Discovery and development of direct thrombin inhibitors the binding site for the globular amino-terminal domain and exosite 1 is the binding site for the acidic carboxy-terminal domain of hirudin. Native hirudin, a 65-amino-acid polypeptide, is produced in the parapharyngeal glands of medicinal leeches. Hirudins today are produced by recombinant biotechnology using yeast. These recombinant hirudins lack a sulfate group at Tyr-63 and are therefore called desulfatohirudins. They have a 10-fold lower binding affinity to thrombin compared to native hirudin, but remain a highly specific inhibitor of thrombin and have an inhibition constant for thrombin in the picomolar range. Renal clearance and degradation account for the most part
Salivary duct carcinoma SDC are diagnosed by examination of tissue, e.g. a biopsy. Their histologic appearance is similar to ductal breast carcinoma. Salivary duct carcinoma Salivary duct carcinoma, abbreviated SDC, is a rare type of aggressive cancer that arises from the salivary glands. It is predominantly seen in men and, generally, has a poor prognosis. Other high grade carcinomas can mimic SDC. About 40-60% of SDC arise in pleomorphic adenomas. Most, if not all, SDCs express androgen receptor by immunohistochemistry. Therapeutically relevant genetic alterations include "ERBB2/Her2" amplification, "PIK3CA" and/or "HRAS" mutations. The typical presentation is a rapidly growing mass with associated pain. This