We applied this ALT/LDH ratio to patients with ALI and confirmed histologically that sinusoidal fibrin deposition and the expressions of tissue factor (TF) and hypoxia-related proteins significantly increased in the sinusoidal microcirculatory disturbance (SMD) group (ALT/LDH ratio ≤ 1.5) than in non-sinusoidal microcirculatory disturbance (NSMD) group (ALT/LDH ratio > 1.5) [10]. The gene discussed is TF; the disease is acute respiratory distress syndrome.