62 



The Chemistry of the Injured Cell 



bilirubin. Large doses of vitamin K are thought also to cause 

 further damage to liver cells. 



Glucose- 1 6' Phosphate -^ ^-UTP 



^Pyrophosphate 

 UDP Glucose 

 ^-DPN 



^►Reduced DPN 



UDP Glucuronic Acid 



"Indirect -reacting"^. 

 f Bilirubin 



k Bilirubin Glucuronide 



^ ["Direct-reacting" 



UD 



P 



Bilirubin] 



ATP 



•Haem 



ADP^ 



f 



UTP 



* Enzyme catalysing this step is temporarily deficient in the neonatal 

 liver and permanently absent in one variety of congenital jaundice. 



Fig. 7. The Conversion of Bilirubin from the "Indirect" to the "Direct-Re- 

 acting" Form. 



Diabetes 



In diabetes mellitus carbohydrate cannot be fully utilised and 

 supplies of oxaloacetate are thus reduced, this substance being 

 formed chiefly by glycolysis. As a result, less citrate is formed, and 



