 78 Immunised spleen cells 118 Immunoelectrophoresis 832 Immunofluorescence of tissue sections 688, 689 In utero radiation exposure 737 Indolyl acetonitrile 788 Infantile mitochondrial myopathy 146 Infectious hepatitis 664, 665, 668 mononucleosis 112 Influence of sleep 751 Influenza 304 Inherited deficiency of enzyme isomerase 200 pyruvate dehydrogenase 336 disorders 8, 146, 374, 412, 500, 516, 524, 623 hyperprolinaemias 523 of glycine metabolism 512 of S-containing amino acids 508 enzyme deficiencies 322 hyperammonaemia 478 lactase deficiency 323 Inhibition of glucuronyl transferase activity 552 Inhibitors of electron transport chain 143 oxidative phosphorylation 145 protein synthesis 270 Inner mitochondrial membrane 6, 139f Inosinic acid 219, 232 Inositol 201 Insulin 322, 332, 358, 402, 581 secreting tumor 377 stimulation test 680 Integral membrane proteins 10, 12 proteins 14 Interaction of histones 240 invading cancer cell with extra cell 807 Interconversion of sugars 28 Interferons 799 Intermittent acute porphyria 545 claudication 172 Internucleotide bonds 219 Interstitial and lymph fluid 694 connective tissue 807 tissue fluid 694 Intestinal absorption of calcium and phosphate 169 amylase 320 epithelial cells 395f isoenzyme 648 juice 698 lipase 53 motility 440 secretion 70 Intracellular fluid 694 Intracranial haemorrhage 211 Intradermal test 177 Intravenous pyelography 656 Inulin 37 clearance test 653 Invert sugars and inversion 34 Iodination of tyrosine 573 Iodine number 54 trapping 572 Iodoacetamide 330 Iodoacetate 129, 330 Ion exchange chromatography 829 transport and secretion 58 Ionic head 11 Ionophores 15 Iron 543, 616 deficiency anaemia 620 overload 621 requirement 620, 770, 771 requiring enzymes 617 storage depletion 620 sulphur proteins 137 supplements 523 toxicity 19 transport and utilisation 620 Irradiation of ergosterol 52f Ischaemia 654 Isocitrate dehydrogenase 339, 342 Isoenzymes of alkaline phosphatase 647 CPK 647 nitric oxide synthase 522 Isomaltase 320 Isoriboflavin 180 Isotonic contraction 705 expansion 705 Isotope renogram 739 Index J Jaffe’s reaction 528 Jamaican vomiting 788 sickness 414 Jaundice 661 JC virus 304 JG cells 596 of kidney 563 Junk DNA 243 Juvenile onset diabetes 380 pernicious anaemia 200 K Kaposi’s sarcoma 67 Kaschinbeck disease 632 Keratan sulphate 38 Keratins 84 Kerato sulphate 38 Keshan disease 631 Ketoacidosis 425 Ketogenesis 427f Ketogenic substances 431 Ketolysis 427 Ketonaemia 425 Ketone body formation in liver 425 Ketonuria 425 Ketosis 425 Kidney 479 damage 719 diseases 610 Kimmelsteil-Wilson lesions/disease 384 Kinetic properties of enzymes 124 Kinky or steel hair syndrome 624 Knoop’s experiment 407 Kodak photochemistry analysers 837 Krabbe’s disease 62 Krebs-Henseleit cycle 479 Kwashiorkor 632, 766 L M Macroamylasemia 642 Macrocytic anaemia in liver diseases 196 Macular degeneration of eye 857 Magnesium 624 deficiency 615, 625 Magnitude of ketogenesis 428 Major classes of proteins 251t glucose transporters 322t Malabsorption and biliary tract obstruction 174 Malate shuttle 143, 344 Male hormones 600 Malignant diseases 225 phase of hypertension 654 Maltase 320 Maltosazone 28 Maltose 24, 36 Mammary antigens 813 Manganese 628 Mao inhibitors 128 Maple syrup urine disease 524 Marasmic-kwashiorkor 766 Maturity onset diabetes 380 Maximum urea clearance 652 McArdle’s disease 354 Mechanism of RNA interference 303f Medullary carcinoma of thyroid 70, 615 Megaloblastic anaemia in caeliac disease and sprue 196 of infancy 196 of pregnancy 196 Megx test 668 Melanic acids 777 Melanocyte stimulating hormones 570 Melatonin 520, 855 Membrane glycerophospholipids 12 Menke’s disease 624 Mental retardation 508 Mepacrine 69 Meprobamate 557 Messenger RNA 244 Metabolic acidosis 717 alkalosis 719 diseases 767 fate 495, 513 of cysteine 506 of L-threonine 522f of tryptophan 517f of tyrosine 495, 496 pathways of fructose 372 role of aldosterone 595 catecholamines 598 cobamide coenzymes 199 cysteine 507 FSH 569 glucocorticoids 592 glycine 511 insulin 584 lipoic acid 187 methionine 505 oxytocin 571 thyroid hormones 576 tyrosine 497 vasopressin 571 Metabolism of acyl glycerols and sphingolipids 419 adipose tissue 400 carbohydrates 325 INDEX Labelled rose bengal dye 739 Lability of proteins 472 Lac-Operon structure 273 Lacrimal glands 166 Lactase deficiency 323 Lactate dehydrogenase 640, 730 propanediol pathway 370 Lactosazone crystals 28 Lactose 24, 33 synthetase 371 Lactulose 24, 34 Laevulinic acid 30 Lanosterol 431 Lashmet and Newburg concentration test 655 Lead acetate test 87 Leber’s hereditary optic neuropathy 10, 19 Lecithin-sphingomyelin ratio 59 Leiner’s disease 192 Leptin resistance and obesity 770 Lesch-Nyhan syndrome 236 Leucine crystals 665 encephalin 570 Zipper motif 277 Leukaemias 627 Leukoplakia 792 Lidocaine 668 Liebermann-Burchard reaction 51 Ligand gated channels 15 Light chain types 115 Limit dextrin 37 dextrinosis 354 Limiting amino acid 756 Lineweaver-Burk plot 126f Lingual lipase 53, 392 Linkages in glucuronides 559f Linoleic acid series 47 Lipid fractions in plasma 399t molecules 11 peroxidation 210 storage diseases 424 Lipoic acid 122, 187, 335, 341 Lipoprotein 46, 85, 448 electrophoresis pattern 452f Lipoxins 74 Lipoxygenase inhibitor 74 system 74 Lithocholic acid 438 Live attenuated vaccines 850 vector vaccine 850 Liver and heart muscle 233 cell carcinoma 670 necrosis 373 diseases 224, 669, 767 function tests 659 isoenzyme 648 phosphorylase 349 Loading test 363 Löhmann reaction 147 Loss of potassium ions 311 Low density lipoproteins 444 lactase activity 323 Lower fatty acids 47 Lucey-Driscoll syndrome 552 Luft’s disease Lung scanning 740 Luteinising hormone 569 Lycopene 801 Lycophyll 50 Lysophosphatides 56 Lysosomal enzymes Lysosomes 7, 869 INDEX 870 Textbook of Medical Biochemistry cholesterol 431 creatine 525 cystine 506 ethanol 460 fructose 372 GABA 492 galactose 369, 370f glycogen 346 HDL 449 histamine 492 lipids 398 minerals and trace elements 608 propionic acid 368f prostaglandins 67 proteins and amino acids 470 purines 229 and pyrimidines 226 sulphur-containing amino acids 504 superoxide radical 154 Metachromatic leucodystrophy 61 Metal activated enzymes 122 Metalloproteins 85 Metastatic carcinoma 669 Methaemalbumin 154 Methaemoglobin 153 Methionine 78, 526 encephalin 570 Methotrexate 128, 195 Methyl malonic aciduria 200 trap hypothesis 199 Micelles formation 440 Michaelis-Menten equation 125 Microcytic hypochromic anaemia 678 Micronodular cirrhosis 621 Microsomal chain elongation 418 system 414 Mild diabetic curve 386 Millon’s test 87 Mineralisation of bones 169 Mineralo-corticoids 594 Miscellaneous tumour markers 810 Missense mutation 277 Mitochondria power house of cell Mitochondrial chain elongation 419 CK 647 isoenzyme 647 DNA 243 electron transport chain 138 matrix membranes shuttle systems 143 system 414 Mixed stones 440 water and sodium depletion 703 Moderate diabetic curve 386 Moderately severe diabetic curve 386 Molecular oxygen 495 weight 36, 86, 93 Molecules of pyruvate dehydrogenase 335 Molisch’s test 30 Molybdenum 630 Mono unsaturated fatty acids 47 Monoacyl glycerol lipase 401 Monoaminodicarboxylic acids 78 Monoclonal antibody 118 hybridoma 118 Monoglutamate 192 Monomeric enzymes 122 Monosaccharide 24, 26 malabsorption 323 Motor vehicles 783 Mouse myeloma cells 118 Mucic acid 27 Mucopolysaccharide synthesis 167 Mucopolysaccharidoses 43 Mucosal atrophy of stomach 199 block theory 618 Multidrug resistance 802 Multigene disorders 307 Multiple sclerosis 424 warts 795 Muramic acid 32 Muscle phosphorylase 186, 349 Muscular dystrophy 172 exercise 750 Myeloproliferative disorders 801 Myoglobin 616, 642 Mysteries of life 294 Myxoedema 440, 749 N Nagao isoenzyme 648 Nasopharyngeal carcinoma 794 Natriuretic peptides 699 Natural toxins 787 Nature of bile pigments 549 L-amino acid oxidases 476 lipid 61, 62 polymer 158 Necrotising enterocolitis 211 Neonatal hypocalcaemia 615 tyrosinaemia 502 Nephrogenous diabetes insipidus 225 Nephrotic syndrome 108, 440 Neuraminic acid 32 Neuroblastomas 792 Neurosyphilis 727 Neutral amino acids 77 fats 46, 52 N-glycosylamine linkage 40 Niacin 163, 341 antagonists 184 therapy 456 toxicity 185 Nickel 629 Nicotinamide 183 adenine dinucleotide 181, 341 Nicotinic acid 163, 182, 435 Niemann-Pick disease 57 Nieweg’s hypothesis 201 Night blindness 166 Nitrogen balance 472 Nitroglycerine 523 Nocturnal muscle cramps 172 Nomenclature of fatty acids 47 Non-competitive inhibition 129f Non-essential amino acids 80, 472 Nonne-Apelt test 729 Non-oxidative deamination 475, 476 Non-standard amino acids 79 Non-viral vectors liposomes 302 Normal basal secretion rate 681 blood ammonia level 478 level 164, 171 electrolyte balance 697 human haemoglobin 151 serum level of B12 198 urinary excretion 739 values of plasma proteins 98 water balance 697 Norum’s disease 51 Nuclear proteins 796 Nucleic acids 239 Nucleoplasm Nucleoproteins 84, 215 Nucleoside phosphorylase 233 deficiency 236 Nucleosomes 240 Nucleotides 218 Nucleus 5, Nutrients in leafy vegetables 775 requirement in lactation 771 requirements during pregnancy 770 Nutritional macrocytic anaemia 196 Nutritive value of egg 774 milk 772 Nyctalopia 166 O Oat-cell carcinoma 798 Oatmeal porridge 677 Obesity 767 Obligatory loss 697 Obstruction of biliary tree 553 Obstructive jaundice 440, 662, 664, 665, 667, 670 Occurrence of amino acids 80 Ochronosis 502 Ocular albinism 503 Oculocutaneous albinism 503 Oestradiol 471 O-glycosidic linkage 40 Oleic acid 47 Oligomenorrhoea 767 Oligomeric 122 Oligomycin 145 Oligosaccharides 24, 35 Oliguria 701 Open-circuit system 747 Opening of hemiacetal ring 25 Oral hippuric acid test 665 Organ scanning 737 Index Organic acids 710 compounds of small molecular size 695 pollutants 784 proteinurias 107 substances of large molecular size 695 Organocarbamates 785 Organophosphorous poisoning 641 Orientation of amphipathic lipids 62 Ornithinemia 482 Orotic acid 459 aciduria 236 Osazone crystals 29f formation 28f Osmol units 818 Osmosis 818 and osmotic pressure 818 Osmotic loading 610 Osteomalacia 170 and rickets 615 Outer mitochondrial membrane Ovalbumin 774 Ovarian steroid hormones 605 Overdosage of vitamins 614 Ovoglobulin 774 Ovomucoid 774 Oxaloacetate forming amino acids 368 Oxalosis 363 Oxaluria 186 Oxidases 136 Oxidation 53, 81, 326 Oxidation of fatty acids 407 iodide 573 malic acid to oxaloacetate 340 succinic acid to fumaric acid 340 Oxidative deamination 475 decarboxylation 523 of pyruvic acid 337f phosphorylation 143, 174 stage aerobic final 532 Oxides of carbon 783 sulphur 783 Oxygen-saturation curve 205f Oxyhaemoglobin 155 Oxynervon 59 Oxytocin 570 P Phospholipids 46, 399 Phosphoproteins 85 Phosphoric acid 710 Phosphorus 615, 773 Phosphorylase enzyme 349, 350 Phosphosphingosides 55 Photochemical oxidants 783 Photoelectric colourimeter 826 Physostigmine 128 Phytic acid 201 Phytyl alcohol 50 Pigment stones 440 Pineal gland 563 Pink striae 769 Pinocytosis 18 Pituitary gonadotropins 569 hormones 566 tropic hormones 568 Placental hormones 605 isoenzyme 648 Plant albumins 84 Plasma buffers 711 derived enzymes 637 lipids 399 lipoproteins 400t and atherosclerosis 455 and metabolism 443 membrane 10 proteins 97 surface tension 821 tyrosine level 687 volume 694, 695, 738 Plasmalogens 57f Plethora 770 Polenske number 54 Polyacrylamide gel electrophoresis 830 Polyamine synthesis 505 Polyclonal antibody 118 Polyfunctional alkylating agents 802 Polymer of glucose 35 Polymerase chain reaction 287 Polypeptide chain 151 Polyphenolic glycosides 788 Polyribosomes 268 Polysaccharide 24, 35 inulin 27 Polyunsaturated fatty acids 47 Pompe’s disease 354 Porphyria 544 cutanea tarda 545 Porphyrin 540 synthesis 186 Porphyrinurias 545 Post prandial hyperglycaemia 760 Post-absorptive state 374 Postrenal diseases 482 Postural proteinuria 107 Potassium 610 deficiency 721 Powder puff 28 Power house of cell Prausnitz-Küstner reaction 113 Pregnancy tests 605 Pre-hepatic jaundice 661 INDEX Paget’s disease 581 Palmitoyl-CoA 423 Pan proteinase inhibitor 105 Pancreatic diabetes 381 juice 698 lipase 53, 393 secretion 70 somatostatin 589 Pandy’s test 729 Pantothenic acid 163, 187, 341, 544 Papain 116 Paper chromatography 827 electrophoresis 830 system 831f Papillary necrosis 384 Paps-phosphoadenosine phosphosulphate 222 Para-amino hippurate 654 Parafollicular C-cells 571 Parasitic infections 620 Parathormone 578, 624, 625 Parathyroid glands 578 Parenchymal liver diseases 667 Parenchymatous liver diseases 665, 667 Parenteral nutrition 632 Parkinson’s disease 187, 777 Pasteur effect 343 Patent ductus arteriosus 211 PCR first and second cycles 288f Pellagra 184 Pentagastrin test 681 Pentoses 24, 27, 30 Pepsin 116, 464 Peptic ulcers 620 Peptide 86 bond formation 267 hormones 605 linkage and peptides 88 Peptones 85 Percentage of total proteins 729 Peripheral artery disease 171 membrane proteins 10, 12 neuritis 384 proteins 14 Periventricular leukomalacia 211 Pernicious anaemia 680, 681, 739 Peroxidase 85 Peroxisomes Pesticides 785 Phagocytosis 18, 212 Phagolysosomes 18 Phagosomes 18 Phenol sulphthalein excretion test 655 Phenolphthalein 677 Phenyl acetic acid 500 alanine 495, 730 hydroxylase 500 ketonuria 500 Pheochromocytoma 67 Pheomelanins 499 Phosphate buffer system 711 transporter 139f Phosphatidic acid 57, 58f Phosphatidyl choline 55, 399, 424 ethanolamine 56, 399 glycerol 57 serine 56 sphingosides 57 Phosphodiesterase 223 Phosphoenol pyruvate 331 carboxykinase 364, 369 Phosphoinositides 55 Phospholipases 55 871 INDEX 872 Textbook of Medical Biochemistry Pressor amines 788 Primary aliphatic and aromatic alcohols 556 alkali excess 719 and secondary structure of t-RNA 245f bile acids 438 carcinoma 669 derived proteins 85 haemochromatosis 621 hereditary haemochromatosis 621 hyperlipoproteinaemias 451 hyperoxaluria 512 hyperparathyroidism 614 hypothyroidism 685 low lactase activity 323 prostaglandins 67 structure of DNA 240 RNA 244 Principle of Beacon probe system 290f chemiosmotic theory 144f Taqman probe system 290f Prion diseases 92 Proanthocyanidines 211 Probenecid 236 Process of oxidative deamination 476 Progestational hormones 604 Progesterone 604 Progestins 605 Prokaryotes and eukaryotes 255t Prokaryotic and eukaryotic DNA polymerases 251t cells Prolactin 402 Prolidase 467 Prolonged use of antibiotics and sulfa drugs 174 aspirin 74 Promoter insertion 797 Properties of amino acids 80 cancer cells 791 colloids 822 disaccharides 33 foods 761 hybridoma cell 118 myeloma cells 118 splenic cells 118 Propionic acid 364, 367 Propyl gallate 211 Prostacyclins 66 Prostaglandins 66 Prostanoic acid 66f Prostanoids 66 Prostatic acid phosphatase 814 Protamines 83 Protease inhibitors 788, 847 Protective colloids 823 Proteins 12, 76, 83, 775 buffer system 712 energy malnutrition 765 nature of enzymes 121 synthesis 180, 383 Proteinuria 107 Proteoglycans 40 Proteolytic enzymes Prothrombin index 667 Proton pump 142 Proto-oncogenes 794 Provocative tests 643 Pseudohypoparathyroidism 224, 614 Pseudouridine 219 Psychosin 59 Pteroic acid 192 Pulmonary function 739 tuberculosis 385 ventilation 204 Pure salt depletion 701, 702 sodium depletion 703 water depletion 701 Purine nucleoside phosphorylase 234 cycle 219f salvage cycle 233, 234f pathways 232 Puromycin 270 Pyelonephritis 384 Pyranoses 26 Pyridine-linked dehydrogenases 137 Pyridoxal phosphate 122 Pyridoxine 163, 185 deficiency 436 Pyrimethamine 195 Pyrimidine base salvage 233 phosphoribosyl transferase 233 Pyrithiamine 179 Pyrophosphorylase 347 Pyrrolysine 80 Pyruvate carboxylase 364, 369 dehydrogenase complex 187 forming amino acids 341, 368 symport 139f Pyruvic acid 334 Q Quaternary structure 91 Quercetin 801 R Racemic 25 Radiation absorbed dose 736 hazards 736 safety and protection 737 Radioactive emissions 734 materials 784 renogram 657 scanning 657 Radioactivity radioisotopes in medicine 734 Radioimmunoassay method 688 Radioisotopes 735 in medicine 736 Random DNA 281 Ranges of normal excretion of polyamines 494 Rapoport-Luebering shunt 333 RB cells folate 194 volume 738 Reactions of citric acid cycle 338 glycolytic pathway 328 synthetic pathway 347 Recombinant adenoassociated virus 302 Recycling of iodine in gland 574 Red cells abnormalities 360 membranes 14 Redox potential and free energy 138 of redox couples 138t Reduction in serum albumin 614 Refrigeration test 452f Refsum’s disease 412 Regan isoenzyme 648 Regulation of bile acid synthesis 438 biosynthesis of lactose 371 blood glucose 374 sugar level 345 creatine synthesis 527 fatty acid synthesis 418 gluconeogenesis 368 glutamine synthetase activity 485 glycogen metabolism 352 glycogenesis 348 glycogenolysis 350 glycolysis 332 HMP shunt 358 hormone secretion 566 insulin receptors 583 lipoprotein lipase activity 447 purine synthesis 233 synthesis of ribosomes 246 TCA cycle 342 testosterone secretion 570 Regurgitation jaundice 661 Rehfuss tube 676 Reichert-Meissl number 54 Relation of cholesterol 441 tyrosine kinase 585 Relative viscosity of gelatine 822 Relaxin 604 Removal of free radicals 171 Renal action 70 aminoaciduria 94 clearance-study 739 diseases and renal failure 614 function tests 650, 651 glycosuria 378-380, 387 osteodystrophy 170 plasma flow 654 scan 740 Renin angiotensin system 596 Resistance against blood flow 822 Respiratory acidosis 718 alkalosis 721 Index minerals in diet 762 nitric oxide 520 oxaloacetate 429 peroxisomes in oxidation of fatty acids 412 phosphorylation of tyrosine kinase 566 prostaglandins 699 protein phosphatases 584 quinones in ATP formation 147 respiration in acid-base regulation 713 selenium in cancer 632 HIV infection 632 suppressor T-RNA molecules in mutations 280 vitamins in TCA cycle 341 Rose-bengal dye test 666 Rotor syndrome 553 Rous sarcoma virus 796 Ryle’s tube 676 S Saccharomyces cerevisae 293 Sakaguchi test 87 Salicylates 236 Saliva 698 Salivary amylase 320 Salkowski test 51 Salmonella infections 158 typhimurium 831f Salt bridges 155 formation of amino acid 81f Salvage pathways for purine and pyrimidine bases 232 Sanger’s reagent 82 Saponification number 54 Sarcomas of bones and skeletal muscles 792 Scanning of thyroid gland 684 Scavengers of free radicals 210 Schiff’s reagent 57 Schilling test 200, 739 Schumm’s test 154 Sclera of eye 43 Screening test 669 Scripp’s vaccine 770 Sebaceous glands sebum 47 Seborrhoeic dermatitis 180 Secondary bile acids 438 haemochromatosis 622 hypothyroidism 685 low lactase deficiency 323 structure of DNA 240 RNA 244 Secretion of bilirubin in bile 551 Sedoheptulose 27 Selenium 211, 630, 801 deficiency in humans 631 poisoning 560 toxicity 631 Selenocysteine 80 Selenophosphate synthetase 80 Seliwanoff’s test 30 Semi-essential amino acids 80, 473 Separation of plasma lipids 399 proteins 97 proteins from small solutes 819 Septic shock 523 Serine 513 Serotonin 519 Serum alkaline phosphatase 669 amylase 642, 671 cholesterol 440 cholinesterases 670 CK level 687 copper 622 CPK 643 creatine level 687 enzymes in bone diseases 643 GI tract diseases 642 heart diseases 639 liver diseases 642 muscle diseases 643 glutamate oxaloacetate transaminase 640 hydroxy butyrate dehydrogenase 671 isocitrate dehydrogenase 670 lactate dehydrogenase 670 leucine amino peptidase 670 level of cholesterol 48 lipase 53, 643 ornithine carbamoyl transferase 670 pepsinogen 681 sorbitol dehydrogenase 671 transaminases 668 triglyceride level 768 TSH level 686 uric acid level 687 Severe acute hepatic necrosis 665 diabetic curve 386 exercise 378 liver diseases 94, 377 Shine-Dalgarno sequence 266 Shuttle systems 343 Sia test 112 Sialic acids 32 Sickle cell anaemia 158, 627 erythrocytes 158 Simple lipids 46, 52 monoamino monocarboxylic acids 77 proteins 83 sugars 24 Single point mutation 797 Sinigrin 802 Skeletal deformities 508 muscle 234 Skin disorders 767 Slow transforming retroviruses 795 Small cell carcinoma of lung 798 nuclear RNAs 246 RNAs 246 INDEX proteins 83 quotient 749 tract 166 Restriction fragment map 294 Retention jaundice 661 Retinoblastomas 792 Retinoic acid functions 167 Retinopathy of prematurity 211 Retroviruses 301 Rheumatoid arthritis 212, 620 Rhizopterin 193 Rhodopsin cycle 164, 165f Riboflavin 179, 771 Ribonucleic acid 244 Ribonucleoproteins 84 Ribonucleotide reductase 228 Ribosomes 264 Ribosylamine 32 Rich’s classification of jaundice 661 Richnar-Hanhart syndrome 502 Rickets 169 Riegel meal 677 RNA polymerase viruses 795 Rochelle salt 31 Roentgen equivalent mammals 736 Role of apolipoproteins 441 apoptosis in carcinogenesis 805 bile salts in pancreatic lipase activity 393 calcium in hormone action 565 carbohydrates in diet 758 catabolite gene activator protein 274 ceruloplasmin 209 C-GMP in action of neurotransmitters 224 hormone action 566 insulin actions 224 phosphorylation of proteins 224 retinal light-dark adaptations 224 vasodilatation 224 cholesterol 441 creatine in muscles 527 cysteine in detoxication 508 dietary fibres 775, 776 different buffer systems 711 dopamine receptors in ageing 856 EFA in fatty liver 48 fat in stomach 392 FSH in spermatogenesis 569 glutamine in brain 486 conjugation reaction 487 kidney 486 glutathione in amino acid absorption 468 hormones 434 interleukins 103 kidneys 615 kinins 699 lipids in diet 760 liver 447 liver glycogen 346 in copper absorption 622 in lipid transport and metabolism 453 marine fish lipids 72 metal ions in enzymes 122 873 INDEX 874 Textbook of Medical Biochemistry Smoke index 783 Smooth muscle cell 522 injury 455 Sodium citrate 31 pump 609 Soiling index 783 Solubility curve 93 of cholesterol 440 Soluble starch 35 Solutes in body fluids 695 Somatic cells 305 gene therapy 299 mutations 852 Somatostatin 588 Sorbitol intolerance 373 Soret band 153 Sources of acetyl-CoA 418, 442t air pollution 783 bilirubin 549 plasma enzymes 637 Sparsomycin 271 Spectrin 14 Spectrophotometer 826f Sphingolipidoses 63t, 424 Sphingolipids 11 Sphingomyelins 57, 399 Sphingosine 50 Spina bifida 197 Spoilt sweet-clover hay 174 Spontaneous hypoglycaemia 378 Stable non-radioactive isotopes 735 Stages of biosynthesis 541 diabetes mellitus 380 lipid peroxidation 210 transcription 260 Stagnant hypoxia 207 Standard histamine test 679 oral glucose tolerance test 385 Starch electrophoresis 831 granules 35 Starling hypothesis 696 Steatorrhoea 378 Stereoisomers 24 of glucose 25f Steroid hormones 563, 589 therapy 610 Sticky patch 158f Stimulates glycogenesis 584 Stimulation of respiratory centre 721 tests 678 Stomatitis 184 Storage iron 617 Streptomycin 270 Strontium 785 Structural element of gonads 48 mitochondrial membrane 48 tissues 48 genes 273 organisation of proteins 89 proteins 83 Structure and functions of electron transport chain 139 molecular features of HIV 839 Structure of adiponectin 770 amino acids 77 blood groups 41f choleratoxin 312 chondroitin SO4 39f cyclic amp 223f fibrinogen 104f folinic acid 193 haem 150f Hb 150 heparin 39f hyaluronic acid 38f immunoglobulin 115f insulin schematically 582f lac operon 272f lipoprotein complex 444 molecule 444f natural polyamines 494 vitamin B12 196f, 197 Subclinical jaundice 662 Substituted fatty acids 47 Substrate level phosphorylation 147 Succinate-glycine cycle 513, 514f Succinylcholine 128 Succinyl-CoA formation and fate 342f forming amino acids 341 Suicide enzyme 68 Sulfhaemoglobin 157 Sullivan reaction 87 test 644 Sulpholipids 46, 61 Sulphonamides 128, 360 Sulphones 360 Sulphur 615 dioxide 783 Sulphuric acid 710 Super heated steam 53 Superoxide dismutase 210, 234 Symport system 16 Synthesis of arachidonic acid 423 argininosuccinate 480 asparagine 486 calcitriol 169f carbamoyl phosphate 227 cardiolipin 421 catecholamines 497 ceramide 423 certain blood coagulation factors 660 cholesterol and steroids 342 citrulline 480 estrogens 602f glucocorticoids 590f glutamine 484 haemoglobin 544 inosinic acid 230f melanin 499, 500f mevalonate 431 phosphatidyl serine 421 polyamine 493, 494f prostaglandins 48 pyrimidine deoxyribonucleotides 228 serotonin 519 sphingomyelin 423 thymine deoxyribonucleotides 228 thyroglobulin 572 thyroid hormones 497 T Tabetic curve 732 Tanned red cells haemagglutination test 688, 689 Tannic acid 776 Tapeworm infection of GI tract 200 Tay-Sachs disease 61 TCA cycle 147 Teletherapy 740 Tertiary hypothyroidism 685 structure of RNA 244 Testosterone 600, 856 Tests based on drug metabolism 660, 668 excretory function of liver 666 Tests of tubular excretion and reabsorption 655 function 654 Tetracycline 270 Tetroses 24, 27 Thalassaemias 159 Theobromine 218, 777 Theophylline 218 Theory of Berczeller 555 Quick 555 Sherwin 555 Therapeutic uses of calcitonin 581 enzymes 132, 133 isotopes 740 retinoic acid 167 Thiamine 177, 336, 341, 771 antagonist 179 deficiency 178 pyrophosphate 122, 335 Thioctic acid 187 Thiocyanogen 788 Thio-oxazolidone derivatives 788 Thioredoxin reductase 80, 228 Thrombocytopenia 196 Thrombosis 632 Thromboxanes 66, 71 Thymidine 118 diphosphokinase 228 Thymidylate kinase 228 synthetase 228 Index Tumour markers 808 Turbidimetric method 728 Types of abnormal Hb 157 acyl-CoA dehydrogenases 409 amylases 36 apoproteins 445 cells cerebrosides 59 chromatography 827 colloidal solutions 823 conjugation 557 crystals 28 cytochromes 137 DNA 241 electrophoresis 830, 833t endocytosis 17 endorphins 570 fatty acids 47 liver 457 gallstones 440 gangliosides 60 gates 15 gene expression 272 glucose tolerance test 385 glycosurias 378 growth factors 799 histamine test 679 histones 240 immunoassays 834t inositol 201 lipids present in biomembranes 11 melanins 499 mucopolysaccharidoses 42t obesity 767 phospholipases 55 plasmids 283 prions 92 proteinurias 107 receptor antibodies 690 reverse turns 90 RNA 244 stomach tubes 676 storage fats 404 transport system 16 tumour markers 809 vitamin K 173 Tyramine 491 Tyrosinase negative albinos 503 positive albinos 503 Tyrosine crystals 665 U Ubiquitin-protease pathway 131 Ulcerative colitis 792 Ultracentrifugation 93, 399 Uncouplers of oxidative phosphorylation 146 Uniport system 16 Unit of serum enzyme activity 638 viscosity 822 Unoxidised sulphur test 87 Urate oxidase 236 Urea clearance test 652 Uric acid 730 Uridine nucleotides 220 Urinary chlorides 701 excretion 526 lithiasis 170 tract 166 Urine 372, 425, 483, 501, 502 ascorbic acid saturation test 177 urobilinogen 662 Uronic acid pathway 361f, 362 acids 29 Uses of enzymes 132 glycerol 49 liposomes 64 monoclonal antibodies 119 ribozymes technology 309 synthetic DNA linker 284 Uterine muscle 70 Utilisation of glucose 326 in body 326 ketone bodies 427 V Van Der Waal forces 91 Variegate porphyria 545 Vascular powerful vasodilator 700 Very low density lipoproteins 444 Vibrio cholerae 310, 311, 312, 314 foetus 310 toxins 310 Vibrionaceae 310 Vinculin 796 Violent muscle contraction 611 Viral meningitis 727 oncogenesis 794 quantitation 291 Virion structure 839 Virus life cycle 840 Viscosity of blood plasma 822 protein solutions 86 solvent 817 whole blood 822 Vision docosahexaenoic acid 48 Visual colourimeter 826 Vitamin 162, 322, 730, 773 A 162, 163 B complex 435 B1 163, 177 B12 163, 197 deficiency 200 B2 163, 179 B3 181 B5 187 B6 163, 185, 187 B7 190 C 163, 174, 176 content of egg 773t D 162, 167, 613 INDEX Thymine 216, 217, 229 Thymol flocculation 664 turbidity and flocculation test 664 Thymus 563 Thyroglobulin 571, 688 Thyroid aciner cells 572 antibodies in thyroid diseases 689 clearance rate 684 disorders 225 function tests 683 gland 571 hormones 322, 358, 377, 434, 571, 625 microsomal antigen 688 scanning 688, 740 stimulating hormone 688 immunoglobulins 690, 691 Thyrotoxicosis 441, 741 Thyrotropin binding inhibitory immunoglobulins 690 Thyroxine 79, 571, 688 Tissot method 747 Tissue amino acids 471 folate 194 polypeptide antigen 812 Tocopherols 171 Total body water 695, 738 cholesterol 399 exchangeable sodium 738 lipids 399 phospholipids 399 Tourniquet test 177 Toxaemia of pregnancy 767 Toxic hyperbilirubinaemia 552 Toxicity in humans 631 Transcellular fluid 694 Transfer of bilirubin 551 Translation of m-RNA 264 Transport of bilirubin 550 carbon dioxide 207 cholesterol 434 lipids from liver 58 macromolecules 16 oxygen 205 Transportation of plasma lipids 399 zinc 105 Traumatic blood 726 Treatment of cancer 495 Triacyl glycerol 399 Tricarboxylate transporter 139f Trichochromes 499 Triglutamate 192 Tripeptides 86 Triple helix 90 Trypsin 464 Tryptamine 491 Tryptophan 78, 516 Tubeless gastric analysis 681 Tuberculous meningitis 727 Tubulin 875 876 Textbook of Medical Biochemistry E 171, 801 K 163, 172 analogue 146 K1 173 K2 173 K3 173 von Gierke’s disease 235, 353 W INDEX Wald’s visual cycle 164, 165f Waldenström’s macroglobulinaemia 112 Water dilution/elimination test 655 intoxication 701, 706 pollution 784 soluble vitamins 163, 174 Watson and Swartz test 546 Wernicke-Korsakoff syndrome 360 Wet beriberi 178 Wilms’ tumour 792 of kidney 798 Wilson’s disease 94, 623 Wobble phenomenon 277 Wolff-Chaikoff effect 577 Wolman’s disease 453 X Xanthine oxidase 209, 234 Xanthinuria 236 Xanthochromia 726 Xanthomatosis 440 Xanthomatous biliary cirrhosis 440 Xanthoproteic reaction 87 Xenobiotics 555 Z Zak’s reaction 51 Zellweger’s syndrome 8, 413 Zinc 211, 626, 801 binding factor 626 finger motif 277, 628 sulphate turbidity test 664 Zollinger-Ellison syndrome 681 .. .Textbook of Medical Biochemistry Textbook of Medical Biochemistry Eighth Edition Dr (Brig) MN Chatterjea BSc MBBS DCP MD (Biochemistry) Ex-Professor and Head, Department of Biochemistry... Cover Design: Seema Dogra Textbook of Medical Biochemistry First Edition Second Edition Third Edition Fourth Edition Fifth Edition Sixth Edition Seventh Edition Eighth Edition : : : : : : : : 1993... Ex-Professor and Head Department of Biochemistry Patna Medical College Patna, Bihar, India PREFACE TO THE EIGHTH EDITION It is a great pleasure to present the Eighth Edition of Textbook of Medical