Textbook of Biochemistry for Medical Students DM Vasudevan, Sreekumari S, Kannan Vaidyanathan
INDEX
Page numbers followed by b refer to box, f refer to figure, and t refer to table.
A
Abetalipoproteinemia 269, 270
ABO system 750
Abruptio placenta 454
Absorption
bands 383, 383t
defective 223, 541
Academia, propionic 227
Acanthocytes 269
Acarbose 199
Aceruloplasminemia 575
Acesulfame potassium 100
Acetaminophen 437
Acetazolamide 431, 469, 485
Acetic acid 105, 506
Acetoacetate 333, 368
decarboxylation of 64f
Acetoacetic acid 414, 829
Gerhardt's test of 237
Acetone 195, 236, 414
smell of 196, 237
Acetyl 377, 378
serotonin 314
Acetylation 506, 506f, 638, 664
Acetylcholine 312, 547, 794, 804
clinical applications of 548b
esterase 609
receptor 22, 22f
synthesis 547
Acetylcholinesterase 78
Acetyl-coenzyme A 121, 123, 125, 157, 160, 224
carboxylase 188, 189, 231, 539
complete oxidation of 123
oxidation of 237
transfer of 228f
Acetyltransacylase 229
Achlorhydria 546, 572
Acid 458
excretion, mechanism of 465
peptic disease 281
phosphatase 13, 78
secretion 343
regulation of 423
strong 458, 459
Acid-base 459, 459b
abnormalities 473t
balance 458, 466
clinical applications of 461b
catalysis 60, 60f
disturbances 466b, 467b
causes of 472t
chemical pathology of 468
classification of 466
clinical assessment of 466b
types of 465t
parameters 466b
assessment of 472
Acidemia 227
Acidic amino acids 32
Acidic dyes 43
Acidity 459, 559
Acidophils 808
Acidosis 366, 393, 461, 465, 466, 472, 563
inorganic 469t
Aciduria
argininosuccinic 300, 346
dicarboxylic 232
glycolic 310
propionic 300
Acne 517, 517f
Aconitase 127
Acquired immunodeficiency syndrome 214, 764
epidemic of 764
Acrodermatitis enteropathica 576
Acromegaly 192
Actin 789, 790
Actinomycin D 657, 782
Active methionine 313
formation of 314f
Acute respiratory distress syndrome 110, 760
Acycloguanosine 630
Acyclovir 630
Acyl carrier protein 229, 230
Acyl cholesterol acyltransferase 247
Acylcarnitine 224, 226
Acyl-coenzyme A 224
Dehydrogenase
long chain 227
medium chain 227
synthetase 222
Addison's disease 481, 814, 815
Adenine 617, 619
dinucleotide 439t
nucleotide transporter 139f, 140
phosphoribosyltransferase 623
Adenoma, adrenal 814
Adenosine 619
deaminase 748
deficiency 626
diphosphate 120, 370, 790
ribosylation 72, 535, 638
monophosphate 208, 367, 619
triphosphate 59, 123, 130, 160, 208, 367, 370, 617, 620f, 790
binding cassette protein 187, 252
hydrolysis of 120
synthase 13, 136, 136f, 137f
Adenosylcobalamin 544
Adenovirus 698
Adenylyl cyclase 804
Adipocytes 416, 592, 786
Adipokines 233
Adiponectin 233
Adipose tissue 108, 148, 232, 233, 233t, 250, 364, 592, 593f
derived hormones 233, 820
metabolic profile of 369
metabolism of 232
Adrenal androgen secretion, assessment of 814
Adrenaline 166, 190, 802
deficiency of 335
Adrenergic receptor system 272
Adrenocorticotropic hormone 181, 333, 809
Adrenodoxin 504
reductase 504
Adrenogenital syndrome 814, 815t
Adrenoleukodystrophy 16, 278
neonatal 228
Adrenomedullin 264
Adriamycin 647, 782
Adsorption chromatography 722, 722f
Aducanumab 797
Advanced glycation end products 199
Aflatoxins 611, 771
Agar 98, 720
Agarose 98, 720, 723
gel 721
Aglycone 95
Air pollutants 609
Alanine 32, 160, 295, 311, 312, 723f
aminotransferase 77, 158, 211, 294f, 295
estimation of 77
glyoxalate aminotransferase 310, 310f
transamination of 160f
Albinism 334, 338
Albumin 9, 44, 45, 254, 384, 413, 444, 446, 448, 450, 478
appearance of 430
clinical significance of 447
creatinine ratio 438
estimation of 419
functions of 446
globulin ratio 447
half-life of 446
Albuminuria 438, 447
Alcian blue staining 354
Alcohol 44, 45, 211, 487, 504, 536
abuse 78
acute toxicity of 210
dehydrogenase 57, 64, 210, 504, 516
groups, oxidation of 505f
metabolism of 209, 210f, 216
Alcoholic ketoacidosis 469
Alcoholism 194, 211, 234, 567, 811
Aldehyde 210, 536
dehydrogenase deficiency 210, 504
group 90f
test 36
Aldimine 294
Aldolase
A 150
B 185, 208
Aldonic acid 94
Aldoses 90
epimerism of 92
Aldosterone 479, 735, 815
decreased levels of 815
Alemtuzumab 782
Aliphatic amino acids 30
metabolism of 307
Alkalemia 461
Alkali
reserve 458, 461
resistant 651
Alkaline phosphatase 68, 77, 388, 419, 522, 561, 565, 726
isoenzymes of 77
Alkaloid 610
Alkaloidal reagents 44
Alkalosis 393, 466, 472, 484, 485, 563
hypochloremic 470, 486
Alkapton bodies 337
Alkaptonuria 186, 337, 338f, 346, 352
diagnosis of 338
Alkoxyl 496
Allelic expression 685
Allergy 536, 600, 601, 754
Alloenzymes 75
Allogenic bone marrow transplantation 701f
Allograft, rejection of 743
Allopurinol 70, 498, 500, 629
inhibits xanthine oxidase 626f
Allosteric enzymes 71t
action of 71f
Allosteric inhibitor 71, 71b, 71f
Allozymes 75
Alpha 1 antitrypsin deficiency 419, 446, 449
Alpha 2 macroglobulin 450
Alpha adrenergic stimulation 187
Alpha amanitin 657
Alpha amino
acids 30
group 36
Alpha amylase 97, 146
Alpha antiproteinase 449
Alpha carboxyl group 36
Alpha fetoprotein 356, 357, 420, 450, 490, 779
measurement of 490
Alpha galactosidase 284
Alpha helix 39
structure of 39f
Alpha hydroxyprogesterone 358
Alpha ketoglutarate
dehydrogenase 121, 123f, 126, 127, 531
formation of 121
Alpha ketoglutaric acid 294
Alpha lipoprotein deficiency, familial 270
Alpha maltose 97
Alpha methenyl bridge 384
Alpha methyldopa 334
Alpha oxidation 227
steps of 228
Alpha thalassemia 399
genotypes of 399t
phenotypes of 399t
Alpha tocopherol 500, 523, 523f
Alumina 722
Aluminum toxicity 608
Alzheimer's dementia 499
Alzheimer's disease 16, 250, 292, 575, 576, 608, 700, 754, 797
Amadori rearrangement 197
Amanita phalloides 653
Amelogenin 22
American Diabetes Association 183
Ames test 678, 679f
Amethopterin 543
Amide
formation 35
group 31f
reaction of 35
Amine 506
Amino acid 30, 30f, 31, 31f, 32, 32f, 34, 34t, 36, 37, 61f, 125, 296b, 300, 312, 313, 318t, 345, 364, 413, 503, 507f, 559, 565, 590f, 590t, 659, 659t, 660, 723f, 794, 821
absorption of 291
activation of 660
aliphatic 30
amino groups of 33
basic 32
catabolism 624
classification of 30
clinical applications of 291b
color reactions of 36, 36t
decarboxylation of 35f
derivatives 36
dibasic 31f
dicarboxylic 31f
endogenous 294f
essential 33b, 46, 289, 325, 588
fate of carbon skeletons of 345
general
metabolism of 293
reactions of 35
structure of 30f
glucogenic 125, 159, 312, 313, 320, 321, 345
heterocyclic 31, 332
interconversion of 295
interorgan transport of 293, 293f
ionic forms of 33f
isoelectric pH of 43
ketogenic 125, 345
limiting 590
metabolic fates of 345f
metabolism 289, 289f, 342, 414, 536
modifications of 664
natural 34
non-alpha 32
non-protein 32
numbering of 37
oxidation 533
pool 294f
profile 724f
properties of 33
sequence of 37, 42f
simple 30f
sulfur-containing 536
synthesis of nonessential 35, 295
transport of 316, 317
Amino aciduria 209, 318t, 468
Amino carboxyamino imidazole ribonucleotide 622
Amino group 35, 59
Amino imidazole ribonucleotide 622
Amino sugars 95, 95f
interpretation of 212f
metabolism of 212
Aminoaciduria 342, 345, 346t
diagnosis of 345, 358
dicarboxylic 321
Aminoacyl site 661
Aminoacyl transfer ribonucleic acid synthetases 660
Aminoglycosides 437, 487
Aminolevulinic acid 378, 382, 383, 507, 685
dehydratase 382
deficiency 378, 381
synthase 72, 685
deficiency 381
repression of 72f
synthesis 377
Aminopeptidase 290
Aminopterin 543, 543f
Aminotransferases 294
Ammonia 294, 296, 301, 608
detoxification of 296, 415
disposal of 296
fate of 294f
formation of 294
mechanism 464f
minor pathways producing 295
sources of 294f
transportation of 297
trapping of 296
Ammonium 293
ions, excretion of 465
sulfate 44, 45
Amniocentesis 209, 355
Amniotic fluid 490
cells, collection of 490
normal composition of 490t
Amphibolic pathway 125, 363
Ampholyte 33
Amphotericin 437, 487
Amylase 79
Amylodextrin 97
Amyloid
A 748
precursor protein 797
Amyloidosis 748
Amylopectin 97
Amylopectinosis 167
Amylose 97
Anabolic pathways 363
Anabolic reactions 293
Anaerobiasis 126
Anaphylaxis 343, 746
Anaplerotic reactions 530t
Anderson's disease 167
Androgens 421, 802, 807, 811, 816
binding protein 816
Anemia 400, 401, 537, 551, 571, 573, 606, 607, 629
addisonian pernicious 544
causes of 401b
classification of 572b
hemolytic 541, 610
hypochromic microcytic 399
macrocytic 541, 542f, 546
megaloblastic 545, 545f
microcytic
hypochromic 572, 572f
normochromic 575
pernicious 545f
symptoms of 401f
Angelman syndrome 679
Angina pectoris 324
Angiogenesis 778
inhibitors 781
Angiotensin production, pathway of 480f
Angiotensin-converting enzyme 438, 480, 760, 761
inhibitors 485
clinical significance of 480b
Angular stomatitis 533
Aniline 771
Animal steroid 243
Anion
gap 196, 468
metabolic acidosis, normal 469, 469t
strong 724
transport 386
Ankyrin 792
Anomeric carbon atoms 92
Anorexia 777
Anserine 313, 314
Antacids 487, 567
Anti-apoptosis 501
Antibacterial agents 542, 647
Antibiotics 17, 665
abuse of 694
Antibody
concentration 726
dependent cell 744, 778
natural 746
opsonization effect of 746
radioactive 705
Anticancer
agents 630, 647
drugs 543, 781, 782t
Anticoagulants 99, 454, 735
Antidote 44, 607
Antigen 213, 743
molecular structure of 750
unlabeled 725
Anti-glomerular basement membrane antibody 440
Antihemophilic globulin 453
Antihistamines 343
Anti-insulin hormones 191, 191t
Antiketogenic effect 190
Antilipolytic effect 189
Antimalarial drugs 170, 543
Antimetabolites 543
Antimicrobial techniques 834
Antimutagens 772
Antinuclear antibodies 422
Antioxidant 495, 500, 501, 783
activity 576
commercial use of 500
defense 376
mitigate 798
preventive 500
property 517, 550
role of 500, 500f
status 798
Antiport transport systems 24, 24f, 430
Anti-retroviral therapy 767
Antisense therapy 667
principle of 667f
Anti-streptolysin-O 272
Antithyroid drugs 817
Anti-thyroperoxidase antibodies 819
Anti-tumor necrosis factors therapy 753
Antivitamins 610
Apoferritin 570
Apolipoprotein 248, 249, 797
Apoproteins, characteristics of 249f
Apoptosis 140, 681, 682f, 770, 778
pathways 681
Apoptosome complex 140
Appetite 591
regulators of 592
Aptamers 667
Aquaporins 21, 21f
Aquasomes 100, 835
Arabinose 95
Arachidonic acid 278, 279, 279f
Argemone mexicana 611
Argentaffinomas 341
Arginase deficiency 300
Arginine 3234, 307, 322, 353, 723f
formation of 298
metabolism of 322f
Argininemia 346
Argininosuccinate
formation of 298
lyase deficiency 298, 300
synthetase 298, 300
Aromatic amino acid 31, 31f, 332
metabolism of 342, 342t
Aromatic hydrocarbon hydroxylases 504
Arrhythmia, cardiac 487, 795
Arsenic
oxides of 608
toxicity 608
Arterial blood 420, 735
gas values 472b
Arterial oxygen saturation 472
Arteriosclerosis 184
Artery disease, coronary 270, 542, 592, 598, 599t, 700
Arthritis 626
Artificial kidney, principle of 10
Asbestos 771
Ascites 415
pathogenesis of 415f
Ascorbic acid 185, 333, 530, 548, 549, 550f, 551, 552, 568, 787
biosynthesis of 548
deficiency of 788
metabolism of 548
Asparaginase 80
Asparagine 32, 35, 296, 320f, 321
synthesis 321f
Aspartame 100
Aspartate aminotransferase 77, 132, 158, 264, 295, 321
estimation of 77
Aspartic acid 32, 34, 307, 321, 723f
ionization of 34f
metabolism of 320f
Aspartyl protease 61, 63
mechanism of 63f
Aspergillus flavus 771
Aspirin 70, 78, 269, 280, 505
mechanism of action of 281b
toxicity 422
Assisted reproductive technologies 679
Asthma 372, 600, 601, 754
Ataxia 795
telangiectasia 646, 749, 772
Atherosclerosis 199, 244, 252, 256, 260, 261, 270, 498
prevention of 267
progression of 261
risk markers of 265
Atomic number 828
Atomic weight 828
Atractyloside 138
Atrial natriuretic peptide 264, 480
Atriopeptides 806
Attitude 591
Augmented histamine test 424
Autism 140
Autoantibodies 211, 422, 798
Autocrine 802
Autoimmune
diseases 754
disorders 601
hemolysis 401, 572
Autophagy 15
types of 16f
Autoradiography 704
Autosomal dominant inheritance 674f
Autosomal recessive inheritance 674, 674f
Autotrophs 5
Avidin 540
Axitinib 822
Azacytidine 630
Azaserine 36, 311
Azauridine 630
Azidothymidine 767
Azotemia 437
B
Babinski's sign 545
Bacteria 661, 684, 772
resistant strains of 694
reversible inhibitors in 665
Bacterial cell 5t, 694
wall 19, 100
Bacterial deoxyribonucleic acid polymerases 641
Bacterial diseases, diagnosis of 708
Bacterial system 653
Bacteriophages 692
Bantu siderosis 574
Barbiturates 172, 379, 381, 419
Bariatric surgery 199
Barlow's disease 550
Baroreceptors 272
Basal acid output 423
Basal metabolic rate 584
measurement of 584, 584f
normal value for 584
Base excision repair 646
Base pairing rule 636, 637f, 642, 654
Batch analyzers 732
B-cells 743, 752
Beckwith-Wiedemann syndrome 679
Beer-Lambert law 727
Bell-shaped curve 67, 68
Bence-Jones proteinuria 438, 747
Benedict's reaction 93
Benedict's test 96f, 185, 338, 549
principle of 93f
Benzene 32
Benzoic acid 310, 506
Benzopyrenes 771
Benzoquinone acetate 337
Benzoyl glycine 362, 506
Beriberi 157
cerebral 531
dry 531
infantile 531
wet 531
Beta alanine 313
Beta aminoisobutyric acid 630
Beta amylases 97
Beta amyloid precursor protein 797
Beta blockers 485
Beta carotene 500, 514
Beta galactosidase 284
Beta glucosidase 284
Beta glycosidic linkage 96
Beta hairpin 40
Beta human chorionic gonadotropin 779f
Beta hydroxybutyric acid 414
Beta ionone 514
Beta maltose 97
Beta O-glycosidic linkages 213
Beta oxalyl amino alanine 611
Beta oxidation 190, 223, 224, 224b, 225f, 226, 226b, 226f, 228
energetics of 226
preparative steps for 224
regulation of 226
steps of 225
Beta pleated sheet, structure of 40f
Beta radiation 828
Beta thalassemia 396, 399, 699, 701
Beta trace protein 490
Bevacizumab 782, 783, 822
Bhopal gas tragedy 610
Bicarbonate 430, 461, 468
buffer system 461
normal 461
primary excess of 470
reabsorption of 463f, 464
therapy 470
Bicinchoninic acid assay 47
Bifidobacterium 601
Bile 256, 478
duct, obstruction of 223
secretion of 256
Bile acids 223, 244, 310
binding resins 269
formation of 255
secondary 255
structure of primary 255f
Bile pigments 383, 383b, 433
excretion of 413
tests for 386, 386t
Bile salts 220, 222, 244, 255, 277, 383, 383b, 433
action of 221f
enterohepatic circulation of 222, 256
excretion of 413
formation of 255, 255f
functions of 256
Biliary obstruction 78
Bilirubin 384, 416, 417, 446, 447, 506
conjugated 387
diglucuronide, production of 384f
disposal of 414
excretion of 384, 385f
generation of 383
metabolism 414
production of 385f
synthesis 417
toxicity 388
type of 418
unconjugated 209, 387
uptake of 386
Biliverdin 384
Binding cassette transporter-1 269
Bioactivation 503
Bioactive peptides 46
Biocatalysts 56
Biochemical
defect 337
disturbances 352
genetics 356
markers 357
parameters 522, 532
Biochemistry 3, 4t, 758, 770
historical background of 3
Bioenergetics 7, 127b
Biogenic amines 325, 325t
Bioinformatics 833
applications of 833
Biological fluid 720
pH of 731
Biological oxidation 119, 128, 278
Bioluminescence 728
Biomarker 76
Biomembranes 110
Biomolecules 4, 835
quantitative preparation of 690
Biosensors 731
Biosynthesis 212
Biotin 59, 158, 227, 530, 539, 549, 551, 552
antagonists 540
avidin immunofluorescence 727f
coenzyme activity of 539
deficiency of 540, 540f
independent carboxylation reactions 540
requirement of 540
sources of 540
structure of 539, 539f
Biotransformation 503
Birth defects 542
Bisphenol 609
toxicity 609
Bisphosphate 152b
Bisphosphoglycerate 152, 156, 156f, 393
significance of 156
Bitot's spots 517, 517f
Biuret method 46, 444
Black liver jaundice 386
Blinatumomab 782
Blindness 666, 795
Blood 432, 719
alcohol estimation 211
ammonia, estimation of 419
brain barrier 447
calcium 562
level, homeostasis of 561
capillary 735
cells 832
cultures 272
flow studies, technetium for 830
glucose 180b, 190f, 198f
homeostasis of 181f
regulation of 180, 181f
group antigens 45
phenylalanine 336
pressure 272
reference ranges in 488
samples 736
smear, peripheral 572f
stem cells 701
toxins 799
transfusion 573, 750
urea 437, 437b
level 436
nitrogen 436
value, interpretation of 436
vessels 323, 344
Bloom's syndrome 646
Blot transfer techniques 705f
Body
buffers systems of 461t
fluid 181, 477, 488
buffers of 461
compartments 478t
iron
status of 573t
stores 571
mass index 194, 592
metabolism 74
proteins, synthesis of 588
water 477
compartments 477f, 478
Body's immune mechanism 778
Bohr effect 391
double 391
Bone 465, 550, 560, 814, 830
deformities 521
diseases 77, 79, 566
biomarkers of 566
forming cells 830
growth of 565b
inhibits resorption of 562
isoenzyme 419
marrow 318
transplantation 701
mineralization of 520, 564
pathological fracture of 563
scanning 830
Bony exostosis 519
Bovine spongiform encephalopathy 796
Brachytherapy 831
Bradykinesia 797
Brain 277, 300, 368, 420
function 549t
metabolic profile of 367
natriuretic peptide 264, 450
tumors 489
Branched chain amino acids 30f, 325, 366, 368
catabolism of 326t
Branched chain ketoacids 325
Breast 780
cancers 775, 780
milk jaundice 387
Brittle bones 788
Bronchodilator 281
Bronchopneumonia 471
Bronze diabetes 574
Brown adipose tissue 138, 139, 233
Brown-Schilder's disease 16
Brussels sprouts 610
Bruton's disease 748
Buccal cancer 831
Buffer 460
act 460, 462
composition of 460
effective range of 460
systems, relative capacity of 462
Burkitt's lymphoma 773, 778
Burning foot syndrome 538
Butyric acid 105
C
Cachexia 777
Cadaverine 322, 325
Cadherins 19
Cadmium 44, 609
Caenorhabditis elegans 696
Caffeine 500, 625
Cahill cycle 160
Calbindin 520, 559
Calcinosis 523
Calcitonin 520, 520b, 561, 561b, 562565
action of 562f
Calcitriol 487, 519, 520, 520b, 559, 561, 561b, 563
generation of 520f
receptors 520
regulation of 520
Calcium 59, 187, 431, 559, 560, 563, 565, 594, 730, 735, 805, 814
absorption of 423, 520, 520f, 559f, 561
based signal transduction 805
channels 22
cytosolic 805
daily requirement of 559
deficiency of 564
estimation of 561
functions of 559
homeostasis 561f
ions 807
mechanism of absorption of 559
pump 23, 559
reabsorption of 562
sources of 559
Calculi 563
Calmodulin 559, 792, 805
mechanism of action of 560f
Calomel electrode 731
Calorie 594
homeostasis 363
requirement 593, 594, 598
Calpains 560
Calpastatin 560
Calprotectin 450
Calsequestrin 560
Cancer 325, 372, 696, 699, 700, 760, 770772, 781
antigen-125 779
biochemistry of 770
cachexia 777
cells 500f, 647, 772, 776, 776f, 777, 778, 781, 798, 831
multiplication of 781
number of 781
spread of 781
colon 775
colorectal 779
curable 781
detection 708
etiology of 770
probability of 780
promoters of 772
stem cells 778
tissues 776, 832
treatment of 831
types of 822
Captopril 421, 815
Carbaminohemoglobin 392
Carbamoyl phosphatase synthetase deficiency 299
Carbohydrates 90, 124, 125, 235, 341, 364, 531, 534, 586, 587t, 593, 594, 598, 722
absorption of 146, 148b
chemistry of 90
dietary 147t, 586
digestion of 146, 147b
functions of 90
metabolic pathways of 207
metabolism 195, 216t, 371, 414
simple 597
sources of 586t
Carbon atoms 33
nomenclature of 107
total number of 105
Carbon dioxide 59, 362, 393f
elimination steps 124f
isohydric transport of 392
partial pressure of 390
transport of 392
Carbon monoxide 384, 608, 609, 771
poisoning 394, 608
Carbonic acid 471
Carbonic anhydrase 463, 463f, 464
Carboxy terminal end 37
Carboxyhemoglobin 394
Carboxyl group 35
Carboxylase 227
Carboxylation reactions 64, 539, 539f
Carboxylic acids, aliphatic 105
Carboxypeptidase 290, 291
Carcinoembryonic antigen 779
Carcinogen 606
Carcinogenesis 498, 776
mechanism of 770
Carcinoid syndrome 536
Carcinoma
adrenal 814
chorionic 779f
colorectal 781
hepatocellular 779
Cardiac arrest 485
Cardiac biomarkers 76, 262
Cardiac disease 256, 261f
Cardiac failure 447, 482
congestive 431
Cardiac markers 262, 262b
classification of 262b
Cardiac muscle 148, 789
metabolic profile of 368
Cardiolipin 111, 112, 283
Cardiomyopathy 577, 666
Cardiotoxins 799
Cardiovascular disease 252, 260, 261, 265b, 265f, 501, 575, 598, 609, 760
Cardiovascular system 211, 344, 786
Carditis 272
Carnitine 224, 322
acyltransferase 224
deficiency 224
role of 224
Carnosine 313, 314
Carnosinuria 313
Carpopedal spasm 564f
Carrier protein 147, 448t
Casal's necklace 535, 535f
Cascade system 748
Casein 44
Casirivimab 763
Caspase activation cascade 683, 683f
Castle's intrinsic factor 423
Catabolic pathway 363, 383f
Catabolism 549f, 829
first step of 294
Catalase 16, 129, 497
Catalyst 65, 123
Catalytic efficiency 74
Cataract 172, 197, 498, 550, 793, 793f
congenital 209
formation 199
Catecholamines 333, 735
metabolism of 335f
synthesis of 334
Catechol-O-methyltransferase 74, 335, 342
Catenins 19
Cathepsins 13, 15, 292
Cationic liposomes 698
Caveolae 19
Caveolin 19
Celiac disease 223
Cell 13, 831, 835
body 793
cycle 644, 644f, 673, 680
controls 680, 682f
phases 681f
disease, inclusion 15, 664
division 805
epithelial 773, 793
grown 684
internal parts of 663
lysis 566
membranes 13, 244
components of 743
powerhouse of 16
proliferation 822
surface proteoglycans 785
to cell communication 781
types of 700, 802, 821, 834
Cellobiase 98
Cellular death 832
Cellulose 98, 586
acetate membrane 720
Cementoid 564
Central nervous system 323, 766
Cephalin 111, 111f
Ceramide 112, 112f
oligosaccharides 112
synthesis of 283, 283f
trihexoside 284
Cerebro-hepato-renal syndrome 232
Cerebrosides 209
synthesis of 283, 284f
Cerebrospinal fluid 489, 489t, 490, 719
biochemical analysis of 489
electrophoresis of 489
Ceruloplasmin 79, 449, 500, 570, 574
functions of 574f
levels of 575
Cervical mucosa 773
Cesium 829, 831
Cetuximab 782
Cetylpyridinium chloride test 354
Channelopathy 21
Chaperones 665, 795, 796
Chaperonopathies 665
Chargaff's rule 636
Charlie Chaplin gait 319
Cheilosis 533, 534f
Chemical
amplification 68
catalysis 376
chaperons 796
energy 59
grades of 738
nature 523
structure 280
Chemiluminescence 728
immunoassay 729f
Chemiosmotic theory 135
Chemolithotrophs 5
Chemotherapeutic drugs 781
Chemotherapy 781
high-dose 701
Chenodeoxycholic acid 255
Chimera 676, 692
Chirality 73
clinical applications of 73
Chitin 98
Chloramphenicol 665
Chloride 471, 477, 486, 578, 735
channels 22, 320, 486
shift 8, 391
Chlorofluoromethane 609
Chlorothiazide 566
Chlorpromazine 421
Chlorpropamide 421
Cholagogues 256
Cholecalciferol 519
synthesis of 519f
Cholecystokinin 256, 291, 821
Cholera 805
toxin 283
Choleretics 256
Cholestanol 244
Cholestasis
extrahepatic 421
markers of 419
Cholestatic liver disease, causes of 421b
Cholesterine 243
Cholesterol 18, 221, 243, 244, 246, 247, 256, 261f, 270, 414, 536, 587, 818, 819
absorption of 244
biosynthesis of 244, 245f
clinical significance of 244, 260
dietary 268
efflux 252
ester transfer protein 254
esterase 220
excretion of 247, 247f
forward transport of 260f
functions of 244b
pool 247, 247f
reverse transport of 260f
solubilization of 256
structure of 244, 244f
synthesis
pathway 245f, 246f
regulation of 246, 246f
transport, reverse 254
Choline 110, 235, 302, 314, 315, 547
biochemical functions of 547
structure of 547f
synthesis 312
Cholinesterase 78, 799
Chondroitin sulfate 99, 99f, 567
Choriocarcinoma 779, 781
Chorionic gonadotropin, beta chain of 736, 779
Chorionic villi sampling 355
Christmas disease 454
Chromatin 637
activity of 639
fibers 638
remodelling 639
Chromatography 722
affinity 724, 725f
partition 722
Chromium 578, 829
deficiency 578
toxicity 578
Chromoproteins 45
Chromosomal disorders 351
Chromosome 14, 637, 638, 686, 797
abnormal number of 776
banding 638f
end region of 778
translocation 773
Chronic kidney disease 436, 571, 597
grading of 436t
stages of 436
Chronic liver disease 413
synthetic function, markers of 419
Chylomicrons 222, 223, 248, 250
fate of 223
functions of 251
metabolism of 250, 250f
structure of 250f
synthesis of 250
Chylothorax 223
Chyluria 223
Chymosin 290
Chymotrypsin 42, 63, 291
action of 63
Ciprofloxacin 647
Circadian rhythm 808
Circumcorneal vascularization 533, 534f
Cirrhosis 166, 211, 235, 421, 445f, 446, 447
Cisplatin 487, 782
Cistron 639, 750
Citrate 126, 160, 231, 736
lyase 229
synthase 121, 124f, 126
Citric acid
cycle 119, 120, 122f, 123, 298f
functions of 121
regulation of 126
significance of 123, 123b
formation of 121
Citrulline 300
formation of 297
Citrullinemia 300, 346
Clathrin coated pits 26, 251
Claudins 19
Claviceps purpurea 611
Clindamycin 665
Clomiphene citrate 816
Clostridium
histolyticum 788
tetani 805
Coagulation 560
profile 452
Cobalamin 543, 552
deficiency 319
Cobalophilin 544
Cobalt 577, 829
Cockayne syndrome 645, 646
Cockcroft-Gault equation 435
Codon
deletion of 677
triplet 659
Coenzyme 58, 58b, 59t, 123, 129, 367
A 59, 208, 315, 353, 370, 506
structure of 224f, 538f
first group of 58
functional 544
Q 131, 133
reductase 666
second group of 59
Colchicine 626
Colipase 221
Collagen 318, 550, 786
degradation of 788
disorders 748
extracellular maturation of 787
fibers 787
functions of 788
helix 39
post-translational processing of 788b
structure of 786
synthesis of 786
Collagenase 778, 788
Colloid osmotic pressure 9, 478
Colon cancer, hereditary polyposis 646
Color vision 516
Colorectal cancer, hereditary nonpolyposis 772
Colorimeter 727
Colostral milk 489
Colostrum 489
Coma 196, 237
Compartmentalization 73, 299, 379
Compensation
maximum limits of 471b
stages of 467t
Complement system 748
Complex disorders 351
Compound lipids 104, 105, 108
synthesis of 282
Computer-aided drug design 834
Concentration test 439
Conjugation 316, 384, 386, 506, 507
reactions 505
Conjunctiva 599
Conn's syndrome 814, 815
Connective tissue 814
Conopsin 516
Convulsions 226, 320, 336
Cooley's anemia 399
Copeptin 264
Copper 44, 59, 333, 488, 497, 574, 788
abnormal metabolism of 575
binding ATPase 575
deficiency 334, 789
anemia 575
functions of 574
low levels of 575
toxicity 575
transporters 574
Coproporphyria, hereditary 380382
Coproporphyrin 382, 383
Coproporphyrinogen 383
synthesis of 378
Coprostanol 244
Cordocentesis 355
Cori's cycle 155, 155f, 167
significance of 155
Cornea, softening of 517
Corneal arcus 270
Coronavirus disease-2019 (COVID-19) 393b, 422, 499, 709, 756, 759, 760
biochemistry of 758
complications of 763
infection 453, 696, 710, 763
laboratory diagnosis of 762
liver function in 422
pandemic 4
prevention of 763
syndrome 762
vaccine, types of 764
virus 763
Corrosives 608
Corticosteroids 468, 485, 802
Cortisol 247
binding globulin 448, 812
blood level of 813
synthesis 812f
Corynebacterium diphtheria 665
Cosmetics 611
Cosmids 692
Cosyntropin stimulation test 810
Cough 760
Covalent
bond 5, 5f
catalysis 60, 61
modification 72, 73t, 155f, 247, 311
Covaxin 763
Covishield 763
Cowpox vaccination 742
C-peptide 38, 186
C-reactive protein 261, 266, 272, 449, 450, 751, 763
Creatine 308, 309, 314, 315, 322
kinase 263, 264, 734, 791
isoenzymes of 263, 263t
reaction 263f
metabolism 309f
phosphate 130, 308, 791
generation of 309f
shuttle 139, 139f
Creatinine 197, 293, 309, 431, 734
clearance test 434, 434b, 435
interpretation of 435
coefficient 435
estimation 309, 433
reference values of 434
Crigler-Najjar syndrome 386
Crispr activation 696
Crohn's disease 223, 451, 600
Crystal, petal shaped 96
Crystallins 793
C-terminal amino acid 42
C-type natriuretic peptide 264
Curcumin 772
Cushing's disease 192, 194, 483, 517, 592, 813, 814
Cushing's syndrome 471, 485, 486, 810
Cyanide 70, 138, 139
nitroprusside test 317, 319
poisoning 608
Cyanocobalamin 543
Cyanogen bromide 42
Cyanopsin 516
Cyclamate 100
Cyclic adenosine monophosphate 164, 312, 366, 617, 804, 807
degradation of 804f
generation of 164
synthesis of 804f
Cyclic hydrocarbons 108
Cyclic nucleotides 620
Cyclin, types of 680
Cycloheximide 665
Cyclooxygenase 71, 280, 281
Cyclopentanoperhydro phenanthrene 244
Cyclophilin-D 140
Cyclophosphamide 782
Cycloserine 36, 311, 537
Cyclosporin 421, 485, 487
Cyperus rotundus 269
Cystathionase 315
deficiency 319
Cystathionine 314
beta synthase deficiency 319
Cystathioninuria 318, 319, 346
Cystatin C 435
Cysteine 32, 34, 295, 307, 311, 315, 315f, 506
decarboxylation of 315f
degradation of 315
formation 314f
metabolic functions of 315
metabolisms 317f
synthesis 315
Cystic fibrosis 21, 22, 358, 486, 664, 677, 690
Cystine 35, 723f
crystals 318
lysinuria 317
stone 318f
Cystinosis 318
Cystinuria 25, 317, 318, 351
Cytidine 619
monophosphate 619
triphosphate 72
Cytochrome 129
A 134
A3 134
B 134
C 131, 134, 574
oxidase 129, 134, 568, 574
p450 504
enzyme system 17, 414, 504, 508
reductase 134, 134f
Cytogenetics 355
Cytokine 751, 751t, 798
receptors 752
storm 760, 763
Cytoplasm 13, 224, 228, 651
Cytoplasmic acetoacetyl-coenzyme A synthase 245
Cytosine 321, 618, 619
methylation of 685
Cytoskeleton 20, 20f, 792
Cytosol 17
Cytosolic fraction 245
Cytotoxic drug 781
Cytotoxins 799
D
D isomers 34
Daboia russelli 799
D-amino acids 34f
Dansyl chloride 42, 42f
Daratumumab 782
Dark adaptation
mechanism 516
test 518
time 516
Darwin's natural selection 675
Daughter cells 700
Dawn phenomena 199, 200
D-dimer 453
De Novo synthesis 228, 230f, 231, 620
Deafness 666
Decarboxylation 35, 167, 245, 315, 325, 536, 627
spontaneous 236
Deep vein thrombosis 763
Degradation, homocysteine 314
Dehydration 196, 229, 237
Dehydroepiandrosterone sulfate 815
Dehydrogenases 129, 167, 225, 281, 325, 568
aerobic 129
anaerobic 129
fad-linked 129, 225
Deiodinase defect 818
Delirium 535
Delta gap 470
Dementia 535, 666
Demyelinating disorders 795, 795t
Demyelination 545, 547
Dendritic tree 794
Densitometer 720
Density gradient centrifugation 721
Dental caries 587
Deoxy sugars 95, 95f
Deoxy uridine 630
Deoxyhemoglobin 397
Deoxynucleosides 618
Deoxynucleotide 641
Deoxyribonucleic acid 4, 14, 45, 355, 363, 635, 636, 638, 651t, 703
binding proteins 641
fibrils 638
higher organization of 637
hybridization 704
hydrolysis of 647
ligase 643
enzyme 692
methylation 315, 643
mismatch repair deficiency 646
mitochondria 665
molecule
polarity of 636
preparation of chimeric 692
polymerase 641
polymorphism 707
preparation 703
probe 337, 704
procedure of 692
profile 706
recombinant technology 693f
repair 772
mechanisms 644, 644t
repeat sequences of 639
replication 639
inhibitors of 647, 647t
replisome, components of 640
sequencing 43, 712
strands, denaturation of 639
structure 636
synthesis 189, 541, 641
technology, recombinant 690
unwinding of 640
viruses 698
Deoxyribonucleoside 619
phosphates 619
Deoxyribonucleotide 619, 620
formation 629
regulation of 629t
Deoxythymidine nucleotides, synthesis of 630
Dephosphorylation 188, 804
Depressive psychosis 341
Dermatan sulfate 99
Dermatitis 381, 535
Dermatosparaxis 787
Desmosine 575, 789
Desmosterol 246, 246f
Detoxification 316f, 503, 504
functions 414
processes, phases of 504
Deuterium 827
Dexamethasone suppression test 810
Dextran 98, 98b, 723
Dextrin 98, 98b
Dextrose 91, 98, 98b
D-fructose 91, 93f, 98
D-galactose 91
D-glucose 91, 93f
anomers of 92f
epimers of 91f
Diabetes insipidus 439, 808
Diabetes mellitus 93, 148, 172, 180, 183b, 185, 191, 193f, 195, 195f, 196, 233236, 260, 266, 592, 600, 601, 700, 760, 793
acute complications of 195
chronic complications of 197, 197f
diagnosis of 183, 192
gestational 184, 192
management of 199, 597
type 1 192
type 2 192, 372, 609
Diacylglycerol 220, 221, 805
pathway 805
Dialysis 9
clinical importance of 10b
Diaminobenzidine 726
Diarrhea 469, 482, 535, 760, 832
Dichlorodiphenyltrichloroethane 608
Dickens-Horecker pathway 166
Dicobalt edetate 608
Dicoumarol 69, 454, 525
Dicysteine 35
Didanosine 767
Dideoxycytidine 767
Dideoxy-inosine 767
Dideoxy-thymidine 767
Diet 592b, 595, 596, 734
influence of 466
nature of 735
prescription of 593, 594t
role of 508
Dietary fiber 100, 586t, 587
Digestion 146, 147b, 220, 227
defective 223
minor 223
Digestive juices, absence of 223b
Diglucuronide 384
Digoxin 23, 485
Dihydrofolic acid 630
Dihydrolipoyl dehydrogenase 157
Dihydrolipoyl transacetylase 156
Dihydrotestosterone 816
Dihydrouridine 658
Dihydroxycholecalciferol 561
Dilantin 419
Dilute acids 45
Dilute salt solutions 45
Dilution tests 439
Dimercaprol 468
Dimeric inhibin A 357
Dimethyl sulfoxide 500
Dimethylthiourea 500
Dinitrophenylhydrazine 77, 300, 354
test 354
Dinutuximab 782
Diodrast clearance 437
Dioxygenases 130
Dipeptidases 291
Dipeptide 36
Diphosphate 152b
Diphtheria toxin 665
Diploid cells 639t
Direct oxidative pathway 166
Disaccharides 90, 96, 97
Disseminated intravascular coagulation 454
Distal convoluted tubules 430
Distal histidine 388, 389
Disulfide bonds 42
Disulfide bridges 37
formation of 36f
Diuretics 437, 485, 567
clinical applications of 431b
Diurnal variation 734
Divalent metal transporter 569
Dixon plot 67
D-mannose 91
Docking protein 663
Docosahexaenoic acid 277
Dolichos biflorus 45
Donnan's equation 8
clinical applications of 8b
Donnan's membrane equilibrium 7, 8f
Dopa decarboxylase 334
Dopa quinone, formation of 333
Dopamine 333, 334, 794
clinical applications of 335b
formation of 574
Double labeled water method 584
Double marker test 356
Down syndrome 351
Doxorubicin 139, 647
Drugs 311, 362
delivery 834
detoxification of 170
effect of 172, 379
interactions 447
metabolism 74
Dry chemistry systems 732
Dubin-Johnson syndrome 386, 417
Duchenne muscular dystrophy 679, 706, 792
Dulcitol 94
Duodenum 559
Dwarfism 809
Dynamin 26
Dysarthria 795
Dyslipidemia 193
Dysplasia, bronchopulmonary 498
Dystrophin 706, 792
absence of 792
E
Eating behavior 194
Ecchymosis 550
Eclampsia 273
Ectoenzyme 17, 77, 78
Ectopia lentis 319
Edema 446, 447, 482
angioneurotic 748
Edman's degradation technique 42, 42f
Edman's reagent 42f
Ehlers-Danlos syndrome 788
Ehrlich's aldehyde reagent 386
Eicosanoids 279
Eicosapentaenoic acid 277
Elastase 291
Elastin 788
Electrodialysis 10
Electrolyte 814
analyzer 730
balance 477
concentration 478t
imbalance 481b
Electron 827
flow 135f
transport chain 16, 119, 128, 131, 132b, 132f, 376
complex 133
inhibitors of 138f
organization of 131
specific inhibitors of 139
Electrophoresis 75, 76, 249, 398, 444, 719721
apparatus 720, 720f
capillary 721, 721f
high voltage 721
support medium for 720
Electrophoretogram 445f
Electrospray ionization 732
Electrostatic bonds 5, 39
Elemental mercury 607
Elotuzumab 782
Embden-Meyerhof pathway 149, 150f
Embelia ribes 269
Emission spectroscopy 730
Emphysema 419, 450
Emulsification 220
Enalapril 815
Encephalopathy 299, 606
End point method 65
End product inhibition 72
Endergonic reaction 64f
Endocrine 802
disruptors 606
organ 593f
Endocytic vesicle 25
Endocytosis 25, 793
receptor mediated 25
types of 25f
Endonuclease 645, 647
Endopeptidases 289
Endoplasmic reticulum 14, 17, 279, 568, 663f, 664f, 761, 805
Endorphins 810
Endosmosis 10
Endosymbiotic theory 17, 665
Endothermic reaction 64
Enediol 92
formation 92
Energetics 157, 163
Energy 90, 599
law of conservation of 7
metabolism 583
requirement 159, 585t, 662
storehouse of 369
yield 153, 153t
Enkephalins 821
Enolase 79, 152
Enoyl reductase 229
Enteroglucagon 190
Enterohepatic circulation 222, 256, 385
Enterokinase 291
Enthalpy 7
Entoxification 504
Entropy 7
effect 60, 61
Envelope protein 761
Enzymatic method 182
Enzyme 41, 56, 71, 79, 80, 127, 129, 153, 154, 188, 340, 342, 367, 575, 647, 654, 655, 691, 691t
activation of 68, 188, 316, 559
active center of 62, 62b, 63t
aldose reductase 793
assays 73, 198, 356
carnitine acyltransferase 224
catalysis, discovery of 57t
characteristics of 56
classification of 56, 58t
concentration of 65, 66
condensing 229, 230
defect 284
deficiencies 401
engineering 74
fad-dependent 533, 533b
functional 76
gluconeogenic 158, 160f
hydrolyses peptide bond 290f
inducible 504
inhibition 68
kinetics 56, 65
linked immunosorbent assay 521, 540, 726, 797
indirect 726f
method 726
technique 47, 726, 727f
test 47, 80, 726, 766
location of 131b
mechanism of action of 60
mode of action of 60
multifunctional 623
nonfunctional 76
patterns 79b
processive 74
profile 76, 77b
specificity of 73
substrate complex theory 61, 62f
synthesis 188
therapeutic use of 80t
Eosinophils 496
Epidemic dropsy 611
Epidermal growth factor
inhibitors 517
receptor 821
Epigenetic 686
Epimerase reaction 209
Epinephrine 187, 190, 232, 314, 315, 333, 334, 794
action of 334
Epithelial growth factor receptor 782
Epitopes 743
Epstein-Barr virus 773, 778
Equilibrium 7, 65
Erectile function 324
Erethysm 607
Ergocalciferol 519
Ergot 611
Ergotism 611
Error catastrophe theory 798
Eruptive xanthomata 270
Erythema 833
Erythroblastosis fetalis 387
Erythrocyte 792
membrane integrity 170
sedimentation rate 272
Erythrodextrin 97
Erythromycin 421, 665
Erythropoietic porphyria, congenital 380382
Erythropoietin 376, 429, 776
Escherichia coli 641, 684, 691, 696
Ester, formation of 35, 95, 107
Estriol, unconjugated 357
Estrogen 802, 807, 815
high-doses of 815
receptor 780
Ethacrynic acid 468
Ethanol 161, 504, 537
Ethanolamine 312, 314
plasmalogen 111f
Ethereal sulfate 567
Ethyl alcohol 161
Ethylenediaminetetraacetic acid 735
Etoposide 647, 782
Euchromatin 639
Eukaryotes 665, 665t, 685
Eukaryotic cell 5, 643t
Ex vivo gene therapy 697f
Excinuclease 645
Excretion test 546
Excretory function 414, 416, 437
Exercise 268, 584, 734
aerobic 369
anaerobic 369, 792
Exergonic reaction 64
Exocytosis 25f, 793
Exons 639
Exonucleases 647
Exopeptidases 290
Exosomes 15, 26, 781
Exothermic reaction 64
External quality assessment schemes 737
Extracellular fluid 479b
isotonic contraction of 481
maintenance of 477
Extracellular matrix 785, 792
components of 785
Extrinsic death receptor pathway 682
Eye 666
diseases of 498
lens of 170
F
Fabry's disease 284
Fanconi's anemia 646
Fanconi's syndrome 184, 522, 666
Fasting plasma glucose 182, 183
level, normal 149
Fat 594, 599
absorption of 222f
balance studies 425
deposition, causes of 234
excessive mobilization of 234
metabolism 234b
rancidity of 108
recommended daily intake of 588
utilization of 223f
Fatigue 760
Fat-soluble vitamins 513
Fatty acid 104, 105t, 125, 221, 227, 277, 588t, 593, 600
absorption 222f
long-chain 221
activation of 224
beta oxidation of 223, 224b, 225f
binding protein 254
cis and trans forms of 106f
classification of 105b
de Novo synthesis of 228, 230f
desaturation of 279
digestion of medium chain 277
elongation of 279
entry of 236
essential 278, 279
ethyl ester 211
long chain 222f, 277
medium chain 223, 277, 278
metabolism of 220
monounsaturated 106, 107, 278, 588
nonesterified 254, 593
oxidation of 107, 227
properties of 106
short-chain 223, 277, 278
synthase complex 229, 229f
synthesis 228, 229
coenzyme of 231
regulation of 231
transport protein 254
unsaturated 106
Fatty liver 195, 210, 211, 235, 547, 591
causes of 234, 234f
disease
markers for nonalcoholic 420
nonalcoholic 78, 193, 235, 420
Favism 78, 170, 610
Fecal microbiota transplantation 601
Fenton reaction 497f
Fermentation, bacterial 210
Ferric chloride test 337, 338, 354
interpretation of 354t
Ferric pyrophosphate 573
Ferritin 570
Ferrochelatase 378
deficiency 381
Ferroportin 569, 570
Ferroprotoporphyrin 377
Ferroxidase 449
Fetal
albumin 779
blood sampling 355
disorders 356t
hemoglobin 393
lung maturity 111
warfarin syndrome 525
Feulgen staining 95
Fever 584, 760
Fiber 599
Fibrin 453
Fibrinogen 446, 451
degradation products 453
Fibrinolysis 453
Fibrocystic disease 425
Fibrosis 235, 420
actual stage of 420
pulmonary 760
stage of 420
Finasteride 816
Fingerprint 691
Fischer's theory 60, 61, 62f
Fish tapeworm 545
Flame photometer 730, 730f
Flavin adenine dinucleotide 45, 225
Flavonoids 772
Flavoproteins 533
Fleeting thrombophlebitis 454
Fluid 814
and electrolyte balance 481
compartments 478f
infusion of 481
mosaic model 17, 18f
phase pinocytosis 25
volume, disturbances of 481t
Fluorescent dyes 730
Fluorescent in situ hybridization 355, 705, 705f
Fluoride 70, 152, 182, 576
Fluorodeoxyglucose 830
Fluorosis 576
Fluorouracil 630
Foam cells 261
formation of 261
Folate antagonists 542, 542f
Folate deficiency 541, 544
assessment of 542
causes of 541
Folate trap 302, 541, 545
Folic acid 318, 530, 540, 542f, 544, 549, 551, 573, 597, 782f
absorption of 540
chemistry of 540
coenzyme functions of 540
deficiency 344, 542f
metabolism 550
sources of 542
structures of 540f, 543f
therapy 542
toxicity of 542
Folinic acid 781
Follicle stimulating hormone 809
Follicular dendritic cells 765
Food
allergy 291b
exchange system 594, 595t
general composition of 594
hormone regulating digestion of 820
items, nutritive value of 595t
preparation, toxins entering during 611
preservatives 500
Foodstuffs
calorific value of 583t
oxidation of 119
toxic substances in 610
Formaldehyde 609, 610
Formiminoglutamic acid 546
Formiminoglutamic excretion test 344, 542
Formyl aminoimidazole carboxamide ribonucleotide 622
Formyl glycinamide ribonucleotide 622
Fossil studies 708
Fouchet's test 386
Fraction antibody 745
Fractional test meal 423
Fragile X syndrome 680
Frameshift mutation 678
Fredrickson's classification 260, 270, 270t
Free acidity, estimation of 424
Free fatty acid 190, 193, 223, 248, 249, 254
Free radical 495, 776
formation of 497f
generation of 496
reaction theory 798
scavenger
enzymes 497f
systems 497
scavenging 170, 170f, 316f
toxicity 499f
Free testosterone 727f
Friedreich ataxia 680
Fructokinase 207, 208
deficiency of 185
Fructosamines 198
Fructosamino albumin 199
Fructose 92, 93, 207, 212
1,6-bisphosphatase 159, 160
2,6-bisphosphate 154
intolerance 185
hereditary 208
malabsorption 208
metabolism 207
pathway 207f
Fructosuria 185, 208
Frusemide 431
Fumarate 333
formation of 122
Fumarylacetoacetate hydrolase 338
absence of 338f
Fungal infections 611
Furanose ring structure 92
Furosemide 468, 566
Fusion proteins 667
G
G protein, action of 803
Gabapentin 36
Galactocerebroside 284
Galactokinase
deficiency 209
reaction 209
Galactorrhea 371
Galactosamine 95
Galactose 91, 92
1-phosphate uridyltransferase 209
deficiency of 185
metabolism 208, 208f
utilizing steps 209
Galactosemia 209, 358
clinical features of 209f
Galactosuria 185, 209
Galactosyltransferase 13
Gallbladder stones 417
Gamblegrams 468f, 478f
Gamma aminobutyric acid 32, 36, 319, 794
Gamma carboxyglutamic acid 319, 524, 524f
Gamma carboxylation 451, 664
Gamma globulin 744
Gamma glutamyl
cycle 291, 292f
transferase 77, 78, 211, 506
Gamma linolenic acid 279
Gamma radiation 829
Ganglioside 112, 284
synthesis of 283, 284f
Gangliosidoses 284
Garrod's tetrad 337
Gas
gangrene 788
liquid chromatography 723, 723f
transport of 376
Gastrectomy 184
Gastric
atrophy 545
function 423
assessment of 423
tests 413
juice 424, 478
analysis, interpretation of 423
lipase 220
secretions 423
Gastrin 423, 424, 821
Gastritis, atrophic 545f
Gastrointestinal secretions 478t
Gastrointestinal tract 119, 281, 599, 781, 821t
argentaffin cells of 341
normal motility of 587
Gaucher's disease 283, 284
Gel filtration chromatography 723
Gelatin 41, 788
Gene 750
abnormal 675
alpha chain 399
ampicillin resistance 693
amplification 685
antibiotics resistance 692, 694
apoptosis mediating 681
chloramphenicol resistance 693
defective 705
deletions, large 677
derepression of 684
expression 683
control of 673
regulation of 683, 685
gun method 698, 698f
marker 781
mutation, single 698
regulation 516
operon concept of 684
selection applied to 675
structural 684
switching 686
tetracycline resistance 693
therapy 690, 691, 697, 699t
potential of 699
transcription 188
transposition of 750
X-linked 686
Genetic code 659, 659b
salient features of 659
Genetic diseases 696
antenatal diagnosis of 690
diagnosis of 705
treatment policies of 677b
Genetic disorders 676, 696
diagnosis of 708
Genetic engineering techniques 691
Genome 667
Genomic 363, 667
library, production of 694f
Genu valgum 576
Gerhardt's test 237
Geriatrics 797
Germ cell line 646
Germ layers 700
Germline mosaicism 679
Ghrelin 593, 809, 821
Gibbs free energy concept 7
Gigantism 809
Gilbert's disease 352, 386
Gingivitis 550f, 607
Glands
adrenal 504
exocrine 344
Glass electrode 731
Glibenclamide 224
Globoside 112, 284
Globulins 44, 45
Glomerular dysfunction 440
Glomerular filtration rate 430, 434t, 435, 490
markers of 433, 435
Glomerular function 430
Glomerulonephritis 748
acute 437
chronic 498
Glomerulopathy 250
Glomerulus filtration rate 443
Glossitis 533, 534f
Glucagon 155, 190, 196, 232, 236, 823
inhibits lipogenesis 232
mechanism of action of 191, 191f
physiological actions of 190
secretion 191f
Glucocerebroside 284
Glucocorticoids 155, 160, 190, 191, 807, 811, 813
biological effects of 813
effect of 814t
production of 813f
secretion, assessment of 813
Glucogenic pathway 308
Glucokinase 72, 150, 152, 152t, 153, 192
Glucometer 182, 732, 732f
Gluconeogenesis 154, 155f, 158, 158f, 160f, 181, 181f, 189, 190, 196, 237, 293, 294, 366, 372, 818
clinical significance of 161b
hormonal regulation of 160, 161f
metabolic significance of 161b
pathway 158f
regulation of 160
regulatory enzymes of 161t
significance of 159
steps of 158
stimulation of 195
substrates for 159
Glucosamine 95, 212
Glucose 23, 91, 93, 146, 186, 212, 379, 430, 433f, 484
6 phosphatase 13, 163, 166
deficiency 625
reaction 159
6 phosphate
dehydrogenase 75, 78, 167, 394, 496, 497
fate of 152f
regeneration of 168
absorption of 146, 148f
activation of 163
alanine cycle 160, 160f, 313
anhydrous 182
clinical importance of 149b
D isomerism of 91
depletion of 180
determination of 181
diastereoisomers of 91
entry of 180
intestinal absorption of 148f
L isomerism of 91
level, monitor 148
load dose 182
metabolic pathways of 146
metabolism 148, 369
polyol pathway of 172, 172f
oxidase 80, 182
oxidation products of 94f
phosphate dehydrogenase 351
deficiency 351
pyrophosphorylase 163
regulation, impaired 184
structure 92
tolerance
impaired 184, 192, 193
test 182
transport 148, 148f, 189, 369
transporters 21, 147t, 148b
uptake of 189
utilization of 189
Glucosuria 93, 185, 195, 432
hyperglycemic 185
Glucuronic acid 94, 171, 506, 506t
pathway 171, 171f
Glucuronides 185
Glucuronyl transferase 386, 506
Glutamate 794
dehydrogenase 295
oxidative deamination of 295
semialdehyde dehydrogenase 344
Glutamic acid 32, 34, 35, 295, 297, 307, 319, 320f, 540, 677
gamma carboxylation of 664
Glutaminase 465
Glutamine 32, 34, 35, 212, 296, 296f, 297, 319, 320, 320f, 507
formation of 35f
metabolism 321f
synthetase 320
Glutaric aciduria 227, 300
Glutathione 46, 170, 291, 296, 316, 316f, 319, 333, 497, 506, 506f
coenzyme role of 316
formation of 315
peroxidase 312, 316, 497, 523, 577
reductase 170, 316, 497, 625
S-transferase 316, 771
synthesis of 310
Glycation 197, 213
Glycemic index 597, 598t
curve 598f
Glyceraldehyde-3-phosphate dehydrogenase 152
Glycerol 160, 222
3-phosphate shuttle 133, 133f
kinase 232
Glycerophosphatides, synthesis of 282
Glycinamide ribonucleotide 622
Glycine 32, 34, 38, 255, 302, 307, 310, 506, 723f
aminotransferase 308
cleavage system 308, 308f
formation of 307f
metabolic functions of 308
metabolism 308f
serine choline cycle 312f
synthase 307, 308
titration curve of 34f
uses of 310
utilization of 308
Glycinuria 311
Glycobiology 212
Glycocalyx 99, 213
Glycoforms 213
Glycogen 97
binding subunit 165
degradation of 162
functions of 162
metabolism 162, 166f
regulation of 163, 166t
phosphorylase 162, 805
reaction of 162f
regulation of 165
storage disease 166, 167t, 625
synthase 163, 165, 188
synthesis 163, 164f, 165, 165f
steps of 163
Glycogenesis 163
Glycogenin 98, 163
Glycogenolysis 162, 162f, 165, 181, 181f, 366, 537
reciprocal regulation of 165f
steps of 162
Glycohemoglobin 183
values, interpretation of 198
Glycolipids 112, 209
Glycolysis 149, 150f, 151f, 153, 160f, 189, 232, 777
aerobic 777
anaerobic 149, 777
inhibition of 195
partial reversal of 159
regulation of 153, 154f
regulatory enzymes of 154t
significance of 149
steps of 150
Glycolytic enzymes 150, 152, 160f
clinical applications of 157b
deficiency of 157
Glycolytic pathway 153t, 154t
Glycome 100, 212
Glycomics 100, 212
Glycophorin 99
Glycoproteins 45, 99, 209, 212, 213, 311, 312, 758
biosynthesis of 213
catabolism of 213
functions of 213t
hormones 810
Glycosaminoglycans 98, 209, 212, 213t, 317, 785
Glycosides 95f, 95t
cyanogenic 610
Glycosphingolipids 112
synthesis of 283
Glycosuria 185
alimentary 185
transient 185
Glycosylation 197, 213, 787
congenital disorders of 214
Glyoxylate 344
pathway, minor 310
Gmelin's test 386
Goiter 820
euthyroid 820
Goitrogens 610, 817
Goitrous belts 817
Goldberg-Hogness box 653
Golgi apparatus 14, 760, 793
Golgi complex 13
Gonadotropin 810
abnormalities of 811t
production 810
releasing hormone 810
Gonads 781
Gout 15, 625, 627
attacks 625, 626f
location of 626f
clinical findings of 625
primary 625
treatment policies in 626
G-protein 803, 805
activates adenylyl cyclase 803
subunit activation of 803
Gramicidin 23, 38, 46, 138
Granulocyte 26
colony stimulating factor 751, 752, 776, 822
Grave's disease 819
Growth 119
factor 261, 325, 774, 776, 776t, 821
hormone 190, 191, 694, 808, 809
release 593
releasing hormone 809
stimulation test 809
retardation 591
Guanidinium 32
Guanidoacetic acid 308, 314
Guanine 321, 617
Guanosine 619
monophosphate 623f
Guanylate cyclase 323
action of 806
Guillain-Barre syndrome 794, 795
Gusten 576
Gut microbiome 600
Guthrie test 336
Gyrase 640
H
Haber-Weiss reactions 497f
Haemophilus
influenzae 696
parainfluenzae 691
Hair 591
follicles 781
growth, flag type of 575
loss 833
waving of 789
Halides 610
Halogenation 106
Haloperidol 487
Hamburger effect 391
Haptoglobin 448, 449, 571
Hardy-Weinberg law 674
Harrison's sulcus 521
Hartnup's disease 25, 291, 341, 342, 352, 536
Hashimoto's thyroiditis 819
Hay's test 433
Hazard warning 738
Heal wounds 551
Heart 344
attacks 281, 517
disease 215, 587, 598, 609
coronary 267, 601
ischemic 270
rheumatic 272
failure, congestive 264
Heat
and acetic acid test 44
coagulation 44, 45f
coagulation, significance of 44b
stability 75
Heavy chain disease 748
Heavy metal
ions 44, 127
poisons 606
Helicase 640
Helices 39
Helicobacter pylori 214, 424
Helium nucleus 828
Helix-loop-helix 40
Helix-turn-helix 41
Hematin 378, 383
Hematopoietic stem cells 701
Hematopoietic system 781
Heme 134, 376, 379
biosynthesis of 377
breakdown of 384f
catabolism of 383
generation of 378
heme interaction 389
linkage of 388f
molecule 379f
structure of 377, 377f, 377t
synthesis 310, 377f, 401, 537
disorders of 380
enzyme of 379f
regulation of 379
steps of 378f
Hemicellulose 586
Hemin crystals 395
Hemochromatosis 351, 574
Hemodilution 481
Hemoglobin 41, 197, 376, 390, 393, 393b, 396, 398, 568, 685, 720, 761
action of 463
C 398
catabolic pathway of 383f
D 398
derivatives 394
E 398
embryonic 392
glycated 197, 395
lepore 400
level 572
metabolism 550
molecule 389f
S 396
structure of 388
unstable 396
variants 395
inheritance of 398
Hemoglobinopathies 395, 396, 401
Hemoglobinuria 438
Hemolysis 10, 401, 523, 542, 735
Hemolytic anemia, drug-induced 78, 170
Hemolytic disease 387, 490
Hemopexin 448, 449, 571
Hemophilia 699
A 453
B 454
classical 453
inheritance pattern of 453f
Hemorrhage 401, 572
internal 550
postpartum 454
splinter 551f
Hemosiderin 571
Hemosiderosis 573
primary 574
treatment of 574
Hemotoxins 799
Henderson-Hasselbalch's equation 458, 459
clinical applications of 460b
Heparin 99, 250, 454, 735
sulfate 99
Hepatic aminolevulinic acid synthase 379
Hepatic coma 301
Hepatic diseases 77, 79
Hepatic encephalopathy 419
Hepatic excretory function, tests of 416
Hepatic failure 419
Hepatic fibrosis 416
markers of 420
Hepatic mitochondrial damage 422
Hepatic scavenger receptor B1 253
Hepatic triglyceride lipase 254
Hepatitis
A 421
virus 421
acute 77
B
acute 421
chronic 421
infection, markers of 422t
virus 234, 421, 690, 773
C 421
virus 421
D 421
virus 421
E 421
virus 421
G virus 421
Hepcidin 570
action of 570f
regulation by 570
Hephaestin 569, 574
Herceptin 782, 822
Herpes simplex virus 758
Hers’ disease 167
Heterochromatin 639
Heteroduplex analysis 711, 711f
Heteroglycans 97, 98
Heteromultimer 75
Heteroplasmy 666
Heteropolysaccharides 90
Heterotrophs 5
Heterozygote 674, 706
Hetoacyl reductase 229
Hexokinase 57, 152, 152t, 153, 157
Hexosaminidase
A 284
B 284
Hexose monophosphate shunt pathway 166, 168f, 169b
steps of 167
High anion gap metabolic acidosis 468, 468t
High pressure liquid chromatography 724
High-energy 59
compounds 130, 130t
phosphate bond 152
Highly-active antiretroviral therapy 767
High-performance liquid chromatography 722
High-sensitivity
cardiac troponins 263
C-reactive protein 266, 267
Hill equation 67
Hinge region 745
Hippuric acid 310, 362, 506
Histamine 36, 343, 423, 747, 794
action of 344t
fast achlorhydria 424
metabolism of 343f
release 536
Histidase 344
Histidine 31f, 3234, 36, 302, 307, 314, 343
load test 542
metabolism of 343f
proximal 388, 389
Histidinemia 344, 346
Histones 637
sumoylation of 638
Hodgkin's disease 831
Holo-enzyme 58
Homeostasis 363, 364
Homeostatic model assessment 194
Homocitrullinuria 300
Homocysteine 537
methyltransferase 544
Homocysteinemia 542
Homocystinuria 314, 318, 346, 537, 545, 546, 788
Homodimer 41
Homogenates 363
Homogentisate oxidase 337
Homogentisic acid 185, 186, 333, 337
oxidation of 337f
production of 333
Homoglycans 97
Homomultimer 75
Homopolysaccharides 90
Homovanillic acid 336
Hopanoids 243
Hormone 21, 181, 519, 446, 589, 726f, 802804, 806, 807
adrenal 812
antidiuretic 479, 808
assay of 818
binding 805
activates G-protein 803f
classification of 802
glucagon 160
hyperglycemic 190
hypothalamic 807
levels, pattern of 816f, 817t
local 281, 776
luteinizing 809, 810
mechanism of action of 803t
receptor complex 806
response element 514, 685, 686f, 807, 807f
secretion of 560, 792
sensitive lipase 189, 232, 254, 804
cascade activation of 231f
stimulating galactopoiesis 371
Horse radish peroxidase 726
Host cell membrane 765
Hot strong acids 45
Hotspot genes 675
Household, pollutants in 611, 611t
Human chorionic gonadotropin 357
Human gene, preparation of specific 692
Human genome project 4, 695
Human immunodeficiency virus 214, 765
antibody, detection of 726
genes 765
replication cycle 765f
replication of 765
structure of 765f
Human insulin, primary structure of 38f
Human oncogenic viruses 773t
Human papilloma virus 773, 774f
Human uterine cervix 774f
Humanize cow's milk 488
Hunter's syndromes 215, 354
Huntington's chorea 706
Huntington's disease 292, 680
Hurler syndrome 215, 354
Hyaline membrane disease, neonatal 111
Hyaluronic acid 98
Hyaluronidase 799
Hybrid
cells 753
molecules 692
Hybridization 704f
technique 704, 704f
Hybridoma 362
production of 753
technique 753, 753f
Hydration 225
Hydrocarbon chain, length of 105
Hydrochloric acid 423
secretion 423f
mechanism of 423
normal 423t
Hydrogen 829
bond 5, 39, 636
fad-accepts 533
ions 458, 464, 459t
concentration of 458
excretion of 463f
peroxide 78, 129, 277, 495, 496, 624, 726
sharing of 5
Hydrogenation 106
Hydrolase 57, 333
Hydrolysis 42, 333, 505, 505f, 818
Hydroperoxidases 129
Hydroperoxyl 496
radical 495
Hydrophobic bond 6, 39
Hydroxy amino acids 31f
Hydroxy ethyl 59
Hydroxy lysine 787
Hydroxyapatite crystals 565
Hydroxycobalamin 543
Hydroxyeicosa tetraenoic acid 282
Hydroxyindoleacetic acid 341
Hydroxyl 496
ions 459t
radical 495, 496
Hydroxylase 130
deficiency 814
Hydroxylation reactions 255
Hydroxylysine 322
Hydroxymethylbilane 378
synthase 382
Hydroxyproline 344
Hydroxypyruvate 311
Hydroxysteroids 813
Hydroxytoluene, butylated 500
Hyper hydroxyprolinemia 344
Hyperacidity 424, 424b
Hyperaldosteronism 470, 485, 814
Hyperammonemia 296, 299, 300
acquired 301
differential diagnosis of 300f
management of 301
Hyperbilirubinemia 385, 386, 413
acquired 386
congenital 386
conjugated 417
neonatal 386
unconjugated 416
Hypercalcemia 468, 563, 567
causes of 563b
symptoms of 563b, 564b
Hypercarotenemia 519
Hyperchloremia 486
Hyperchloremic acidosis 469, 563
Hypercholesterolemia 243, 271, 664
primary familial 271
Hyperchylomicronemia 271
Hyperemesis 196, 236
Hyperferritinemia 762
Hyperfunction, adrenal 814, 814t
Hypergammaglobulinemia 447, 748
types of 748
Hyperglobulinemia 484
Hyperglycemia 182, 195, 592, 798
nonketotic 300, 311, 345
Hyperhomocysteinemias, acquired 319
Hyperinsulinemia 193, 194
Hyperkalemia 465, 468, 470, 485
causes of 485b
treatment of 486
Hyperkeratosis 517, 517f
Hyperlactatemia 161
Hyperlipidemias 193195, 260, 270, 271, 484, 592, 798
clinical classification of 271f
electrophoretic pattern of 271f
secondary 271t
Hyperlipoproteinemia 271, 271t
familial 260
Frederickson's classification of 270t
Hyperlysinemia 321
Hypermagnesemia 468, 487, 564
causes of 487b
Hypermethioninemias 318
Hypernatremia 482, 808
acute 483
causes of 483b
correction of 483
Hyperornithinemia 300, 346
Hyperosmolar nonketotic coma 196
Hyperoxaluria, primary 16, 310, 664
Hyperparathyroidism 563, 566
Hyperphosphatemia 488
causes of 566b
Hyperplasia 592, 811, 820
congenital adrenal 814
Hyperprolactinemia 811, 816
Hyperprolinemia 346
Hypersensitivity 744
Hypertension 193, 266, 272, 273t, 437, 482, 592, 609, 760, 798
causes of 272, 273
complications of 273
gestational 273
portal 415
pulmonary 324
Hyperthermia, malignant 161, 792
Hyperthyroidism 184, 819, 819t
primary 819
secondary 820
Hypertonic contraction 482
Hypertriglyceridemia 193, 271
Hypertrophy 592
Hypertyrosinemia 338, 338f, 346
Hyperuricemia 166, 625
Hyperventilation 462
Hypervitaminosis
A 519
D 523
E 524
K 525
Hypervolemia 481
Hypoacidity 424, 424b
Hypoalbuminemia 445f, 447, 564, 591
Hypoalphalipoproteinemia 269, 270
Hypobetalipoproteinemia, familial 270
Hypocalcemia 564, 566
causes of 564b
treatment of 564b
Hypocapnia 470
Hypocarbia 470
Hypochloremia, causes for 486
Hypofunction, adrenal 814, 814t
Hypogammaglobulinemia 748
Hypoglycemia 166, 182, 189, 200, 208210, 591, 679
neonatal 208b
postprandial 200
Hypogonadism 576
Hypokalemia 470, 484, 591
causes of 485b
treatment of 485
Hypolipidemic drugs 268
Hypolipoproteinemias 269
classification of 270t
Hypomagnesemia 485, 487, 591
causes of 487b
Hyponatremia 481, 483
causes of 483b
dilutional 479
hypertonic 483
normotonic 483
treatment of 483
Hypoparathyroidism 566
Hypophosphatemia 488
causes of 567b
hereditary 567
Hypopigmentation 336
Hypopituitarism 819
Hypoproteinemia 447
Hypothalamic releasing factors 808
Hypothalamus 592, 808
Hypothesis, signal 663, 663f
Hypothyroidism 260, 820, 820t
congenital 820
primary 820
secondary 820
Hypotonic solution 9
Hypouricemia 626
Hypoventilation 471
Hypovolemia 480
Hypoxanthine
guanine phosphoribosyl transferase 627
phosphoribosyltransferase 353
Hypoxemia 393b
Hypoxia 397, 682, 777
inducible factor 1 501
I
Ileum 544
Imatinib 782
Imdevimab 763
Imidazole 32
aminoaciduria 344
Imino acid 31, 32
Immature skin cells 517
Immune
attack 766
cells 763
deficiency, primary 446
effector cells 744f
function 599
response, primary 749
system 814
tolerance 754
Immunity 281
acquired 743
active 749
adaptive 743
cell mediated 743
cellular theory of 742
humoral 743, 744
innate 743
passive 749
Immunochemistry 742
Immunoelectrophoresis pattern 721, 721f
Immunofluorescence 726, 727f
Immunoglobulin 567
A 746
E 746
functions of 746t
G 41, 744, 745, 746f
M 746, 747
molecule 745f
structure of 744
synthesis 686
Immunological system 516
Immunology 742
Immunoperoxidase technique 705f
Immunoturbidimetry 47
In situ hybridization 705, 714
In vitro synthesized protein assay 711
Inclusion bodies 399
Incretin 821
hormones 187, 190
Indole 32
ring 339
Indolequinone, formation of 333
Indoxyl sulfate, production of 567
Induction 72
Industrial hazard 609
Industrial pollution 609, 610t
Infarction 262
acute myocardial 263
Infections 401, 499, 517, 773
bacterial 489
chronic 445, 445f, 447
recurrent 195
immunity against 743
Infectious diseases, detection of 708
Inflammation 281
acute 498
chronic 498
Inflammatory bowel disease 342
Influenza virus 758
Ingram's finger printing method 43
Inherited metabolic disorders 351
Inner membrane 13, 131
Inorganic ions 68
Inorganic mercury 607
Inosine 619
monophosphate 208, 622, 623f
Inositol 547
biochemical functions of 548
structure of 548f
Inositol triphosphate 548
Insecticides 608
Insomnia 607
fatal familial 796
Insulin 98, 98b, 148, 150, 155, 161, 180, 186, 236, 247, 250, 484, 485, 567, 576, 663, 694, 823
action of 191t
biological effects of 189t
biosynthesis of 186, 186f
deficiency of 192, 196, 236
degradation of 187
favors lipogenesis 231
general effects of 190
insensitivity 233
mechanism of action of 187
metabolic effects of 189
overdose of 200
physiological actions of 189
primary structure of 38
rapid acting 199
receptor 187, 187f, 592
substrate 187, 807
replacement therapy 199
resistance 192194, 371, 798
effect of 193
secretion of 186, 187
mechanism of 187f
structure of 186
therapy 485
Insulinoma 200
Integral membrane proteins 19
Interchain disulfide bonds 35
Interferon 751, 752
Interleukin 593, 694, 751, 752
Interstitial cell stimulating hormone 816
Intestinal loss 487
Intestinal mucosal cells 250
Intestinal secretion 478
Intestinal system 323
Intestine 245
Intracellular buffer 461
Intracellular fluid 477, 479b
Intracellular protein degradation 291
Intracellular sodium 23
Intracorpuscular defect 401, 572
Intrahepatic cholestasis 77, 421
Intralysosomal accumulation 214
Intravenous saline infusion 485
Introns, removal of 656
Inulin 98, 98b
clearance 437
Invasive trophoblast antigen 357
Invisible fat 587
Iodine 575, 829
deficiency 820
metabolism 817
number 108
oxidation of 817
radioactive 725
salvaging of 818
uptake of 817
Iodoacetate 70
Iodopsin 516
Iodouracil 630
Ion activated enzymes 60
Ion channel 21, 21b, 21f
Ion exchange chromatography 724, 724f
Ion gap, strong 470
Ion selective electrode 730
principle of 731f
Ionic bond 5, 5f, 39
Ionophores 22
Ipilimumab 782
Iron 59, 488, 567, 571, 594
absorption of 423, 568, 569
atom 333
binding capacity, total 570, 573
carries oxygen 389
conservation of 571f
containing proteins 568t
distribution of 567
excretion of 571
homeostasis, maintenance of 569
kinetics, normal 568f
reduced form of 568
requirement of 567
response element binding protein 571
sources of 568
storage of 570
sulfur complexes 568
vessels 574
Iron absorption 569f, 570
luminal phase of 569
mechanism of 570
Iron deficiency 400, 545f, 572f
anemia 571, 572, 597
chronic 545, 573f
causes of 572b
diagnosis of 572
treatment of 573
Iron metabolism 550, 570f
disorders of 571
regulation of 570
Iron overload 573
causes of 573
secondary 574
Irritable bowel syndrome 600
Isocitrate
dehydrogenase 121, 126, 577
formation of 121
Isocyanates 610
Isoelectric pH, significance of 43b
Isoenzymes 56, 75, 720
identification of 75
true 75
Isoforms 75, 504
Isoimmune hemolysis 401
Isoleucine 32, 307, 326
Isomaltase 146
Isomaltose 96, 97f
Isomerase 57, 150, 221, 278, 333
Isomerization 167, 333
Isoniazid 194, 517, 536
Isonicotinic acid hydrazide 69
Isopentenyl pyrophosphate 245, 245f
Isosthenuria 439
Isothermal amplification, loop-mediated 709, 710f
Isothermic reaction 64
Isotonic expansion 482
Isotonic solution 9
Isotopes 827
Isotretinoin 517
Isovaleric aciduria 300, 326
J
Jaundice 385, 387f, 413f, 415, 819
cases, serum in 417t
classification of 418t
differential diagnosis of 388t
hemolytic 387, 388, 416
hepatocellular 387, 388, 417
latent 385
obstructive 260, 387, 388, 417
pathological 387
physiological 386, 387, 387t
posthepatic 417
prehepatic 416
types of 417, 418t
urine in 417t
Jejunal mucosa 222
Jejunum, upper part of 540
Juxtaglomerular cells 480
K
Kartagener's syndrome 789
Karyorrhexis 235
Kayser-Fleischer ring 449
Keratan sulfate 99
Keratin 41b, 789
Keratomalacia 517, 517f
Kernicterus 384, 386, 387
Keshan disease 577
Keto group 90f
Ketoacidosis
diabetic 195, 196, 237, 463, 468
management of 237
Ketoacids 325
Ketogenesis 190, 195, 235, 235f
regulation of 236
Ketogenic diet 598
Ketogenic steroid 813
Ketohexose 92
Ketolysis 236
Ketone 90
Ketone body 366, 432
excretion of 236f
formation of 235f, 236f
metabolism of 235
primary 235
secondary 235
utilization of 236f
Ketonemia 195, 236
Ketonuria 195, 236
Ketosis 90, 195, 236, 236f, 468
consequences of 196
diagnosis of 196, 237
differential diagnosis of 196, 237
management of 196
salient features of 237
Kidney 308, 503, 519
disease, chronic 436, 571, 597
function 429b, 433t
tests 429
injury, acute 436
regulation by 479
scanning 830
tubules, functions of 430t
Kill bacteria 277, 834
Killer cells 744
Kimmelstiel-Wilson syndrome 184, 197
Kinase 560, 680
inhibitors 781
phosphorylates enzymes 804
Kinetochore 639
Kinin-Kallikrein system 272
Kjeldahl's procedure 46
Klenow enzyme 712
Klinefelter's syndrome 351, 811, 816
Knock-knee defect 565f
Koilonychia 573f
Kornberg's enzyme 641
Koshland's induced fit theory 60, 62, 62f
Kozak sequence 661
Krabbe's leukodystrophy 284
KRAS mutations 780
Krebs cycle 122f, 124f, 127
Krebs-Henseleit urea cycle 297
Kussmaul's respiration 196, 237, 470
Kwashiorkor 590, 591
marasmic 591
salient features of 591t
Kynureninase 339
L
Laboratory waste management 738
Lac operon
derepression of 684
repression of 684f
Lactalbumin 488
Lactase 57, 146, 147
deficiency of 147
Lactate 97, 149, 159
dehydrogenase 13, 41, 75, 158, 264, 734
isoenzymes of 75, 75f
reaction of 59f
formation 153f
production, significance of 152
Lactic acid cycle 155
Lactic acidosis 157, 161, 166, 196, 196b, 210, 468, 532
types of 468b
Lactose 96, 96f, 97
free diet 209
intolerance 147, 488b
synthesis 208, 488
Lactosuria 185
Lactosyl ceramidoses 284
Lactosylceramide 284
Lactotrops, hyperplasia of 811
Lagging strand 642
Lambert's law 727
L-amino acid 34f
oxidase 295, 296f
Lamp technology 710
advantage of 710
Lamp test 709, 762
Langerhans cells 765
Lanosterol 246, 246f
Lapatinib 782, 822
Laser desorption ionization, matrix-assisted 732
L-asparaginase 321
Lateral flow immunoassay 729
advantage of 730
Lathyrism 611, 788
Lathyrus sativus 611
Lead 44
pipes 607
Lead poisoning 382, 606
signs of 607
sources of 606
symptoms of 607
treatment of 607
Leber's hereditary optic
myopathy 140
neuropathy 666, 699
Lecithin 109f, 110, 235, 253
cholesterol acyltransferase 244, 247, 249, 253f
lysolecithin acyl transferase 282
Lectins 45
Leigh's syndrome 666
Lens proteins 793
Leptin 233, 592
Lesch-Nyhan syndrome 626, 627
Lethal infantile mitochondrial ophthalmoplegia 140
Lethal mutations 678
Leucine 32, 307, 326, 723f
aminopeptidase 291
Leukemia 518, 699
acute
lymphoblastic 770, 782
myeloid 701
chronic
lymphatic 446
lymphocytic 782
myeloid 701, 782
Leukocyte 786
adhesion deficiency 214
Leukoderma 334
Leukodystrophy, metachromatic 284
Leukopenia 542, 832
Leukotriene 279, 282
synthesis of 282f
Levy Jening's chart 737
Lewy body 797
Leydig interstitial cells 810
L-gulonolactone oxidase 172
Liddle's disease 22
Liddle's syndrome 273
Lifestyle diseases 372, 420
Ligand-gated channels 22
Light-emitting diode 730
Lignin 586
Linear accelerator 831
Lineweaver-Burk
equation 67b
plot 67, 67f, 69f, 70f
Lingual lipase 220
Linkage analysis 695
Linoleic acid 278, 279, 279f, 587
Linolenic acid 278, 279, 587
Lipase 79, 80, 108, 221
Lipemia, postprandial 222
Lipid 104, 105, 110, 223, 722, 814
absorption of 221, 223, 415
chemistry of 104
classification of 104, 105b
clinical applications of 104b
digestion of 220
steps of 223b
functions of 104b
metabolism 195, 364, 371, 414
nutritional importance of 587
peroxidation 278, 499, 500f
peroxide radical 495
rafts 19
simple 104, 105, 107
storage diseases 112, 284, 284t, 285f
Lipidomics 112
Lipogenesis 189
Lipoic acid, structure of 156f
Lipolysis 236, 366
Lipolytic enzymes 220
Lipo-oxygenase 496
Lipoprotein 45, 243, 248, 249t, 252, 256, 266, 270, 720
beta 524
cascade pathway 251
classification of 248
functions of
high-density 254
very low-density 251
general characteristics of 248
high-density 211, 247250, 252, 260, 270, 448
intermediate density 248, 251
level, high-density 193
lipase 232, 250
metabolism 254f
of high-density 252
of very low-density 251
sizes of 248f
synthesis of very low-density 251
ultracentrifugation patterns of 248f
very low-density 223, 247249, 251, 260, 270
Liposome 109
classification of 109
Lipotropic factor 548
Lipoxin 282
Lisinopril 815
Lithium 517, 578, 730
therapy 563
Litmus, reaction to 432
Liver 211, 236, 247, 308, 318, 384, 413, 420, 503, 504, 830
adipose tissue axis 233
cells 78
cirrhosis of 419, 446, 447
enlargement of 519
enzyme panel 416
excretory function of 416
failure, clinical features of 420b
fibrosis, stage 420
functions of 414
glycogen 162, 162f
injury, enzyme markers of 417
metabolic profile of 368
metabolism 368
metastasis, suspected 415
mitochondria 235
regeneration 422b
role of 234b, 466
to tissues, transport from 514
Liver disease 76, 77b, 352, 415, 421
alcoholic 415, 416
causes of 421
chronic 413
diagnosis of 418f
Liver dysfunction 415, 452
clinical manifestations of 415
Liver function 310
tests 235, 413, 415, 416, 422, 446
classification of 416b
indications for 415b
Lobry de Bruyn-van Ekenstein transformation 93f
Lohmann's reaction 308, 309f, 791
Lopinavir 763
Lou Gehrig's disease 497
Low-carbohydrate ketogenic diet 199
Low-density lipoprotein 207, 247249, 251, 251f, 260, 270, 498
cholesterol
estimation 248
level 266
clinical applications of 252b
functions of 251
Lowry's method 46
L-phosphatidic acid 109f
Luft's syndrome 792
Lundh test 425
Lung 420, 599
disease, chronic obstructive 471
disorders 397
maturity 490
Lymphadenopathy 765
Lymphokines 751
production of 744
Lymphoma 773, 831
Lynch syndrome 646
Lynen's spiral 228
Lysine 32, 34, 307, 314, 321, 723f
hydroxylation of 550, 787
vasopressin 808
Lysolecithin 110
Lysophospholipid 221
Lysosomal enzymes 796
Lysosomal storage disorders 214
Lysosome 13, 15, 17
clinical applications of 15b
function 15f
secondary 15
Lysozyme, active center of 61f
Lysyl oxidase 574, 575, 787, 789
M
Macroglobulins 746
Macroglossia 679
Macrominerals 558
Macrophage 26, 323, 496, 496f, 744
bactericidal activity 170
colony stimulating factor 822
function 576
migration inhibition factor 751, 753
surface of 766
Mad Hatter's disease 607
Magnesium 59, 477, 486, 487, 578
functions of 487
normal serum level of 486
Maillard reaction 197
Malabsorption 425
studies on 425
syndromes 559
Malaria 78, 398f
parasites 675
Malate
aspartate shuttle 132, 132f, 158, 159, 159f, 321
dehydrogenase 123, 132, 158
formation of 123
Malic enzyme 231
Malnutrition 234, 447
acute 590
chronic lymphocytic 590
classification of 591t
moderate acute 590
severe acute 590
Malonate inhibits succinate dehydrogenase enzyme 68f
Malondialdehyde 498
Malonyl
transacylase 229
units 229
Maltase 146
Maltose 96, 97f
Mammalian cells 5t, 681
Mammalian system 654
Mancini's technique 47
Manganese 59, 497, 577
deficiency manifestations 577
functions of 577
Mannitol 94, 431
Mannosamine 95
Mannose 9193
Maple syrup urine disease 300, 325, 325f, 346
Marasmus 590, 591
salient features of 591t
Marble bone disease 565
Marfan syndrome 788
Maroteaux-Lamy syndrome 215
Mass spectrometry 732, 733f
Massive blood transfusions 566
Mast cell 747
degranulatioin 747f
Maternal serum screening 356
Matrix metalloproteinase 420, 786
McArdle's disease 167
Meconium aspiration syndrome 111
Median values, multiple of 733
Medical waste 738
Medicine, branch of 830
Medicolegal cases 708
Meister cycle 291, 292f
clinical applications of 291b
Melanin 333, 341, 341b, 575
clinical applications of 334b
synthesis 333, 334, 334f
Melanocyte stimulating hormone 809, 333
Melanoma 338, 778, 780
malignant 334
Melatonin 314, 315, 341, 341b
synthesis 340f
Membrane
fluid mosaic model of 18f
protein 18, 760, 761
receptor 187
Memory
cells 744
loss 607
Menadione 524
Menke's disease 575, 788
Menke's kinky hair syndrome 575
Menopause 811
Menstrual cycles 816
Mental retardation 209, 214, 319, 344346, 607
severe 325
Mercaptoethanolamine 315
Mercaptopurine 781
Mercurous chloride, mercury with 731
Mercury 44
poisoning 607
Meselson-Stahl experiment 640, 640f
Metabolic acidosis 196, 237, 465, 467, 468, 472
clinical features of 470
compensated 470
treatment of 470
Metabolic adaptations 362, 364, 365
Metabolic alkalosis 465, 467, 470, 471t, 472
clinical features of 471
sub-classification of 471
Metabolic disorder 352
tests for 352
Metabolic effects 281
Metabolic errors 310
Metabolic fate 323
Metabolic fuels 583
Metabolic liver disease, tests for 416, 420
Metabolic pathophysiology 352
Metabolic pathways, types of 363
Metabolic symbiosis 777
Metabolic syndrome 193, 194, 420, 592
diagnosis of 193b
Metabolic traffic circle 125
Metabolism 119, 363, 577, 617
inborn errors of 56, 227, 337, 351, 352, 353t, 359b, 733
integration of 364f
phases of 363
primary 5, 363
tertiary 5, 363
Metabolites 490
Metalloenzymes 59, 59t
Metalloproteins 45
Metallothionein 501, 575
Metanephrine 314
Metastatic calcification 523
Metformin 199
Methanol 211, 468, 609
metabolism of 211
Met-hemoglobin 316, 394
reductase system 394f
Met-hemoglobinemia 78, 170, 394
acquired 394
congenital 394
prevention of 170
Methionine 32, 235, 307, 313, 315, 723f
activation of 313
adenosyl transferase 313
synthesis 313
Methotrexate 69, 543f, 685, 781, 782, 782f
inhibits 630
Methyl 377, 378
acceptor 314
alcohol 211
cholanthrene, injection of 771f
folate trap 544
groups, salvaging of 310
malonic aciduria 227, 346
mercury 607
transfer 313
reactions 315
Methylation 638, 655
reactions 507
Methylcholanthrene 771
Methylcobalamin 544
Methylene blue, effect of 395f
Methylguanosine triphosphate 655
Methylhistidine 314
Methyllysine 314
Methylmalonic acid 546
Methylmalonic aciduria 227, 300, 544
Methylmalonyl-CoA isomerase 544
Micellar formation 222f
Micelle 244, 256
formation 109
mixed 221
Michaelis constant 65, 66
derivation of 65b
Michaelis-Menten
saturation curve 69f, 70f
theory 60, 61
Microalbuminuria 197, 438
Microangiopathy 197
Microarray technique 705, 706f
Microbiota 223, 601
Microflora 600
Microsomal cytochrome 14, 130
Microsomal ethanol oxidizing system 210
Microsomal heme oxygenase system 383
Microsomal system 279
Microsomes 13, 14, 228
Microtubules 793
structure of 793
Microvilli 20
Middle-East respiratory syndrome 759
Migraine 336
Milk 488
composition of 488t
lipids in 488
mineral 489
content of 489t
proteins in 488
Millon's test 36
Minamata disease 607
Mineral 558t, 569
Mineralocorticoids 807, 811, 813, 813f
biological effects of 815
effect of 815t
synthesis of 812f
Miscarriage 607
Mitochondria 13, 16, 17, 17f, 121, 131b, 131f, 139, 140, 224, 236, 379f, 568, 660, 665t
cytochrome 130
encephalomyopathy lactic acidosis stroke 140
inheritance 675, 680
inner membrane of 131
membrane 128, 132
pathway, intrinsic 682
permeability transition pore 140, 682
transport systems 139
Mitochondrion, structure of 131
Mitomycin 657
C 782
Mobile elements 639
Modular proteoglycans 785
Molecular biology 615, 635
central dogma of 652
techniques 356, 701
Molecular cloning 699
Molecular cytogenetics 355
Molecular diagnostics 703
Molecular scissors 691
Molecular sieving 723
Molecular weight 11, 43
Molecule
enzymology, single 75
signal 822t
transport of large 24
Molisch test 94
Molybdenosis 577
Molybdenum 59, 577, 624
deficiency 577
toxicity 577
Monkey kidney cells 758
Mono amino monocarboxylic acids 30
Monoacylglycerol 220222
Monoamine oxidase 74, 335, 341, 342, 610
Monoamino dicarboxylic acids 31
Monocarboxylic acids, dibasic 31
Monoclonal antibody 269, 362, 753, 753f, 754t, 782
advantage of 754
applications of 754
humanization of 754
nomenclature of 754
production of 753f
Monoclonal gammopathy 747
Monocyte 496
colony-stimulating factor 776
Monogenic disorders 351
Monoglucuronides 384
Monokines 751
Mono-oxygenase 130, 332, 812
Monosaccharides 90, 91t, 97
absorption of 148, 149f
reactions of 92
Monosodium glutamate 611
Morphine binds 810
Morquio syndrome 215
Mosaicism 679
Motor paralysis 795
Mucins 214
Mucopolysaccharides 98
Mucopolysaccharidoses 214, 215, 786
features of 215t
Mucoproteins 45, 99
Mucosal block
basis of 570
theory 569
Mucosal cellular phase 569
Mucous membrane 832
lesions 517
Multienzyme complex 74, 121, 229, 308, 628
Multifactorial disorders 351
Multifactorial inheritance 680
Multigene panel tests 780
Multiple antibiotic resistances 694
Multiple myeloma 445, 445f, 448, 747
Multiple sclerosis 285, 489, 499, 754, 794, 795
Multiplex polymerase chain reaction 709, 709f
Multipotent 700
Muscle 560
biopsy 792
cells 193f
contraction 789f, 790f, 791b
cramps 309
diseases 79, 264
fatigue 792
functions of 162f
glycogen phosphorylase, regulation of 163
lacks glucose-6-phosphatase 163
metabolism 368
proteins 789
relaxant 548
weakness 566
Muscular dystrophy 264, 309, 435
Mutagen 606, 678, 771
Mutagenesis 678
Mutarotation 92
Mutase 227
Mutation 38, 646, 673, 676, 707
classification of 677
detection techniques 710
effect of 677
manifestations of 678
reverse 679
reversion of 679
spontaneous 675
theory 798
Mutual supplementation 590, 594
Myalgia 760
Myasthenia gravis 548
Mycobacterium tuberculosis 696
Myelin sheath 19, 547, 794
Myeloma 748
Myeloperoxidase 254, 496
Myocardial infarction 79, 244, 252, 261265, 309, 498, 537, 791
cardiac markers of 262
markers of 264t
Myocardial stress, markers of 262
Myocarditis 272
Myocardium 560
Myoclonic epilepsy 140
Myoglobin 264, 400, 568, 763, 789
chain 400f
clinical significance of 400b
Myoglobinuria 666
Myopathy 666
Myosin 789, 790
acts 790
heavy chain of 790f
molecules 790
Myotonic dystrophy 680
Myxedema 820
N
N-acetyl 212
glucosamine 61f
neuraminic acid 778
N-acetylcysteine 500, 504
N-acetylglucosamine 19
N-acetylglutamate synthase deficiency 296
N-acetylmuramic acid 19
N-acetylneuraminic acid 758
synthesis of 212f
Nails 550, 552
Nalidixic acid 647
Nanomedicine 827, 834, 835
Nanopore sequencing technology 713f
Nanorobotics 835
Nanotechnology 834
Naphthoquinone derivatives 524
Nasal bleeding 525
Nasopharyngeal carcinoma 773
National Goitre Control Programme 591
National Iodine Deficiency Disorders Control Programme 591
National Nutrition Policy 591
Natriuretic peptides 272
Natural killer cells 744
Nausea 760, 832
Necrosis 682f
Nelson-Somogyi method 737
Neostigmine 548
Nephelometry 47
Nephron 429
loss proteinuria 439
Nephropathy 606
diabetic 438
Nephrosclerosis, diabetic 184
Nephrosis, stages of 437
Nephrotic syndrome 260, 445f, 446, 447, 450, 748, 819
diagnosis of 438
Nerve
cell 793
axons 793
conduction 244, 560
fiber 793
impulse, generation of 515
Nervous system 211, 802
peripheral 794
Neural tube defects 318
Neuraminic acid 212
Neuritis, peripheral 537
Neuroblastoma 336, 831
Neurodegenerative diseases 140
Neurodegenerative disorders 696
Neurological sequelae 607
Neuropathy 197
peripheral 548
Neuropeptide
hypothalamic 807, 808
Y 593, 820
Neurotoxins 606, 608, 611
Neurotransmitter 794
excitatory 319
Neutral fat 107, 587
Neutron 827
number of 827
Neutrophils 496
Next generation sequencing 712, 713f
Niacin 530, 534, 535, 549, 551, 552
chemistry of 534
coenzyme forms of 534
deficiency 339, 341, 535, 535f
causes for 535
dietary sources of 536
production of 537
structure of 534f
synthesis of 340f
therapeutic use of 536
toxicity of 536
Niacinamide 534
Nickel 577
ions 78
plasma level of 577
Nicotinamide 59, 314
deficiency 339
Nicotinamide adenine dinucleotide 59, 121, 534, 617
phosphate 332, 378, 504, 505, 534
dependent enzymes 535
oxidase 496
Nicotine 771
Nicotinic acid 269, 339
vitamin 534
Niemann-Pick's disease 283, 284
Nifedipine 566
Night blindness 517
Ninhydrin 36
test 354
Nitrates 323, 468
Nitric oxide 272, 307, 319, 322, 324, 395, 495, 496, 501, 806
activity, enhancers of 324
antagonists of 324
mechanism of action of 323
physiological actions of 323, 323f
synthase 496, 568
reaction 322f
synthesis of 322
Nitrites 323
Nitrocellulose membrane 704, 705
Nitrofurantoin 421
Nitrogen 46
balance 292, 588, 589, 589f
maintenance of 589
dioxide 496, 610, 771
fixation 690
Nitroglycerine 806
Nitronium ion 496
Nitroprusside test 36, 806
Nivolumab 782
N-labeled glycine 363
N-methylnicotinamide 314
N-methyltransferase 334
Nocturia 439
Node of Ranvier 19f, 20
Nonapeptide 808
Noncarbohydrate reducing
compounds 185
substances 185
Noncompetitive inhibition 68
saturation curve of 70f
Nonfasting lipid profiles 265
Nonfused myeloma cells 753
Nonheme iron-containing proteins 568
Non-Hodgkin's lymphoma 773, 782
Noninvasive prenatal testing 355
Non-nucleoside analogue 767
Nonphosphorylated lipids 112
Nonprotein nitrogen 433
Nonsteroidal anti-inflammatory drugs 626, 627
Nontemplate strand 652
Non-traditional inheritance 679
Norepinephrine 314, 333, 334, 794
Normal serum electrolyte 472b, 473
Normetanephrine 314
Normoglycemia 182
Novobiocin 647
Nuchal translucency 357
Nuclear codons 666
Nuclear factor kappa-beta 501
Nucleic acid 487, 617, 618f, 703, 722, 814, 834
digestion of 620
sugars of 96f
testing 767
Nucleocapsid protein 760, 761
Nucleoproteins 45
Nucleoside 617, 618, 619t
analogs 767
diphosphate 619
triphosphates 619, 619t
Nucleosomes 637, 638
Nucleotide 617, 618, 619t, 712
composition of 617
derivative 617
excision repair 645, 645f
functions of 617
phosphatase 77, 78
polymorphisms, single 780
Nucleus 13, 14, 14f, 17, 651
Nutrition 370, 511, 583
deficiency 521, 571
dwarfism 591
function 447
indices 589
iron deficiency 572
values 589
assessment of 589
Nyctalopia 517
Nystagmus 338, 795
O
Oasthouse syndrome 318
Obermeyer test 342
Obese 192
Obesity 193, 194, 233, 266, 592, 592b, 600, 601, 760
dietary management of 598
index 592
treatment of 592
Obstruction, extrahepatic 77
Occupational Safety and Health Act 738
Ochronosis 338
Oculocutaneous tyrosinemia 338
Ofatumumab 782
Okazaki fragments 643
Olaratumab 782
Oligomycin 136, 138
Oligonucleotide, antisense 667
Oligopeptide 37, 46
Oligosaccharides 90
Omega 3 fatty acids 235, 267
Omega oxidation 228
Omphalocele 679
Oncofetal antigen 778, 779, 779f
Oncogenes 774
Oncogenic virus 421, 772
Oncosuppressor genes 681, 775, 775t
One-carbon
compounds 301t
group 59, 311
metabolism 289, 301
Oocyte contains 699
Ophthalmoplegia 576
Opioid peptides 794
Optic
activity 33, 91
atrophy 666, 795
density 727
neuritis 609
Optimum temperature 67
Oral cavity 550, 552
Oral contraceptive pills 537
Oral glucose tolerance test 183, 184f
Oral hypoglycemic agents 199
Oral mucosa 599
Oral rehydration fluid 148
Orchitis 811
Organ perfusion 362
Organ slices 362
Organelle, membranes of 20
Organic acid 300
disorders 300
metabolism 353b
Organic acidosis 468t
Organic acidurias 226, 227t, 468
Organic anion transporter, multispecific 384
Organic mercury 607
Organic solvents 44
Organic sulfate 567
Organic sulfur 317
Organophosphorus
compounds 609
insecticides 78
Origin recognition complex 640
Origin replication element 640
Ornithine 36, 322, 324, 723f
biochemical role of 298
cycle 297
decarboxylase 70, 324
metabolism of 322f
transcarbamoylase 297, 699
deficiency 299
transporter deficiency 299
Orotic aciduria 629
drug-induced 629
Orotidine monophosphate, formation of 627
Osazone formation 93
Osmolal gap 470
Osmolality 9, 478, 486
measurement of 439
Osmolar gap 480
Osmolarity 9, 478
Osmosis 8, 9f
clinical applications of 10b
reverse 9, 10f
Osmotic diuresis 196, 237, 431, 439, 485
Osmotic gradient 9
Osmotic pressure 8, 43
Osteoblastoma 830
Osteoblasts 77, 561
Osteocalcin 524, 565
Osteoclasts 562
Osteogenesis imperfecta 788
Osteoid 550, 564
Osteomalacia 521
clinical features of 522
Osteonectin 565
Osteopenia 798
Osteopetrosis 565
Osteoporosis 521, 565
Osteoporotic bone 565f
Ovarian cancers 779
Ovarian hormones 815
regulation of 815
Ovarian tumor 815
Ovary 245, 281
teratomas of 819
Overnutrition 592
Oxalate 559, 736
Oxalic acid 568
Oxaloacetate 121, 123, 125, 157, 158, 196, 237
reactions of 123f
regeneration of 123
Oxaloacetic acid 791
Oxalosuccinate 121
Oxaluria 310f
Oxidases 129, 378
Oxidation 127, 389b, 504, 627
reduction, reversible 550
Oxidative damage 261
Oxidative deamination 35, 295, 319
Oxidative decarboxylation 121
Oxidative metabolism, metabolic defects of 127t
Oxidative pathway 124
Oxidative phosphorylation 128, 135, 138f, 138t, 152, 666, 818
diseases 666t
energetics of 128
inhibitors of 138
uncouplers of 138
Oxidative reaction 504, 504f
Oxidative stress 499, 798
Oxidatively decarboxylated 156
Oxidoreductases 57, 58
Oxoprolinuria 291
Oxygen
calorific value of 584
deficiency 153t
dissociation
clinical applications of 393b
curve 389, 390f, 393
Oxygenation 389b
Oxyhemoglobin 397
Oxytocin 46, 808
Ozone 496, 609
P
P53 oncosuppressor protein 681
Pacemaker theory 798
Paget's disease 565
Pain, acute abdominal 381
Palindrome 691
Palmitic acid 105, 226, 228, 231
beta oxidation of 226f
Pancreas, carcinoma of 454
Pancreatic deficiency 223
Pancreatic disease 79
Pancreatic enzymes, measurement of 424
Pancreatic function
assessment of 424
tests 424, 425t
Pancreatic juice 146, 478
trypsin of 544
Pancreatic lipase 220, 221, 277
Pancreatitis, acute 79, 291, 424, 425
Pancreozymin 291
Panitumumab 782
Pantothenic acid 530, 537, 549, 551, 552
coenzyme activity of 538
deficiency of 538
requirement of 539
sources of 539
structure of 537f
Papain 745
Paper chromatography 722, 722f
Para-aminobenzoic acid 542f
Paracetamol 281, 422
Paracrine 802
Para-hydroxyphenylpyruvic acid 346
Paraoxonase 507
functions of 507f
Paraproteinemias 445, 448, 747
Parathyroid
deficiency of 564
function tests 564b
hormone 433, 559, 562, 565
and bones 562
and kidney 562
mechanism of action of 562
Parenteral nutrition, total 599
Paresthesias 795
Parkinson's disease 292, 608, 797
Passive transport 20
Pauly's test 36
Pazopanib 822
Pectins 586
Pellagra 342, 535, 537
symptoms of 535
Pembrolizumab 782
Penicillin, bactericidal action of 19, 100
Penta marker test 356
Pentagastrin 821
stimulation test 423
Pentose 95
phosphate pathway 166, 231
Pentosuria 185
essential 172
Penultimate carbon atom 91, 91f
Pepsin 63, 68, 290, 423, 745
Pepsinogen 290
Peptide
chemical synthesis of 43
signal 663
Peptide bond 36, 37f
characteristics of 37
formation 36, 36f, 661
Peptidyl transferase 656, 661, 662
Perchlorate 817
Percutaneous umbilical blood sampling 355
Pericarditis 272
Periodicparalysis, hyperkalemic 485
Peristalsis 220
Peroxidase 16, 80, 129
Peroxisomal biogenesis disorders 16b, 228, 278
Peroxisomal oxidation 277
Peroxisomes 16
Peroxyl 496
Peroxynitrite 495, 496
Personal protection gear 738
Pertussis 805
Pesticides 608
Petechia 550
pH 458, 459
bicarbonate 468f
effect of 68, 390
meter 730
normal 461
renal regulation of 463
respiratory regulation of 462
with K+ ion balance, relationship of 465
Phagocytosis 25f, 26, 550
defect of 749
Phagosomes 26
Phaseolus vulgaris 45
Phenol 506
Phenolic hydrogen 500
Phenylalanine 32, 34, 38, 77, 332, 336, 345, 346, 353, 568, 658, 723f
catabolism of 332f, 333f
hydroxylase 332, 336
absence of 338f
load test 337
low 337
Phenylketonuria 336, 336f, 338f, 346, 358, 490, 675, 690
carrier state 337
tests for 337b
Phenylpyruvate 336
Phenylpyruvic acid 337
Phenytoin 421, 517
Pheochromocytoma 336
Philadelphia chromosome 773
Phlorhizin 24
Phosphate 59, 212, 487, 559
absorption of
decreased 567
increased 566
buffer system 461
compounds 130
ions, functions of 566b
levels 567b
Phosphatides 109
Phosphatidic acid 109
Phosphatidyl serine 283f
Phosphatidylcholine 110
synthesis of 282, 283f
Phosphatidylethanolamine 111f
Phosphatidylglycerol 111
Phosphatidylinositol 111, 111f, 548
synthesis of 282
Phosphoadenosine phosphosulfate 317f
Phosphodiesterase 804
Phosphoenolpyruvate carboxykinase 158, 159, 159f, 208, 367
Phosphofructokinase 154, 155f, 207
Phosphoglucomutase reaction 152, 163, 163f
Phosphoglycerate 311
Phospholipase 221, 280, 799
A2 110, 220
C 805
Phospholipid 108, 109f, 220, 221, 311, 547
interconversion of 282f
synthesis 547
Phosphoprotein 45, 312, 775
Phosphoribosyl amidotransferase, abnormal 625
Phosphoribosyl amine 622
Phosphoribosyl pyrophosphate 340, 622f, 627
synthesis 622
synthetase, abnormal 625
Phosphoric acid 112, 534f
Phosphorus 563, 565, 566, 608, 829
decreased excretion of 566
serum level of 566
Phosphorylase 165
A 165
enzyme 537
kinase
activation 165
reaction 805
Phosphorylates 775
proteins 808
Phosphorylation 95, 155f, 165, 664
substrate level 122, 127, 150, 152
Phosphosphingosides 112
Photoelectric colorimeter 727, 728f
Photometric analyzers, semi-automated 732
Photophobia 338
Photosensitivity 381
Phototherapy 387
Phototransduction, disorders of 517
Physiological tolerance test 183
Phytanic acid 227f
Phytic acid 559, 568
Phytin 548
Phytonutrients 500
role of 508
Phytosterols 269
Pigment metabolism 376
Pineal gland 341
Ping pong reactions 75
Pinocytosis 25
absorptive 25
Pitocin 808
Pituitary
adenoma 814
disease 811
gonadotropins 815
pK value 458, 460
Placental isoenzyme 419
Placental lactogen 371
Plasma
bilirubin 385
cells 743
malignant 747
colloid osmotic pressure of 446
glucose 197
postprandial 182
lactate 354, 354b
lipid 247
profile 247f, 264
membrane 17
receptor 807
osmolality of 478, 479t, 480
per minute 434
protein 444
A, pregnancy associated 356, 357
albumin 414
transport proteins of 448t
volume 98
Plasmacytoma 747
malignant 448
Plasmalogens 111, 283
Plasmid 692, 694
carries antibiotic resistance genes 693
liposome complex 698
Plasminogen 252
activator inhibitor 786
Plasmodium falciparum 214, 397
Platelet 323
aggregation 281
derived growth factor 782, 822
Plummer-Wilson syndrome 572
Pneumocystis carinii 325
Pneumonia 760
Poikilocytosis 399f
Point-of-care testing 729
Poisons 68, 234, 606
acute 470
effect of 379
Pollutant 606
Pollution, natural sources of 609
Polyacrylamide gel electrophoresis 720
Polyamine 324
functions of 325
synthesis 324f
Polychloro biphenyls 609
Polyclonal antibodies 753f
Polycystic ovarian syndrome 193, 194
Polycythemia vera 831
Polydeoxyribonucleotide 636
Polydipsia 195
Polyhydroxy aldehydes 90
Polymerase chain reaction 68, 419, 636, 707, 707f, 708f, 711
clinical applications of 708
real time quantitative 709f
Polymerization 642
Polymorphism 75, 449, 504, 707
Polyneuritis 532
Polynucleotide 636f
Polypeptide 37, 678, 750
chain
end groups of 37f
single 38
Polyphagia 195
Polyphenol 501
consumption of 501
Polyposis, familial adenomatous 775
Polyribosomes 662, 663f
Polysaccharide 90, 97, 99, 99t
Polysomes 662
Polyunsaturated fatty acid 16, 106, 106f, 247, 277, 278, 497, 499, 599
peroxidation of 497, 499f
sources of 587t
Polyuria 195
Polyvalent antivenoms 799
Polyvalent serum 799
Pompe's disease 166, 167
Porphobilinogen 382, 383
formation of 378
synthase deficiency 381
test for 355
Porphyria 380, 380t, 382
acquired 382
acute 351
intermittent 380, 382
cutanea tarda 380, 382, 382f
diagnosis of 382, 382f
erythropoietic 381
management of 383
variegata 381
Porphyrin 377, 383
ring 377f
urinary excretion of 383t
Porphyromonas 601
Porphyropsin 516
Portal blood stream 569
Portal hypertension 415
effect of 415
Portocaval anastomosis 419
Post-heparin lipolytic activity 250
Postpubertal deficiency 811
Postrenal causes 437
Postsynaptic neuron 794
Posture 734
Potassium 431, 477, 484, 578, 730
abnormalities 486b
channel 22
chromate 608
decreased renal excretion of 485
excretion 484, 485
high 196
hydroxide 608
redistribution of 485
Potential hazards 738
Potocytosis 26
Preanalytical variables 734
types of 734b
Precision 736
Pregnancy 184, 545, 589
acute fatty liver of 234
Pregnenolone, synthesis of 811f
Prenatal diagnostic tests 355t
Preproinsulin 186
Pressor amines 610
Primary gout 625
causes of 625
Prion diseases 796
pathogenesis of 796
Procalcitonin 450, 562
Procollagen, glycosylation of 787
Product substrate orientation theory 60, 61
Proenzyme 68
Progesterone 811, 815
receptor 780
Progressive renal disease, prognosis of 438
Prohormone 519
Proinsulin 38, 186
Proinsulinemia 186
Prokaryotes 665t
preinitiation complex in 661
tata box in 653
Prokaryotic and eukaryotic transcription 655t
Prokaryotic cell 5, 643t
Prokaryotic ribosome 659t
Prolactin 334, 488, 809, 811
Prolamines 45
Proline 31f, 32, 344
aminopeptidase 291
degradation of 344f
dehydrogenase 344
hydroxylation of 550, 550f, 664, 787
Prolyl hydroxylase 344
Propionyl 377, 378
Propionyl-CoA 160
carboxylase 539
deficiency 227
fate of 227
metabolism of 227f
Prostacyclins 279, 281, 281f
Prostaglandins 277280, 280t
action of 281f
biosynthesis of 280
classification of 280
mechanism of action of 281b
Prostanoic acid 280f
Prostanoids 279
Prostate
cancer 78, 79, 780, 816
specific antigen 78, 780
Prostatic fluid 576
Prosthetic group 58
Protamines 45
Protease 63t, 799
action of 290f
inhibitor 449, 610, 767
Proteasomes 292
Protein 30, 36, 37, 4446, 110, 120f, 432, 478, 576, 588, 590t, 594, 663, 722, 777, 786, 814, 834
A 641
abnormal 796
acute phase 449, 451
bands, visualization of 720
biological value of 589
biosynthesis 657, 662f
bound calcium 447
buffer system 462
C 452
calorie malnutrition 234
sequelae of 592
carboxy terminal end of 663
catabolism 818
classification of 45
component of 312
conjugated 45, 45t, 376
contractile 789
cytoskeletal 792
deficiency 589
denaturation of 44b, 44f, 703
digesting enzyme 703
digestion of 289, 290t
efficiency ratio 589
energy malnutrition 590
treatment of 591
fibrous 46
folding and chaperones 665
gastric digestion of 290
globular 46
intake 537
interactions 6f
intestinal digestion of 291
kinase activation 164
lifespan of 292b
losing enteropathy 291
metabolism 195, 289, 297, 371
microtubular associated 793
misfolding diseases 796
mutual supplementation of 590
negative acute phase 450
nonstructural 760
nutritive value of 589t
organization of 37, 40f
pancreatic digestion of 290
peripheral 18
phosphatase 1 165
phosphorylation 72, 807
physical properties of 43
precipitation reactions of 43
quantitative estimation of 46
requirement 593
S 452
simple 45
sorting 663
sparing effect 588
structure of 37, 41
subunit vaccine 764
synthesis
inhibitors of 660, 665
preinitiation complex of 661f
synthesizing machinery 658
targeting 663
trafficking 663
transport 41, 448
truncation test 711, 711f
utilization 589
western blot analysis for 705
Proteinase K 703
Proteinosis, pulmonary alveolar 111
Proteinuria 438
glomerular 438
overflow 438
quantitation of 438b
Proteoglycan 99, 214, 785, 786
Proteolytic cleavage 663
Proteolytic enzymes 38f
Proteome 667
Proteomics 47, 363, 667
Prothrombin 413, 451
Proton 827
pump 135, 136
Proto-oncogene 774
point mutation of 775
Protoporphyria
erythropoietic 381, 382
hereditary 380
Protoporphyrin
generation of 378
ring 383, 388f
Protoporphyrinogen, synthesis of 378
Pro-vitamin 514
Proximal tubules 463f
Pseudocholinesterase 78
Pseudohyperkalemia 485
Pseudopeptide 38
Pseudouridine arm 658
Pseudoxanthoma elasticum 789
Psoralens 498
Pteridine 540
Pteroic acid 540
Ptosis 666
Purine 321
metabolism, disorders of 625, 627t
structure of 618f
Purine bases 617
minor 618
Purine nucleoside
diphosphates 624
triphosphates 624
Purine nucleotide
biosynthesis of 620
cycle 791
functions of 791
degradation of 624, 624f
synthesis 623
Purine synthesis 310
inhibitors 623, 624f
regulation of 623
steps of 622f, 622t
Puromycin 665
Putrescine 324
Pyelonephritis 437
Pyranose ring 92f
Pyridoxal phosphate 59, 162, 294, 294f, 308, 312, 320, 333, 340, 377, 536
functions of 536
Pyridoxamine 536
Pyridoxine 318, 530, 536, 549, 551, 552
deficiency manifestations of 537
functions of 536b
Pyrimethamine 542f, 543
Pyrimidine 531, 618f, 627f
analogues 630
bases 618
modified 618f
catabolism of 630f
de Novo synthesis of 627
metabolism, disorders of 629, 629t
nucleotides 651
degradation of 630
synthesis of 628f
number of 636
ring 321
formation of 627
salvage pathway of 629
synthesis 630
regulation of 628
Pyrrole ring 377f
Pyrrolidine 32
Pyrrolysine 33
Pyruvate 121, 149, 157, 295, 311, 324
carboxylase 158, 160, 539, 577
deficiency 161
reaction 158
dehydrogenase 121, 156158, 188, 531
complex 156
reaction 157f
significance of 157
formation 315f
kinase 152, 155, 158, 188
deficiency 157
reaction, covalent modification of 155f
metabolic fate of 156
transporter 139f, 156
Q
Q cycle 133
QT syndrome, long 22, 485
Quadruple test 356
Quality control 719, 736
charts 737
Quality management 737
Quantum dots 834
Quaternary nitrogen 724
Quinoa 598
Quinolinate phosphoribosyltransferase 339
R
Racemase 227
Racemic mixture 91
Radial immunodiffusion 47, 47f
Radiation
biological effects of 832
exposure hazards 833b
protection 833
sickness 832
syndrome, acute 833
types of 828
Radioactivity 828
half-life of 829
Radioimmunoassay 724, 725t, 831
advantage of 725
principle of 725f
technique of 724
Radioisotope 829t, 835
tracers, use of 363
Radionuclides 828
Radiosensitivity 831
Radium 829
needles 831
nucleus of 828
Random plasma 182
glucose 183
Ranibizumab 822
Rapid antigen test 762
Rapoport leubering cycle 156
Reaction
reduction 505
transamination 35f, 294f, 319
Reactive oxygen
metabolites 499
species 140, 495, 496t, 497f, 498f
Recycle cell 781
Red blood cell 180, 211, 362, 376, 380, 623, 742, 830
normal 396f
Redox potentials 127, 127t
Reflectance spectrophotometry 732
Refsum disease 228
infantile 228
Regan isoenzyme 70, 77
Renal acid excretion 466
Renal artery stenosis 485
Renal blood flow 430
Renal compensation 470
Renal disease 437, 440
earliest manifestation of 439
Renal excretion 485
Renal failure 468, 566
acute 436
Renal function 309, 370
indicator of 301
tests 429, 440t
classification of 429, 429b
Renal glucosuria 184, 185, 352, 430
Renal plasma flow 437
Renal rickets 522
Renal threshold 430, 563
Renal transplant rejection 754
Renal tubular
acidosis 430, 469, 485
causes of 469b
disease 566
Renal tubules 430t, 520
Renin 290, 290b, 479b, 735
Renin-angiotensin
aldosterone 479f
system 479
Rennin 290, 290b, 479, 479b
Reperfusion injury 498, 498f
Replication
bubble 641, 641f
fork 641f
origin of 640, 641f
Replisomes 640
Reproductive organs 832
Reproductive system 517
Residual dextrin 97
Respiratory
acidosis 465, 467, 471, 471t, 472
acute 471
chronic 471
alkalosis 299, 465, 467, 471, 472
burst 496
chain 533
component 461
control 137
disease 498
chronic 760
distress syndrome 110, 498
quotient 583
tract 281
Resting metabolic rate 584
Restriction endonucleases 80, 647, 691, 704
Restriction enzyme 691
cleavage site 705
specificity of 691t
Restriction-fragment
length polymorphism 707, 707f
clinical applications of 707
patterns 707
Reticulocytosis 542
Retina 22, 277
degeneration 344
pigment epithelium 515f
structure of 515f
Retinitis pigmentosa 277, 666
Retinoblastoma 775
oncosuppressor protein 681
Retinoic acid 514
receptors 516
Retinoids 514
Retinol 514
binding protein 448, 450, 514
palmitate 514
Retinopathy of prematurity 498
Retrolental fibroplasia 498
Retroposon 676
Retroviral vectors 698
Retrovirus 657, 698
efficiency of 698
Reverse transcriptase 647, 657, 765
action of 657f
inhibitors 767
polymerase chain reaction 708, 709f
Reye syndrome 422
Rf value 723
Rh
incompatibility 387
isoimmunization 745
Rheumatic carditis 272
Rheumatic fever 272
Rheumatoid arthritis 214, 498, 601, 754, 798
Rhizomelic chondrodysplasia punctata 228
Rho factor 654
Rhodanase 317
Rhodopsin 277, 514
Riboflavin 530, 532, 549, 551, 552
coenzyme activity of 533
deficiency 533, 534f
dietary sources of 533
structure of 532, 532f
Ribonuclease 60
active site of 63
Ribonucleic acid 4, 651, 651t
decay, messenger 656
extraction 703
interference 666
messenger 652
micro 652, 666
molecule, structure of transfer 657
polymerase 652, 685
bacterial 653
mammalian 653
primer 641
processing of transfer 658
small 652
interfering 666
stranded 657
synthesis, inhibitors of 657, 657t
transfer 652, 657, 658
viruses 698
Ribonucleosides 619
Ribonucleotide 619
reductase complex 629
Ribose 95, 651
Ribosomal assembly 661
Ribosomal ribonucleic acid 652, 658
Ribosome 657, 658, 665, 794
eukaryotic 659t
Ribozyme 73, 656, 661
Ribulose 95
Rickets 521, 566
hypophosphatemic 522
types of 522
Rickety rosary 521, 522f
Rifampicin 194, 657
Right-handed double helix 636
Ringer solution 362
Ritonavir 763
Rituximab 782
Romberg's sign 545
Rothera's test 196, 237
Rotor syndrome 386
Russell's viper 799
S
S protein 759
Saccharic acids 94
Saccharin 100
Saccharopine 321
S-adenosyl methionine 507
Sakaguchi's test 36
Salbutamide 485
Salicylate 185, 468
intoxication 567
Saliva 478
discoloration of 575
Salivary alpha amylase 146
Salivation 607
Salmonella typhimurium 678
Salt
bridges 322
formation 107
Salvage pathway 302, 623
enzymes of 625
Sandhoff's disease 284
Sandwich enzyme-linked immunosorbent assay test 726f
Sanfilippo syndrome 215
Sanger's method 712f
Sanger's reagent 42, 42f
Sanger's sequencing 713f
Sanger's technique 712
Saponification 108, 108f
Sarcolemma 789
Sarcomere 789
Sarcopenia 798
Sarcoplasmic reticulum 790, 792
Saturated fatty acids 105, 107
Scavenger receptor 253, 254
Scheie syndrome 215
Schilling test 425, 546
Schlesinger's reaction 386
Schwann cell 19f
Scleroproteins 45
Sclerosis, amyotrophic lateral 292
Scoline apnea 78
Screening urine samples 354
Scurvy 550
Secosterol 519
Secretin 256, 424
Secretin-cholecystokinin 424
test 425
Secretory antibodies 746
Secretory proteins, synthesis of 664f
Seizures 666
Selectins 213, 214
Selective serotonin reuptake inhibitors 340, 342
Selenium 235, 576
functions of 577
Selenocysteine 32, 33, 312, 660
Selenoprotein P 312
Selenosis 577
Seminal plasma 208
Sensory neuropathy 537
Separate allosteric site 71
Sephadex chromatography 724f
Sepharose 723
Sepsis, biomarkers of 450
Serine 32, 34, 35, 307, 308, 311, 314
analogues 311f
catabolism of 311
decarboxylation of 312f
formation of 311f
hydroxyl groups of 664
metabolic functions of 311
metabolism 312f
protease 63, 291, 804
inhibitors 450
threonine kinases 781
Serotherapy 799
Serotonin 339, 340f, 794
catabolism of 341
functions of 340
Serpins 450
Sertoli cells 816
Serum 444, 720, 736
albumin 591
bile acids 417
calcium 562t, 567b
mild decrease in 564
cholesterol level 265
cortisol 591
electrophoretic pattern 445f
gastrin level 424
glutamate
oxaloacetate transaminase 77
pyruvate transaminase 77
hyaluronic acid 420
lipase 425
normal reference 263
phosphate 566
potassium
estimation 486
redistribution of 485t
proteins 563
triglyceride 266
vitamin D3 521
Severe acute respiratory syndrome 759
Severe acute respiratory syndrome-coronavirus disease-2 759
genes 760f
infection 762f
structure of 759f
variants 760
Sex chromosomes 639
Sex hormones 815, 816
synthesis of 813f
Sex linked recessive inheritance 674, 675f
Sex steroids 565, 813f
Shine-Dalgarno sequence 661
Shock 324
related injury 498
Shotgun
sequencing 696
technique 695, 695f
Shunt
bilirubin 379, 380f
pathway 166168, 169f
clinical significance of 170
Shyness 607
Sialic acid 778
Sialoglycoprotein 795
Sickle cell 396f
anemia 38, 397f, 705
disease 706f
disease 396, 699
management of 398
hemoglobin 396
trait 396, 397, 398f
Sickle syndromes 396
Sickling test 398
Sideroblastic anemia, pyridoxine responsive 381
Signal transduction 187, 312, 376, 806f
Silent mutation 677, 678
Silica gel 722
layer of 722
Silicates 722
Silicosis 15
Single-strand conformation polymorphism 710, 710f
Singlet oxygen 495, 496
Sitosterol 268
Six sigma principles 737
Skatoxyl 341
Skeletal muscle 148, 250, 465, 666, 789, 792
metabolic profile of 368
Skin 503, 517, 519, 552, 591, 832
color of 333
diseases 498
lesions 535f
Sly syndrome 215
Small nuclear
ribonucleic acid 652, 656
ribonucleoprotein 656
Smear, peripheral 546
Smooth muscle 344, 789
Snake
poison, treatment of 799
venom 799
S-nitroglutathione 324
Sodium 430, 477, 478, 482, 486, 578, 599, 730
and water balance, regulation of 479
assessment of 481b
channels 22
control of 480t
dependent glucose transporter 146, 147f, 148f
dodecyl sulfate 703, 720
fluoride 735
hydroxide 608
loss 196, 237
nitrite 806
potassium activated ATPase 23
pump 23, 23f, 24, 147, 482
clinical applications of 23b
restriction 482
sulfate 444
valproate 320
Somatic cloning 699
Somatic mosaicism 679
Somatic mutation 646
Somatomammotropin 811
Somatomedin 809
Somatostatin 187, 794, 809, 821
Somatotropic cells 808
Somatotropin 808
Somogyi effect 199
Sorafenib 782, 822
Sorbitol 94
Sorensen's formal titration 34
Southern blot
analysis 706, 706f
technique 704, 705f
Spastic hemiparesis 795
Spectrophotometer 728, 728f
advantage of 728
estimation 47
Spermidine 324
Sphingolipidoses 284, 284f
Sphingolipids 112
synthesis of 283
Sphingomyelin 112, 112f, 283, 284
synthesis of 283
Sphingomyelinase 284
Sphingosine 112, 112f
Spike protein 760, 761
Spina bifida 680
Spinal cord injury 700
Spironolactone 431, 485
Spleen 318
Splenic lymphoid tissue 762
Spliceosome 656
excise intron 656f
Spoon nail 572, 573f
Sports medicine 309
Spur cell anemia 18
Squamous cell carcinoma 517
Stabilization 73
Standard deviation index 737
Standard urea clearance 436
Starch 146, 587
hydrolysis of 97
tolerance test 425
Starling's hypothesis 446, 446f
Starvation 196, 236, 368
Stationary phase 722
Stearic acid 105
Steatohepatitis, nonalcoholic 77, 78, 193, 235, 419, 420
Stem cells 401, 700
differentiation of 700f
Stercobilinogen 384
Stereoisomers 90, 91f
Steroid 244t, 506
receptor complex 807
synthesis 550
urinary excretion of 813
Steroid hormone 244, 806, 807, 812, 816t
enters nucleus 806f
mechanism of action of 807f
reaches cytoplasm 686f
response element 807
synthesis of 811
Sterol regulatory element binding protein 246
Sticky ends 692
Stomatitis 607
Streptavidin 540
Streptokinase 80, 453
Streptomyces avidinii 540
Streptomycin 665
Stress 371
Strontium, radioactive 830
Subcellular organelles 13
metabolic functions of 17t
separation of 13t
Substrate saturation curve 66f
Substrate strain 60, 61
Succinate dehydrogenase 122, 127
Succinate
generation of 122
thiokinase 122
Succinylaminoimidazole carboxamide ribonucleotide 622
Succinylcholine 78, 548
Succinyl-coenzyme A, formation of 121
Succus entericus 291
Sucralose 100
Sucrase 96, 146
Sucrose 96, 587
hydrolysis of 96
structure of 96f
test, specific 96
Sucrosomial iron 573
Sugar 91
anomerism of 92
oxidation of 94
reducing 432
reference carbon atom of 91
substitutes 100
Suicidal genes 681, 778
Suicide
enzyme 281
inhibition 70, 324, 626
Sulfa drugs 78, 170, 542f
Sulfate 506, 609
conjugation 506, 567
glucosamine-alpha-1,4-iduronic acid 99f
inorganic 567
Sulfatide 112
sulfatase 284
synthesis of 284
Sulfhemoglobinemia 395
Sulfhydryl 538
Sulfite 315
oxidase 317
deficiency 345
Sulfogalacto-cerebroside 284
Sulfolipids 112
Sulfonamides 69, 542
Sulfur 566
compounds 130
dioxide 609, 610
functions of 567
inorganic 317
metabolism of 313, 317
neutral 567
test 36
transferase 317
Summer disease 606
Sumo 638
Sumoylation 638
Sunitinib 822
Superoxide 496
anion radical 495
dismutase 17, 496, 497, 574
Suppressor function 743
Supralethal radiotherapy 701
Surface antigen 421
Surfactant, composition of 110
Surrogate markers 420
Sweat electrolytes, estimation of 425
Syndrome of inappropriate antidiuretic hormone secretion 483, 483b
Synthesis, regulation of 280
Synthetase 58, 224
Synuclein 797
Systemic lupus erythematosus 656, 754, 798
T
T cell receptor 750, 751f
T helper
cells 743, 765, 766
count 767
T lymphocyte 743
receptors 766
T suppressor cells 743
T wave 484
Tacrolimus 487
Tamoxifen 780, 816
Tandem mass spectrometry 336, 358, 733
principle of 733f
Tangier disease 269
Tannic acid 44
Taq polymerase 707
Tartaric acid 78
Tarui's disease 167
Tau protein 797
Taurine 255
formation of 316f, 317
Taxanes 782
Taxol 793
Tay-Sachs disease 284
Teeth 560
Teletherapy 831
Telomerase 647, 798
Telomere 647
terminal transferase 647
Template and coding strands 652
Tendinous xanthomata 270
Teratogen 606
Termination phase 499
Terminator codon 660
mutation 678
sequence 662
Testes 245
Testicular hormones 816
Testosterone 816
Tetracycline 665
effect of 665
Tetradecanoyl phorbol acetate 772
Tetrahydro derivatives 812
Tetrahydrobiopterin 332
Tetrahydrofolate 59
Tetrahydrofolic acid 301f, 302, 307, 308, 540, 541f, 620, 630, 781
Tetraiodothyronine 817
Tetrapeptide 36
Thaimine 326
Thalassemia 395, 396, 399, 399f, 401
genes for 675
inheritance of 399
syndromes 399
Theophylline 563
Therapeutic nutrition 597
Thermodynamics
first law of 7
principles of 7
second law of 7
Thermogenesis 233, 818
diet-induced 585
Thermogenin 138, 139
Thermus
aquaticus 68, 691, 707
thermophilus 708
Thiamine 156, 530, 531, 531b, 549, 551, 552, 618
deficiency 167, 170, 532f
manifestations of 531
functions of 536b
physiological role of 531
pyrophosphate 59, 64, 311, 531
structure of 531f
structure of 531
Thiazide 431, 468, 485
diuretics 563
Thin layer chromatography 722, 723f
Thiocyanate 817
Thioesterase 229, 231
Thiokinase 224
Thiophorase enzyme 236
Thioredoxin 629
reductase 312
Thiourea 817
Third generation sequencing 712
Thorium, radioactive 833
Threonine 32, 35, 307, 313
dehydratase 313
Throat culture 272
Thrombin 451
Thrombocytopenia 832
Thromboembolic episodes 760
Thrombosis 261, 319
Thromboxane 279, 280f, 281, 281t
Thymidine 636
monophosphate 630
Thymidylate synthase 630
Thymidylic acid, synthesis of 302f
Thymine 531, 531b, 618, 651
Thyroglobulin 817
molecule 817
Thyroid 830
acini 817
antibodies, detection of 819
cell surface 810
crisis 820
disease, treatment of 830
function
abnormalities of 819
tests 818
scanning 830
stimulating hormone 353, 358, 809
storm 820
Thyroid hormone 584, 802, 817, 818f, 820
catabolism of 818
mechanism of action of 818
metabolic effects of 818
metabolism of 817f
synthesis of 336
transport of 818
Thyroperoxidase 817
Thyrotoxic periodic paralysis 485
Thyrotoxicosis 192, 566
Thyrotropin 810
releasing hormone 46
Thyroxine 36, 138, 190, 333, 807
binding
globulin 448
pre-albumin 448
blood level of 725
secretion of 817
synthesis of 817, 817f
Tissue 75, 344
anoxia 608
death of 262, 799
extrahepatic 236
inhibitors 420
necrosis factor 593
plasminogen activator 262, 453
proteins 785
uptake by 514
Titratable acid, excretion of 463f
Tolbutamide 224
Tongue cancer 831
Tophi 626
Topoisomerases 641
Total acidity, estimation of 424
Total body iron, compartmentalization of 568f
Total cholesterol estimation 248
Total protein 444
estimation of 419
Totipotent 700
Toxic
adenoma 819
chemicals 612b
injury 234
met-hemoglobinemia 394
minerals 578
multinodular goiter 819
Toxication 503
Toxicity 212, 519, 611, 835
acute 607
Toxins plants 610
Toxoid vaccines 755
Trangenic animals, milk of 695t
Trans fatty acids 18, 106, 268, 279, 588, 599
Transaldolase reaction 167
Transcobalamin 544
Transcription
initiation of 654f
process 652, 653f, 654f
termination of 654
Transcriptomics 363
Transcytosis 26
Transdeamination 35, 295, 295f
Transferases 57
Transferrin 448, 449, 569, 570
receptor
level 573
synthesis of 571
saturation 570
index 570
Transforming growth factor 593
Transketolase 170, 171, 531
activity 532
reaction 167
second 168
Translation, termination of 662
Translocase, deficiency of 224
Translocation process 662
Transmanganin 577
Transmembrane proteins 19
Transmethylation 35
reactions 302, 314t, 315, 541, 541f, 547
Transmissible spongiform encephalopathies 796
Transthyretin 448, 450
Transversion 677
Trastuzumab 782
Triacylglycerol 107f, 207, 220, 221, 249, 364, 587
physical properties of 107
synthesis 232f
Tricarboxylate transporter 139f
Tricarboxylic acid cycle 120, 122f, 123, 125, 154
anaplerotic role of 126
inhibitors of 126
stoichiometry of 124b
Trichloroacetic acid 44
Triglycerides 107f, 248, 270
complete hydrolysis of 221f
dietary 250
digestion of 221
endogenous 251
hydrolysis of 108, 108f
mixed 107
short-chain 220
synthesis of 232
Tri-iodothyronine 817
Trinucleotide 677
sequence repeats 639
Tripeptidases 291
Tripeptide 36
Triphosphates, synthesis of 627
Triplet repeat disorders 680
Trisaccharides 90
Tritium 827
Tropocollagen 786
Tropomyosin 789
Troponin 262, 789, 791
C 791
cardiac 262
complex 790
Trousseau's sign 564
Trousseau's triad 454
Trypanosomiasis 70
Trypsin 42, 80, 291
Trypsinogen 68
Tryptamine 341
Tryptophan 32, 34, 302, 339, 340f, 345, 535
catabolism of 339
dietary deficiency of 535
hydroxylase 339
major catabolic pathway of 339
major excretory products of 342f
metabolism 339f, 343f, 550
putrefaction of 341
pyrrolase 339, 568
Tuberculosis 195, 765
Tuberous xanthomata 270
Tubular dysfunction 440
Tubular fluid 463f
Tubular function, tests for 439
Tubular maximum 430
Tubular proteinuria 438
Tubules, functions of 430
Tubulin 789
Tumor
adrenal 815
antigens 778
carcinoid 341
cell 776, 778
destruction 743
immunology 778
index substances 779
kinetics 776
marker 78, 79, 420, 450, 562, 779, 780t
mass 770, 780
growth of 776
metastasis 15, 788
necrosis factor 751, 752, 776
viruses 657
Tungsten particles 698
Tunicamycin 212
Turner's syndromes 816
Typical nerve cell 794f
Tyramine 336
Tyrosinase 333, 334, 334b, 338, 574
Tyrosine 32, 34, 332, 333, 345, 346, 353, 723f, 804
catabolism of 332, 333f
hydroxylase 334, 334b
kinase 781
metabolism 338f, 550
sparing action of 332
Tyrosinemia 338, 338f
hepatorenal 338
neonatal 339
U
Ubiquitin-proteasome system 293f
Ulcer, duodenal 424
Umbilical hernia 679
Uncompetitive inhibition 70
Uniport system 23
Universal energy currency 130, 620
Unoxidized sulfur 567
Uracil 651, 652
Urea 297, 431
bicycle 299
formation of 298
Urea clearance 436
maximum 436
test 436
value, interpretation of 436
Urea cycle 289, 297, 297f, 298f, 321
disorders 299, 300t, 419
energetics of 299
enzyme 629
regulation of 299
steps of 297
Urease 73, 80
Uremic syndrome 437
Uric acid 293, 297b, 431, 624, 625, 734
increased production of 625
Uricase 626
Uricosuria 625
Uricosuric drugs 626
Uridine 619
5’-diphosphate 506
diphosphate 163, 212, 384, 386
monophosphate 630
triphosphate 163
Urinary acidification 439
Urinary bilirubin 417
Urinary buffer 465
Urinary calculi 517
Urinary free cortisol, estimation of 813
Urinary neutrophil gelatinase 436
Urinary urobilinogen 417
Urine 430t, 719
abnormal constituents of 431
acidification of 463
analysis 431
and pyrimidine synthesis 629
anion gap 469
appearance 432t
bile salts 417
blackening of 337
chemical characteristics of 432
collection 736
physical characteristics of 431
potassium 486
preservatives 736
specific gravity of 439
Urobilinogen 433
Urocanic aciduria 344
Urogenic proteinuria 439
Urokinase 80, 453
Uronic acid 94
Uroporphyrin 378, 382, 383
Uroporphyrinogen 382, 383
formation of 378
Usual conjugating agents 506t
Uterine tissues 780
Uterus 281
V
Vaccines
development of 755
mechanism of action of 755
types of 755, 755t
Vacutainer tubes, use of 735
Vagal stimulation 256
Valine 32, 34, 307
Valinomycin 23, 138
Valvulitis 272
Van den Bergh reaction 385, 416
Van den Bergh test 385
Van der Waals forces 6, 39
Vanillylmandelic acid 335, 734
Vascular diseases 197
coronary 372
Vascular endothelial growth factor 778, 782, 822
Vascular permeability 560
Vasoactive intestinal peptide 821
Vasodilatation 281
Vasodilators, coronary 806
Vasopressin 46, 808
Vector 692, 698
vaccine 764
Vero cell line 758
Vertigo 795
Very low calorie diet 593
Vibrio cholerae 805
Vinblastine 782
Vincristine 782
Vinculin 19
Vinyl 377, 378
phenols 609
Viosynthesis pathways 363
Viper group 799
Viral
diseases, diagnosis of 708
genome 759
hepatitis, type of 421t
infections 489
proteins 759
Virus 214
genetic heterogeneity of 766
glycoproteins of 758
immunoselection of 766
infection 758
effect of 758
life cycle of 758f, 761f
spreads 759
structure of 759
Visible fat 587
Vision 214
in dim light 516
Vitamin 513, 530, 537, 549, 552
absorption of 514
acid 514
alcohol 514
aldehyde 514
biochemical functions of 516
biochemical role of 514
daily requirement of 518
deficiency manifestations of 517
dietary sources of 518
metabolism 515f
molecules, interconversion of 514f
prophylaxis programme 591
role of 515
structure of 514f
therapeutic use of 518
A deficiency 518
assessment of 518
causes for 518
primary 518
secondary 518
A1 514
B complex 547
role of 530t, 549t
B1 531
B12 227, 315, 318, 530, 541, 543, 543f, 545, 545f, 546, 551, 552, 597
absorption of 544, 544f
requirement of 547
storage of 544f
structure of 543f
B12 deficiency 544, 545, 545f, 546f
assessment of 546
causes of 544
clinical manifestations of 546f
nutritional 544
B2 532
B6 536, 537
assay of 537
deficiency 339, 537f
dietary sources of 537
requirement of 537
toxicity of 537
biochemical functions of 550
chemistry of 548
deficiency 345, 550f, 551f
dietary sources of 551
megadose of 551
requirement of 551
synthesis 172
therapeutic use of 551
toxicity of 551
D 25, 519, 520, 524, 559, 561, 563, 596, 807
activation of 519, 521
and bone 561
and calcitriol 565
and immunity 522
and renal tubules 561
biochemical effects of 520
effect of 520
formation of 519
function 516
insufficiency 564
low levels of 522
receptor 519
requirement of 523
resistant 522
sources of 523
toxicity 523
D deficiency 521, 521f, 522, 564
causes for 521
clinical features of 521, 522f
manifestation of 522f
D2 519
D3 244, 519f
deficiency of 513
discovery of 513
E 235, 269, 500, 523, 573, 772
biochemical role of 523
deficiency manifestations of 523
metabolism of 523
sources of 524
fat-soluble 513
group of 530
biochemical role of 524
chemistry of 524
cycle 525f
daily requirement of 525
dependent carboxylase 524
sources of 525
K deficiency 525
clinical manifestations of 525
manifestation of 525f
malabsorption of 521
types of 514t
water-soluble 530, 551, 552
deficiency manifestations of 552
Volatile acids 461
Volatile organic compounds 611
Voltage dependent anion channel 140
Voluntary muscle 789
Vomiting 832
von Gierke's disease 167, 200, 625
W
Wald's visual cycle 514, 515f
Waldenstrom's macroglobulinemia 748
Warburg
effect 777
hypothesis 777
Warfarin 525
Waste disposal 738
Water
balance 477, 478b, 481b
internal 478
control of 480t
facultative reabsorption of 431
intake of 477
obligatory reabsorption of 431
output of 477
reabsorption of 431
Watson-Crick model 636, 637f
Waxes 108
Weak acid 458, 459
Weight, loss of 195, 777
Wernicke's disease 211
Wernicke-Korsakoff syndrome 170, 531
Western populations 252
Westgard's multirule chart 737
White adipose tissues 233
Whole genome sequencing 695f
Wilms’ tumor 679, 775
Wilson's disease 351, 449, 575
Wilson's hepatolenticular degeneration 449
Wiskott-Aldrich syndrome 749
Wobbling phenomenon 660
Wolman's disease 271
Wound healing 700
X
Xanthelasma 270
Xanthine oxidase 496, 498
deficiency 627
Xanthinuria 627
Xanthomas 270
Xanthoproteic test 36
Xanthurenic acid 339
Xanthurenic aciduria 537
X-chromosome 78, 686
Xenobiotics 503
biotransformation of 503
Xeroderma pigmentosum 646
Xerophthalmia 517, 517f
X-linked disorders 358
X-linked recessive trait 170
X-ray plate 712
Xylitol dehydrogenase 172
Xylose 96
Xylulose 96
reductase 172
Xylulosuria 185
Y
Y chromosome 816
Z
Zalcitabine 767
Zellweger syndrome 16, 17, 228, 232, 278, 664
Zidovudine 630, 767
Zinc 44, 59, 497, 575
chloride 608
containing protein 576
deficiency 576f
chronic 576
manifestations 576
finger 40
requirement of 576
toxicity 576
Zollinger-Ellison syndrome 423
Zona
fascicularis 811
glomerulosa 811
reticularis 811
Zymogen 68, 289
activation 72
Zymosterol 246, 246f
×
Chapter Notes

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1Chemical Basis of Life
Section Outline
  • 1. Biochemical Perspective to Medicine
  • 2. Subcellular Organelles and Cell Membranes
  • 3. Amino Acids and Proteins
  • 4. Enzymology: General Concepts, Enzyme Kinetics, Isoenzymes and Clinical Enzymology
  • 5. Chemistry of Carbohydrates
  • 6. Chemistry of Lipids2

Biochemical Perspective to MedicineCHAPTER 1

 
HISTORICAL BACKGROUND OF BIOCHEMISTRY
Biochemistry is the language of biology. The tools for research in all the branches of medical science are based on principles of biochemistry. The study of biochemistry is essential to understand basic functions of the body. This will give information regarding the functioning of cells at the molecular level, which in turn helps to understand the principles of maintenance of homeostasis as well as diagnostic and therapeutic modalities currently in use.
How the food that we eat is digested, absorbed, and utilized to synthesize body structures? How does the body derive energy for the normal day-to-day work? How are the various metabolic processes interrelated? What is the function of genes? What is the molecular basis for immunological resistance against invading organisms? Answers to such basic questions can only be derived by a systematic study of medical biochemistry.
Modern day medical practice is highly dependent on the laboratory analysis of body fluids, especially the blood. The disease manifestations are reflected in the composition of blood and other tissues. Hence, the demarcation of abnormal from normal constituents of the body is another aim of the study of clinical biochemistry.
The word chemistry is derived from the Greek word “chemi” (the black land), the ancient name of Egypt. Indian medical science, even from ancient times, had identified the metabolic and genetic basis of diseases. Charaka (Fig. 1.1), the great master of Indian Medicine, in his treatise (circa 400 BC) observed that madhumeha (diabetes mellitus) is produced by the alterations in the metabolism of carbohydrates and fats; the statement still holds good.
The practice of medicine is both an art and a science. The word “doctor” is derived from the Latin root, “docere”, which means “to teach”. Knowledge devoid of ethical background may sometimes be disastrous! Hippocrates (460 BC to 377 BC, Fig. 1.2), the father of modern medicine articulated “the Oath”. About one century earlier, Sushruta (500 BC, Fig. 1.3), the great Indian surgeon, enunciated a code of conduct to the medical practitioners, which is still valid. He proclaims: “You must speak only truth; care for the good of all living beings; devote yourself to the healing of the sick even if your life be lost by your work; be simply clothed and drink no intoxicant; always seek to grow in knowledge; in face of God, you can take upon yourself these vows.” This year, the National Medical Council (NMC) of India has presented a proposal to replace the ‘Hippocratic Oath’ with the ‘Charaka Shapath’.
Biochemistry has developed as an offshoot of organic chemistry, and this branch was often referred as “physiological chemistry”. The term “Biochemistry” was coined by Neuberg (Fig. 1.4) in 1903 from Greek words, bios (= life) and chymos (= juice). He is considered as the father of modern biochemistry. One of the earliest treatises in the subject was the “Book of Organic Chemistry and its Applications to Physiology and Pathology”, published in 1842 by Justus von Liebig (Fig. 1.5), who introduced the concept of metabolism. He is considered as the father of organic chemistry. The “Textbook of Physiological Chemistry” was published in 1877 by Felix Hoppe-Seyler (Fig. 1.6), who was professor of physiological chemistry at Strasbourg University, France. Some of the milestones in the development of science of biochemistry are shown in Table 1.1.
Biochemistry is perhaps the most rapidly developing subject in medicine. No wonder, the major share of Nobel prizes in medicine has gone to research workers engaged in biochemistry.
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Fig. 1.1: Charaka (400 BC).
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Fig. 1.2: Hippocrates (460–377 BC).
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Fig. 1.3: Sushruta (500 BC).
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Fig. 1.4: Carl Neuberg (1877–1956).
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Fig. 1.5: Justus von Liebig (1803–1873).
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Fig. 1.6: Felix Hoppe-Seyler (1825–1895).
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Fig. 1.7: Hilaire Rouelle (1718–1779).
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Fig. 1.8: Antoine de Lavoisier (1743–1794).
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Fig. 1.9: Friedrich Wöhler (1800–1882).
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Fig. 1.10: Albert Lehninger (1917–1986).
TABLE 1.1   Milestones in history of biochemistry.
Scientists
Fig. no.
Year
Landmark discoveries
Rouelle
1.7
1773
Isolated urea from urine
Lavoisier
1.8
1785
Oxidation of food stuffs
Wöhler
1.9
1828
Synthesis of urea
Berzelius
4.1
1835
Enzyme catalysis theory
Louis Pasteur
8.7
1860
Fermentation process
Edward Buchner
4.3
1897
Extracted enzymes
Fiske and Subbarow
7.17 and 7.18
1926
Isolated ATP from muscle
Lohmann
7.19
1932
Creatine phosphate
Hans Krebs
7.3
1937
Citric acid cycle
Avery
34.4
1944
DNA is genetic material
Lehninger
1.10
1950
TCA cycle in mitochondria
Watson and Crick
34.9 and 34.10
1953
Structure of DNA
Nirenberg
35.31
1961
Genetic code in mRNA
Holley
35.26
1963
Sequenced gene for tRNA
Khorana
35.27
1965
Synthesized the gene
Paul Berg
35.25
1972
Recombinant DNA technology
Kary Mullis
38.12
1985
Polymerase chain reaction
Wilmut
37.23
1997
Cloning of sheep
2003
Human gene mapping completed
Fire and Mellow
35.42 and 35.43
2006
RNA interference
Yamanaka
37.32
2007
Mature cells reprogrammed into pluripotent cells
Blackburn
34.38
2009
Telomerase and telomeres
Rothman
2.7
2013
Regulation of vesicle traffic
Alter
21.4
2020
Hepatitis C virus
Thanks to the advent of deoxyribonucleic acid (DNA) recombination technology, genes can now be transferred from one person to another, so that many of the genetically determined diseases are now amenable to gene therapy. Many genes (e.g. human insulin gene) have already been transferred to microorganisms for large scale production of human proteins. Advances in genomics such as ribonucleic acid (RNA) interference for silencing of genes and creation of transgenic animals by gene targeting of embryonic stem cells are opening up new vistas in therapy of diseases like cancer. It is hoped that in future, physician will be able to treat the patient, understanding his genetic basis, so that very efficient “designer medicine” or “personalized medicine” could cure the diseases. The large amount of data, especially with regard to single nucleotide polymorphisms (SNPs) that are available, could be harnessed by “Bioinformatics”. Computers are already helping in the process of designing drugs. Studies on oncogenes have identified molecular mechanisms of control of normal and abnormal cells. Medical practice is now taking more and more help from the field of biochemistry. With the help of Human Genome Project (HGP) the sequences of the whole human genes are now available; it has already made great impact on medicine and related health sciences.
The COVID-19 pandemic was indeed a great challenge to the scientists to develop new molecular diagnostic techniques and vaccines to identify and fight the pandemic. The RT-PCR and rapid antigen tests have become common household words. Vaccine development is also at the forefront. Hence a health care provider has to have a sufficient knowledge of biochemistry to explain these to the common man.
 
BIOMOLECULES
More than 99% of the human body is composed of six elements, i.e. oxygen, carbon, hydrogen, nitrogen, calcium and phosphorus. Human body is composed of about 60% water, 15% proteins, 15% lipids, 2% carbohydrates and 8% minerals. Molecular structures in organisms are built from 30 small precursors, sometimes called the alphabets of biochemistry. These are 20 amino acids, 2 purines, 3 pyrimidines, sugars (glucose and ribose), palmitate, glycerol and choline.
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TABLE 1.2   Bacterial and mammalian cells.
Prokaryotic cell
Eukaryotic cell
Size
Small
Large; 1,000–10,000 times
Cell wall
Rigid
Membrane of lipid bilayer
Nucleus
Not defined
Well defined
Organelles
Nil
Several; including mitochondria and lysosomes
In living organisms the biomolecules are ordered into a hierarchy of increasing molecular complexity. The simple biomolecules are covalently linked to each other to form macromolecules of the cell, e.g. glucose to glycogen, amino acids to proteins, etc. Major complex biomolecules are proteins, polysaccharides, lipids and nucleic acids. The macromolecules associate with each other by noncovalent forces to form supramolecular systems, e.g. ribosomes, lipoproteins.
Finally, at the highest level of organization in the hierarchy of cell structure, various supramolecular complexes are further assembled into cell organelles. In prokaryotes (e.g. bacteria; Greek word “pro” = before; karyon = nucleus), these macromolecules are seen in a homogeneous matrix; but in eukaryotic cells (e.g. higher organisms; Greek word “eu” = true), the cytoplasm contains various subcellular organelles. Comparison between prokaryotes and eukaryotes are shown in Table 1.2.
Autotrophs synthesize energy by themselves. Chemolithotrophs derive their energy from chemical sources such as ammonia and hydrogen sulfide. Photoautotrophs derive energy through photosynthesis. Heterotrophs obtain energy through oxidation of organic compounds; these are ultimately dependent on autotrophs for these molecules. These include obligate aerobes, facultative anaerobes and obligate anaerobes, depending upon oxygen requirement. Obligate anaerobes may be the oldest organisms to exist on the earth.
 
STUDY OF METABOLIC PROCESSES
Our food contains carbohydrates, fats and proteins as principal ingredients. These macromolecules are to be first broken down to small units; carbohydrates to monosaccharides and proteins to amino acids. This process is taking place in the gastrointestinal tract and is called digestion or primary metabolism. After absorption, the small molecules are further broken down and oxidized to carbon dioxide. In this process, NADH or FADH2 are generated. This is named as secondary or intermediary metabolism. Finally, these reducing equivalents enter the electron transport chain in the mitochondria, where they are oxidized to water; in this process energy is trapped as ATP. This is termed tertiary metabolism. Metabolism is the sum of all chemical changes of a compound inside the body, which includes synthesis (anabolism) and breakdown (catabolism). (Greek word, kata = down; ballein = change).
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Fig. 1.11: Covalent bond.
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Fig. 1.12: Ionic bond.
 
STABILIZING FORCES IN MOLECULES
 
Covalent Bonds
Molecules are formed by sharing of electrons between atoms (Fig. 1.11).
 
Ionic Bonds or Electrostatic Bonds
Ionic bonds result from the electrostatic attraction between two ionized groups of opposite charges (Fig. 1.12). They are formed by transfer of one or more electrons from the outermost orbit of an electropositive atom to the outermost orbit of an electronegative atom. This transfer results in the formation of a “cation” and an “anion”, which get consequently bound by an ionic bond. Common examples of such compounds include NaCl, KBr and NaF. With regard to protein chemistry, positive charges are produced by epsilon amino group of lysine, guanidine group of arginine and imidazole group of histidine. Negative charges are provided by beta and gamma carboxyl groups of aspartic acid and glutamic acid respectively (Fig. 1.13).
 
Hydrogen Bonds
These are formed by sharing of a hydrogen between two electron donors. Hydrogen bonds result from electrostatic attraction between an electronegative atom and a hydrogen atom that is bonded covalently to a second electronegative atom. Normally, a hydrogen atom forms a covalent bond with only one other atom. However, a hydrogen atom covalently bonded to a donor atom, may form an additional weak association, called the hydrogen bond with an acceptor atom. As a result of hydrogen bonding, proton jumping (apparent migration of hydrogen ions in electric field) occurs with little movement of water molecules themselves.
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Fig. 1.13: Ionic bonds used in protein interactions.
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Fig. 1.14: Hydrophobic interaction.
6
In biological systems, both donors and acceptors are usually nitrogen or oxygen atoms, especially those atoms in amino (NH2) and hydroxyl (OH) groups. With regard to protein chemistry, hydrogen releasing groups are -NH (imidazole, indole, peptide); -OH (serine, threonine) and -NH2 (arginine lysine). Hydrogen accepting groups are COO, (aspartic, glutamic) C=O (peptide); and S–S (disulfide). The DNA structure is maintained by hydrogen bonding between the purine and pyrimidine residues.
 
Hydrophobic Interactions
Nonpolar groups have a tendency to associate with each other in an aqueous environment; referred to as hydrophobic interaction. These are formed by interactions between nonpolar hydrophobic side chains by eliminating water molecules. The force that causes hydrophobic molecules or nonpolar portions of molecules to aggregate together rather than to dissolve in water is called the “hydrophobic bond” (Fig. 1.14). This serves to hold lipophilic side chains of amino acids together. Thus, nonpolar molecules will have minimum exposure to water molecules.
 
Van der Waals Forces
These are very weak forces of attraction between all atoms, due to oscillating dipoles, described by the Dutch physicist Johannes van der Waals (Fig. 1.15). He was awarded Nobel Prize in 1910. Van der Walls forces are short range attractive forces between chemical groups in contact. Van der Waals interactions occur in all types of molecules, both polar and nonpolar. The energy of the van der Waals interaction is about 1 kcal/mol and is unaffeced by changes in pH. This force will drastically reduce, when the distance between atoms is increased. Although very weak, van der Waals forces collectively contribute maximum toward the stability of protein structure, especially in preserving the nonpolar interior structure of proteins.
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Fig. 1.15: Johannes van der Waals Nobel Prize: 1910 (1837–1923).
 
WATER: THE UNIVERSAL SOLVENT
Water constitutes about 70–80% of the weight of most cells. The hydrogen atom in one water molecule is attracted to a pair of electrons in the outer shell of an oxygen atom in an adjacent molecule. The structure of liquid water contains hydrogen bonded networks (Fig. 1.16). The crystal structure of ice contains a tetrahedral arrangement of water molecules. Four water molecules bound by hydrogen bonds surround each oxygen atom. On melting, the molecules get much closer and this results in an increased in the density of water. Hence, liquid water is denser than solid ice. This also explains why ice floats on water.
Water molecules are in rapid motion, constantly making and breaking hydrogen bonds with adjacent molecules. As the temperature of water increases toward 100°C, the kinetic energy of the molecules becomes greater than the energy of the hydrogen bonds connecting them, and the gaseous form of water appears. A few gifted properties of water make it the most preferred medium for all cellular reactions and interactions.
  • Water is a polar molecule. Molecules with polar bonds that can easily form hydrogen bonds with water can dissolve in water and are termed “hydrophilic”.
  • It has immense hydrogen bonding capacity both with other molecules and also the adjacent water molecules. This contributes to cohesiveness of water.
  • Water favors hydrophobic interactions and provides a basis for metabolism of insoluble substances. Water expands when it is cooled from 4°C to 0°C, while normally liquids are expected to contract due to cooling. As water is heated from 0°C to 4°C, the hydrogen bonds begin to break. This results in a decrease in volume or in other words increase in density. Hence, water attains high density at 4°C. However, above 4°C the effect of temperature predominates.
    zoom view
    Fig. 1.16: Water molecules hydrogen bonded.
7
 
PRINCIPLES OF THERMODYNAMICS
Thermodynamics is concerned with the flow of heat and it deals with the relationship between heat and work. Bioenergetics, or biochemical thermodynamics, is the study of the energy changes accompanying biochemical reactions. Biological systems use chemical energy to power living processes.
 
First Law of Thermodynamics
The total energy of a system, including its surroundings, remains constant. Or, ∆E = Q–W, where Q is the heat absorbed by the system and W is the work done. This is also called the law of conservation of energy. If heat is transformed into work, there is proportionality between the work obtained and the heat dissipated. A system is an object or a quantity of matter, chosen for observation. All other parts of the universe, outside the boundary of the system, are called the surroundings.
 
Second Law of Thermodynamics
The total entropy of a system must increase if a process is to occur spontaneously. A reaction occurs spontaneously if ∆E is negative, or if the entropy of the system increases. Entropy (S) is a measure of the degree of randomness or disorder of a system. Entropy becomes maximum in a system as it approaches true equilibrium. Enthalpy is the heat content of a system and entropy is that fraction of enthalpy which is not available to do useful work.
A closed system approaches a state of equilibrium. Any system can spontaneously proceed from a state of low probability (ordered state) to a state of high probability (disordered state). The entropy of a system may decrease with an increase in that of the surroundings. The second law may be expressed in simple terms as Q = T × ∆S, where Q is the heat absorbed, T is the absolute temperature and ∆S is the change in entropy.
 
Gibbs Free Energy Concept
Gibbs (Fig. 1.17) put forward a model in which the term “free energy” is used to get an equation combining the first and second laws of thermodynamics. Thus, ∆G = ∆H – T∆S, where ∆G is the change in free energy, ∆H is the change in enthalpy or heat content of the system and ∆S is the change in entropy. The term free energy denotes a portion of the total energy change in a system that is available for doing work. For most biochemical reactions, it is seen that ∆H is nearly equal to ∆E. So, ∆G = ∆E – T∆S. Hence, ∆G or free energy of a system depends on the change in internal energy and change in entropy of a system.
zoom view
Fig. 1.17: Josiah Gibbs (1839–1903).
 
Standard Free Energy Change
It is the free energy change under standard conditions. It is designated as ∆G0. The standard conditions are defined for biochemical reactions at a pH of 7 and 1 M concentration, and represented by a priming sign ∆G0'. It is directly related to the equilibrium constant. Actual free energy changes depend on reactant and product.
Most of the reversible metabolic reactions are near-equilibrium reactions and therefore their ∆G is nearly zero. The net rate of near-equilibrium reactions are effectively regulated by the relative concentration of substrates and products. The metabolic reactions that function far from equilibrium are irreversible. The velocity of these reactions is altered by changes in enzyme activity. A highly exergonic reaction is irreversible and goes to completion. Such a reaction that is part of a metabolic pathway, confers direction to the pathway and makes the entire pathway irreversible.
 
Three Types of Reactions
  1. A reaction can occur spontaneously when ∆G0 is negative. Then the reaction is exergonic. If ∆G0 is of great magnitude, the reaction goes to completion and is essentially irreversible.
  2. When ∆G0 is zero, the system is at equilibrium.
  3. For reactions where the ∆G0 is positive, an input of energy is required to drive the reaction. The reaction is termed as endergonic and those with a negative ∆G0 as exergonic (examples given later).
Similarly a reaction may be exothermic (∆H is negative), isothermic (∆H is zero) or endothermic (∆H is positive). Energetically unfavorable reaction may be driven forward by coupling it with a favorable reaction.
Glucose + Pi → Glucose-6-phosphate
(reaction 1)
ATP + H2O → ADP + Pi
(reaction 2)
Glucose + ATP → Glucose-6-phosphate + ADP
(reaction 3)
Reaction 1 cannot proceed spontaneously. But the 2nd reaction is coupled in the body, so that the reaction becomes possible. For the first reaction, ∆G0 is +13.8 kJ/mole; for the second reaction, ∆G0 is –30.5 kJ/mole. When the two reactions are coupled in the reaction 3, the ∆G0 becomes –16.7 kJ/mole, and hence the reaction becomes possible. Details on ATP and other high-energy phosphate bonds are described in Chapter 7.
Reactions of catabolic pathways (degradation or oxidation of fuel molecules) are usually exergonic, whereas anabolic pathways (synthetic reactions or building up of compounds) are endergonic. Metabolism constitutes anabolic and catabolic processes that are well coordinated.
 
DONNAN MEMBRANE EQUILIBRIUM
When two solutions are separated by a membrane permeable to both water and small ions, but when one of the compartments contains impermeable ions like proteins, distribution of permeable ions occurs according to the calculations of Donnan (Fig. 1.18).
8
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Fig. 1.18: Frederick Donnan (1870–1956).
In Figure 1.19, the left compartment contains NaR, which will dissociate into Na+ and R-. Then Na+ can diffuse freely, but R- having high molecular weight cannot diffuse. The right compartment contains NaCl, which dissociates into Na+ and Cl-. Both ions can diffuse freely.
Thus, if a salt of NaR is placed on one side of a membrane, at equilibrium
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To convey the meaning of the mathematical values, a hypothetical situation is depicted in Figure 1.19. The specific ions shown and the corresponding quantity of the ions are given in brackets. Initially five molecules of NaR are added to the left compartment and 10 molecules of NaCl in the right compartment and both of them are ionized (Fig. 1.19A). When equilibrium is reached, the distributions of ions are shown in Figure 1.19B. According to Donnan's equilibrium, the products of diffusible electrolytes in both the compartments will be equal, so that
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If we substitute the actual numbers of ions, the formula becomes 9 × 4 in left = 6 × 6 in right
Donnan's equation also states that the electrical neutrality in each compartment should be maintained. In other words the number of cations should be equal to the number of anions, such that in left compartment: Na+ = R- + Cl-; substituting: 9 = 5 + 4. In right compartment: Na+ = Cl-; substituting: 6 = 6 (Fig. 1.19B).
The equation should also satisfy that the number of sodium ions before and after the equilibrium are the same; in the given example, initial Na+ in the two compartments together is 5 + 10 = 15; after equilibrium also, the value is 9 + 6 = 15. In the case of chloride ions, initial value is 10 and final value is also 4 + 6 = 10.
In summary, Donnan equations satisfy the following results:
  1. The products of diffusible electrolytes in both compartments are equal.
  2. The electrical neutrality of each compartment is maintained.
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    Figs. 1.19A and B: Donnan membrane equilibrium. (A) Initial condition; (B) After reaching the equilibrium.
  3. The total number of a particular type of ions before and after the equilibrium is the same.
  4. As a result, when there is non-diffusible anion on one side of a membrane, the diffusible cations are more, and diffusible anions are less, on that side.
The clinical applications of Donnan equation are given in Box 1.1.
 
OSMOSIS
Osmosis is an important property of particles in solution. Osmosis is the spontaneous net movement of solvent molecules through a semipermeable membrane into a region of higher solute concentration, in the direction that tends to equalize the solute concentrations on the two sides. In other words, it is also the flow of a solvent from a more dilute solution to a relatively concentrated solution through a semipermeable membrane. Osmosis is the movement of a solvent across a semipermeable membrane toward a higher concentration of solute. Osmosis is a passive movement. In biological systems, the solvent is water. The word “osmosis” descends from the Greek word, “osmos” which means “to push”.
 
Experiment
A beaker is partitioned by a semipermeable membrane. Both sides are filled with equal volume of water (Fig. 1.20A). A known quantity of solute is dissolved in the left compartment. Water molecules tend to passively move toward the left compartment. After some time, equilibrium is reached, the water level in the left compartment is increased (Fig. 1.20B). Eventually, the force of the column of water on the hypertonic side of the semipermeable membrane will equal the force of diffusion on the hypotonic (the side with a lesser concentration) side, creating equilibrium. When equilibrium is reached, water continues to flow, but it flows both ways in equal amounts as well as force, therefore stabilizing the solution.
 
Osmotic Pressure
Osmotic pressure is defined as the external pressure required to be applied so that there is no net movement of solvent across the membrane. Osmotic pressure is a colligative property, meaning that the osmotic pressure depends on the molar concentration of the solute but not on its identity. The force per unit area, or pressure, required to prevent the passage of water through a selectively permeable membrane is the measurement of osmotic pressure.
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Figs. 1.20A and B: Osmosis. (A) Initial condition; (B) After reaching the equilibrium.
The osmotic pressure of a solution is directly proportional to the concentration of the solute and in turn depends on the number of molecules or ions contained in the solution. Though dependent on the number of molecules of the solute, osmotic pressure is independent of the nature of the solute. A substance of lower molecular weight will have more molecules per unit volume than a substance of higher molecular weight and will therefore exert greater osmotic pressure; e.g. albumin has lower molecular weight than globulin; so albumin exerts greater osmotic pressure than globulin.
 
Tonicity
Living cells have selectively permeable membrane which are very permeable to water and some low molecular weight solutes, but much less permeable to other substances. This leads to the inflow of some solute molecule along with the solvent while others are retained. Under these conditions the solution exhibits only that fraction of its total osmotic pressure, due to the solutes, which are retained. This fraction of total osmotic pressure of a solution is termed as its tonicity.
 
Osmotic Gradient
The osmotic gradient is the difference in concentration between two solutions on either side of a semipermeable membrane. It is a measure of the difference in the concentration of a specific particle dissolved in a solution.
The osmotic gradient is used to compare solutions that have a semipermeable membrane between them, which allows water to diffuse between the two solutions. Water will diffuse toward the hypertonic solution (the solution with the higher concentration of solute).
Osmolarity means osmotic pressure exerted by the number of moles per liter of solution. Osmolality is the osmotic pressure exerted by the number of moles per kg of solvent. Crystalloids and water can easily diffuse across membranes, but an osmotic gradient is provided by the nondiffusible colloidal (protein) particles. The colloid osmotic pressure exerted by proteins is the major factor which maintains the intracellular and intravascular fluid compartments. Albumin is mainly responsible in maintaining this osmotic balance (Chapter 23).
Isotonic solution: A pair of solutions, which produce no net flow through a semipermeable membrane, are said to be isotonic solutions.
If the cell is kept in hypotonic solution, the plasma membrane will allow water to pass into it and will set up an excess pressure in the interior of the cell causing the cell wall to be tight. This condition is known as “turgor” and the cell is said to be turgid.
If the cell is immersed in a concentrated solution (hypertonic solution) water will pass out of the cell. The cytoplasm then shrinks and detaches itself from the cell wall. This phenomenon is said to be “crenation”.
The clinical applications of osmosis are given in Box 1.2.
 
Reverse Osmosis
Suppose a solution is separated from pure solvent by a semipermeable membrane. If the pressure applied on the solution is more than the osmotic pressure, the solvent will start flowing from the solution toward the pure solvent. This phenomenon is known as reverse osmosis (Fig. 1.21). In the left hand side of the Figure 1.21, pure water will enter into salt water due to the osmotic pressure. On the right hand side of the Figure 1.21, pressure is applied on the salt water compartment, which overcomes the osmotic pressure, and so the water flow is reversed from salt water to pure water compartment. In other words, reverse osmosis is a separation process that uses pressure to force a solvent through a semipermeable membrane that retains the solute on one side and allows the pure solvent to pass to the other side, forcing it from a region of high solute concentration through a membrane to a region of low solute concentration by applying a pressure in excess of the osmotic pressure. This principle is being employed for getting drinking water from sea water.
 
DIALYSIS
The process of separating crystalloids from colloids by means of diffusion of crystalloid through a membrane is called dialysis and the apparatus used for separation is called as dialyzer. This method is based on the fact that the pores of the membrane are very small and allows the free passage of only the ions of the solution. The colloidal particles are too big to pass through these pores and hence they are retained inside the bag.
Dialysis consists of a parchment or cellulose acetate bag immersed in water. The impure solution (mixture of crystalloids and colloids) is placed in the dialyzer and the outside water is continuously renewed. The crystalloids slowly pass freely through the membrane into the outside water, while the colloidal solution is left inside the dialyzer. Dialysis is a very slow process. The membrane used for dialysis is semipermeable, therefore it allows selective passage of only crystalloids and not the colloidal particles.
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Applying a potential difference across the membrane can accelerate the process of diffusion of crystalloid impurities from colloidal solution. Under the influence of electric field, the cryst