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Object: Although many Japanese patients infected with coronavirus disease 2019 (COVID-19) only experience mild symptoms, in some cases a patient’s condition deteriorates, resulting in a poor outcome. This study examines the behavior of biomarkers in patients with mild to severe COVID-19. Methods: The disease severity of 152 COVID-19 patients was classified into mild, moderate I, moderate II, and severe, and the behavior of laboratory biomarkers was examined across these four disease stages. Results: The median age and male/female ratio increased with severity. The mortality rate was 12.5% in both moderate II and severe stages. Underlying diseases, which were not observed in 45% of mild stage patients, increased with severity. An ROC analysis showed that C-reactive protein (CRP), ferritin, procalcitonin (PCT), hemoglobin (Hb) A1c, albumin, and lactate dehydrogenase (LDH) levels were significantly useful for the differential diagnosis of mild/moderate I stage and moderate II/severe stage. In the severe stage, Hb levels, coagulation time, total protein, and albumin were significantly different on the day of worsening from those observed on the day of admission. The frequency of hemostatic biomarker abnormalities was high in the severe disease stage. Conclusion: The evaluation of severity is valuable, as the mortality rate was high in the moderate II and severe stages. The levels of CRP, ferritin, PCT, albumin, and LDH were useful markers of severity, and hemostatic abnormalities were frequently observed in patients in the severe disease stage.

Tyrosine kinase inhibitors (TKIs) are very effective against non-small cell lung cancer (NSCLC) caused by epidermal growth factor receptor (EGFR) mutation. Before the approval of osimertinib in March 2016, there were only three available EGFR TKIs (gefitinib, erlotinib, and afatinib) for the therapy of NSCLC in Japan. Osimertinib can be indicated only against T790M+ lung cancer as a second-line therapy. However, whether gefitinib, erlotinib, or afatinib is most appropriate as a first-line therapy is still a controversial issue. The aim of this study was to compare the effectiveness of gefitinib, erlotinib, and afatinib. We retrospectively reviewed the records of 310 patients with the diagnosis of EGFR mutation-associated NSCLC including 147 patients treated with EGFR TKIs. Time to treatment failure and overall survival were evaluated. There were no significant differences in time to treatment failure (gefitinib: 9.2 months; erlotinib: 9.8 months; afatinib: 13.1 months) and overall survival (gefitinib: 27.3 months; erlotinib: 29.3 months; afatinib data not available) among NSCLC patients treated with the three different EGFR TKIs. Subgroup analysis showed that smoking status has a significant influence on both time to treatment failure and overall survival. In conclusion, this study showed comparable clinical efficacy of gefitinib, erlotinib, and afatinib in Japanese patients with NSCLC.

Introduction Alectinib and crizotinib have been approved for the therapy of NSCLC caused by anaplastic lymphoma kinase gene (ALK) rearrangement. The effect of alectinib or crizotinib on overall survival (OS) in patients with ALK-rearranged NSCLC remains unknown. Methods A multicenter retrospective study was conducted to compare OS between patients receiving alectinib and crizotinib and between patients treated with alectinib and those treated sequentially with crizotinib and then alectinib after crizotinib failure. The time to treatment failure (TTF), progression-free survival (PFS), and OS were compared. Results Sixty-one patients with ALK-rearranged NSCLC were enrolled. Forty-six patients were treated with anaplastic lymphoma kinase (ALK) inhibitors (31 with crizotinib, 28 with alectinib, and 13 with both ALK inhibitors). The response rate was 66.7% for the crizotinib-treated group and 80.8% for the alectinib-treated group. Among all patients, TTF and PFS were significantly prolonged in the alectinib-treated group compared with in the crizotinib-treated group. Subgroup analyses revealed significantly prolonged TTF for alectinib compared with crizotinib therapy in the ALK inhibitor–naive population. OS was significantly longer in the alectinib-treated group than in the crizotinib-treated group. The TTF and OS of patients treated sequentially with crizotinib and then with alectinib after crizotinib failure tended to be longer than those of patients treated with alectinib alone. Conclusions Therapy with alectinib alone was significantly superior to therapy with crizotinib alone in terms of TTF, PFS, and OS, and sequential therapy with crizotinib and alectinib after crizotinib failure tended to provide a better OS benefit than did therapy with alectinib alone in patients with ALK-positive NSCLC. However, large-scale prospective studies are needed to confirm these observations.

BACKGROUND Empiric therapy of pneumonia is currently based on the site of acquisition (community or hospital), but could be chosen, based on risk factors for multidrug-resistant (MDR) pathogens, independent of site of acquisition. METHODS We prospectively applied a therapeutic algorithm based on MDR risks, in a multicenter cohort study of 1089 patients with 656 community-acquired pneumonia (CAP), 238 healthcare-associated pneumonia (HCAP), 140 hospital-acquired pneumonia (HAP), or 55 ventilator-associated pneumonia (VAP). RESULTS Approximately 83% of patients were treated according to the algorithm, with 4.3% receiving inappropriate therapy. The frequency of MDR pathogens varied, respectively, with VAP (50.9%), HAP (27.9%), HCAP (10.9%), and CAP (5.2%). Those with ≥2 MDR risks had MDR pathogens more often than those with 0-1 MDR risk (25.8% vs 5.3%, P < .001). The 30-day mortality rates were as follows: VAP (18.2%), HAP (13.6%), HCAP (6.7%), and CAP (4.7%), and were lower in patients with 0-1 MDR risks than in those with ≥2 MDR risks (4.5% vs 12.5%, P < .001). In multivariate logistic regression analysis, 5 risk factors (advanced age, hematocrit

A 63-year-old previously healthy man was admitted to our hospital with diarrhea that had lasted for about 4 weeks, high fever and dyspnea. Chest computed tomography showed consolidation with a low-density area in the right middle lobe and small nodules with feeding vessels in the right upper lobe. On Day 8, a cavity was observed in the consolidation, and the lymph nodes in the mediastinum became necrotic. Yersinia pseudotuberculosis (serotype 4b) was cultured from blood, bronchial washing fluid, and lung tissue specimens. We diagnosed the lung lesions as septic pulmonary embolism caused by enterocolitis. We started treatment with tazobactam/piperacillin. It has been reported that high-dose ceftriaxone (CTRX) is effective, but CTRX at normal doses and other beta-lactams are less effective or even ineffective. Therefore, we changed to CTRX (4g/day) on Day 5, CTRX (2g/day) on Day 8, and oral cefditoren pivoxil (600 mg/day; a third-generation cephalosporin) on Day 18. Antibiotic therapy resulted in a favorable response. The patient was discharged from our hospital on day 25 in good health. To the best of our knowledge, this is the first case of a lung abscess caused by Y. pseudotuberculosis reported in Japan.

Background. Optimal empiric therapy for hospitalized patients with healthcare-associated pneumonia (HCAP) is uncertain. Methods. We prospectively applied a therapeutic algorithm, based on the presence of risk factors for multidrug-resistant (MDR) pathogens in a multicenter cohort study of 445 pneumonia patients, including both community-acquired pneumonia (CAP; n = 124) and HCAP (n = 321). Results. MDR pathogens were more common (15.3% vs 0.8%, P< .001) in HCAP patients than in CAP patients, including Staphylococcus aureus (11.5% vs 0.8%, P< .001); methicillin-resistant S. aureus (6.9% vs 0%, P= .003); Enterobacteriaceae (7.8% vs 2.4%, P= .037); and Pseudomonas aeruginosa (6.9% vs 0.8%, P= .01). Using the proposed algorithm, HCAP patients with ≥2 MDR risk factors, one of which was severity of illness (n = 170), vs HCAP patients with 0–1 risk factor (n = 151) had a significantly higher frequency of MDR pathogens (27.1% vs 2%, P< .001). In total, 93.1% of HCAP patients were treated according to the therapy algorithm, with only 53% receiving broadspectrum empiric therapy, yet 92.9% received appropriate therapy for the identified pathogen. Thirty-day mortality was significantly higher for HCAP than for CAP (13.7% vs 5.6%, P= .017), but among HCAP patients with 0–1 MDR risk factor, mortality was lower than with ≥2 MDR risk factors (8.6% vs 18.2%, P= .012). In multivariate analysis, initial treatment failure, but not inappropriate empiric antibiotic therapy, was a mortality risk factor (odds ratio, 72.0). Conclusions. Basing empiric HCAP therapy on its severity and the presence of risk factors for MDR pathogens is a potentially useful approach that achieves good outcomes without excessive use of broad-spectrum antibiotic therapy. Clinical Trials Registration. Japan Medical Association Center for Clinical Trials, JMA-IIA00054.

We construct an adic model for the Denjoy system (X,T) of finite double orbit number. It is based on the dual Ostrowski numeration system. By using this construction, we can determine the K-theory of $C(X)\rtimes _T \mathbb {Z}$ associated with (X,T) in an effective way.

Solidified porous slab is formed through convective drying of glass particle layer wetted with aqueous dilute agar gel. Measured critical mean moisture content increases with increasing initial moisture or agar content. The agar gel moves in viscous flow caused by capillary pressure during drying. A new drying model based on the receding evaporation plane model is proposed. Drying period is divided into surface and internal evaporation periods. Wet slab consists of dried and wet zones during the internal evaporation period, while the wet slab consists of wet zone only during the surface evaporation period. In the new model, the evaporation rate from the wet zone in the internal drying period is estimated with the linear driving force (LDF) approximation in the field of adsorption engineering. Critical moisture content, that is, mean moisture content between the surface and internal periods, is estimated with a mass balance on the surface. Simulated results by the new drying model with reasonable...

We shall construct a pinched circle model of the Julia set of a topological polynomial without recourse to the theory of analytic functions. By using this model, we study conditions under which a topological polynomial has no wandering domain.

材料表面に移動抵抗をもつ親水性多孔平板の等材料温度乾燥においてregular regime(RR)曲線が現れる可能性に関して, 数値実験的, 理論的検討を行った. その結果, 第1に抵抗値一定では抵抗のない場合と同じ描き方でRR曲線が現れたのに対して, 抵抗値が乾燥とともに増加する場合には現れなかった. 第2に水分移動係数の含水率依存性が既知のとき, 流束比較法に基づいた乾燥特性関数で, 移動抵抗をもつ場合の乾燥速度と平均含水率の関係を良好に推定できた.

An experimental investigation on compound heat transfer enhancement by a combination of ribbed tubes with wire coil inserts was performed. Two wire coils with different geometries were inserted in smoothed, straight ribbed and helically ribbed tubes to make six variations of enhanced tube, and the effects of heat transfer enhancement were examined. The heat transfer coefficient was obtained for Reynolds numbers ranging from 300 to 30,000 by means of Wilson’s method. The friction factor was also obtained from the measurement of pressure drop between both ends of the tube. Moreover, the performance of enhanced tubes were evaluated by comparing the heat transfer coefficient with that of the smoothed tube under the condition of the same pumping power. All enhanced tubes exhibit higher performance in the laminar region than in the turbulent region. The highest performance is accomplished by the helically ribbed tube with a wire coil having a pitch ratio P/e = 10.0 and a clearance NDC = 0.04 due to much higher heat transfer enhancement in comparison to the other five enhanced tubes and the smaller friction factor increase in comparison to the straight ribbed tubes.

An experimental investigation on compound heat transfer enhancement by a combination of a helically ribbed tube with twisted tape inserts was performed. The measurement of heat transfer coefficient as well as the pressure drop was performed in order to evaluate the performance of enhanced tubes using the equal pumping power evaluation method. The heat transfer coefficient was obtained by means of Wilson’s method for the Reynolds number ranging from 300 to 30,000. The combination of smoothed tube and twisted tape having a clearance NDC = 0.07 accomplished the highest performance in the laminar region. On the other hand, the combination of helically ribbed tube and twisted tape having a clearance NDC = 0.02 gave the highest performance in the turbulent region. The reasons for these results are discussed well in terms of the compound effect and clearance effect.

大気圧の過熱水蒸気雰囲気下で食品を乾燥あるいは加工処理する方法は，食品が水蒸気の凝縮により処理直後に急速加熱されること，殺菌効果が期待できること，また，空気を用いた処理と比して高温でも製品が酸化されにくいことなど，さまざまな特徴を有している．そのため，過熱水蒸気は乾燥分野のみならず，製品の高品質化・高機能化のために食品加工分野への適用が期待されている．本研究では，代表的な炭水化物系の食材であるジャガイモの生スライスを試料とし，170℃および240℃の過熱水蒸気ならびに高温空気気流中で乾燥実験を行い，特に表面の色の変化とその原因について調べた．その結果，過熱水蒸気乾燥では表面近傍においても澱粉が糊化されることにより，空気乾燥時よりも表面の色味が強くなり，また，光沢を有することが明らかになった．また，試料全体の成分定量結果から，過熱水蒸気乾燥の方が糊化澱粉（水溶性多糖）量の増加がはやく，また，着色に寄与すると思われる低分子糖と遊離アミノ酸の増加量も空気乾燥のものより多くなる傾向が得られた．

本研究ではNa2CO3水溶液の2層の濃度成層を側方加熱冷却したときに発生する二重拡散対流に対して，レーザホログラフィー実時間干渉法を適用し，得られる干渉縞から局所濃度の算出を試みた．それには，干渉縞は等屈折率線と一致すること，屈折率は温度と濃度によって決まることが利用され，その結果，擬定常状態における任意時間の局所濃度分布が干渉縞と実測された局所温度分布から算出された．また，干渉縞より求められた濃度と別途行ったサンプリング法により求めた濃度との比較を行ったところ，両者の一致は非常に良好であり，本結果による濃度計測の信頼性は高く，十分実用的であることが明らかとなった．

A heat and mass transfer model was proposed for the superheated steam drying, focusing on phenomena which occur during the initial stage of drying, i.e., condensation of superheated steam on material surfaces and subsequent shift from condensation to evaporation leading to the beginning of the actual drying (Reverse Process Model). Next, drying equations considering the reverse process were formulated for a shrinking/swelling infinite flat plate to calculate moisture content and temperature distributions in a material, changes in mass of a material with time, and a characteristic drying curve. Then, the influence of the initial thickness of a material and the heat transfer coefficient were investigated. In addition, calculation results were compared with experimental ones with regard to the change in mass of material with time and the characteristic drying curve, and good conformance was obtained for the initial stage of drying.

水溶液を2層に濃度成層させ側方から加熱, 冷却を行った場合に発生する二重拡散対流について数値解析を行い, 本研究室において行われてきた実験結果との比較検討を行った. 計算条件はPr=6.67, Le=184, RαT=2.43×107, Rac=3.13×107, 容器アスペクト比A=1.1とした. 実験結果と計算結果の比較から, 流れ場と温度場の推移において定性的一致が, また上下層間濃度差Δcおよび溶質移動流束jの時間変化において定量的一致が得られた. これらの結果より本数値解析プログラムは二重拡散現象を忠実に再現できる事が確認された. 次に実験では測定が困難な濃度場について数値解析により調査した. その結果, 層境界面崩壊までの一連の現象は, (A) 層境界面が形成する期間, (B) 擬定常状態となり溶質が一定の速度で移動する期間, (C) 層境界面が不安定となり溶質移動が促進される期間, と3つの期間に分けられそれぞれの期間において特徴的な溶質移動機構が存在する事が分かった.

矩形容器内で階段状に2層に濃度成層するNa2CO3水溶液を側方から加熱冷却したときに発生する二重拡散対流を対象に, 広い初期浮力比N0=0.54～7.17のもと, 感温液晶とポリスチレン粒子を用いた温度場と流れ場の同時可視化実験を行なった.加熱冷却後, 間もなく熱と溶質の二重拡散により2層のセル対流構造が形成され, それは比較的長い擬定常状態を経て崩壊した. 崩壊前に界面の波打ち現象が確認されたが, このときの界面近傍の流れ構造, 温度場形状は非常に複雑であり, その現象のスケールは熱レイリー数に依存した. また, 界面崩壊時間は条件により10～600分まで変化するが, それは初期浮力比に大きく依存した. さらに, 本結果と溶液・条件が異なる既往の研究結果との間で界面崩壊時間の比較を行ったところ, 2つ研究で得られた界面崩壊時間は無次元時間FomScを用いて良好に相関できることがわかった.

As a basis for the development of energy storage systems utilizing crystallization/dissolution of chemical substances, an experimental study is performed for crystallization of ammonium sulfamate from an aqueous solution confined in a rectangular vessel. A molded polycrystal adhering to one of the vertical walls in the vessel was made to grow by cooling the opposite wall. The behavior of natural convection in the solution was visualized using granulated tracers. In addition, local changes in solution temperature were also measured.In the neighborhood of the growing polycrystal, upward flows develope through the decerase in concentration of solution due to crystal growth, as well as by the increase in temperature due to the latent heat of crystallization. Dilute solution transferred upward is retained at the top of the vessel to form a horizontal rolling cell there. After that, ascending dilute solution is retained above the cell, and forms a second cell. Finally, horizontal multi-layers are established in the liquid phase. Moreover, the effects of cooling rate and flow structure on the crystal growth is discussed.

This study was undertaken to assess the arterial plasma levels of endothelin-1 (ET-1) and their relationship with pulmonary haemodynamic and gas exchange variables during exercise in patients with emphysema and interstitial lung disease (ILD). Incremental cycle ergometry was performed in all patients up to maximal capacity. At rest, arterial ET-1 levels were higher in emphysema (1.86 +/- 0.35 pg.mL-1; p < 0.02) and ILD (1.75 +/- 0.25 pg.mL-1; p < 0.03) patients than in controls (1.35 +/- 0.18 pg.mL-1). Emphysema (2.08 +/- 0.26 versus 1.70 +/- 0.40 pg.mL-1) and ILD (1.98 +/- 0.21 versus 1.67 +/- 0.02 pg.mL-1) patients with pulmonary hypertension (PH) presented significantly (p < 0.05) higher arterial ET-1 levels than those without. At rest, arterial ET-1 levels were significantly correlated with mean pulmonary arterial pressure (Ppa) in both ILD (r = 0.8, p = 0.01) and emphysema (r = 0.5, p = 0.03) patients. During exercise, the arterial ET-1 levels were significantly correlated with arterial oxygen (Pa,O2) (r = -0.6, p = 0.04), alveolar-arterial oxygen difference (r = 0.8, p = 0.01), and Ppa (r = 0.6, p = 0.04) in ILD patients, but not in those with emphysema. In brief, the results of this study suggest that arterial endothelin-1 is markedly increased in interstitial lung disease and emphysema patients, and that, it is related to the exercise-induced exacerbation of pulmonary hypertension in patients with interstitial lung disease, but not in those with emphysema.

Inhaled nitric oxide (NO) has been shown to reduce the mean pulmonary artery pressure (mPAP) and to improve PaO2 in patients with acute respiratory failure undergoing oxygen (O2) therapy. However, inhaled NO reduced pulmonary hypertension without improving PaO2 in patients with chronic obstructive pulmonary disease (COPD). This study was intended to compare the hemodynamic and gas exchange responses during inhalation of NO or O2 with those observed during the combined inhalation of NO and O2 in 10 spontaneously breathing COPD patients. Hemodynamic and blood gas parameters were measured after breathing: (1) room air; (2) NO added to room air; (3) O2 (1 L/min); or (4) NO and O2. During inhalation of 2 ppm NO added to room air, the mPAP (23.1 +/- 2.5 versus 20.6 +/- 2.2 mm Hg) and the pulmonary vascular resistance (PVR) (434 +/- 70 versus 378 +/- 50 dyne s/cm5) were significantly (p < 0.05) lower than those measured with room air. However, the values of PaO2 did not improve. The combined inhalation of NO and O2 was associated not only with a significant (p < 0.05) decrease of mPAP (21.4 +/- 2.3 versus 19.7 +/- 1.8 mm Hg) and PVR (431 +/- 72 versus 370 +/- 44 dyne s/cm5), but also with a remarkable improvement (p < 0.05) in the values of PaO2 (91.4 +/- 6.6 versus 111.5 +/- 7.8 mm Hg) as compared with values obtained during the inhalation of O2 alone. These findings suggest that combined therapy with NO and O2 may constitute an alternative approach to treating patients with COPD and pulmonary hypertension.

An experimental investigation to obtain heat transfer correlation in a Votator type scraped surface heat exchanger with two-blades was performed by an electro-chemical method. Measurements were carried by mass transfer under diffusion control in a ferricyanide/ferrocyanide redox electrochemical reaction. The heat transfer correlation was obtained from an analogy of heat and mass transfer. Local heat transfer coefficients on the wall of the outer column of the exchanger was measured by varying the rotational Reynolds number, flow rate of fluid, Prandtl number and equivalent diameter in order to obtain the unity thermal design equation. The time averaged local Nusselt number in a high Prandtl number fluid was found to be correlated by the following equation: Nu = 1.53Re r 2.51 Pr 0.33 (D o /D e ) 0.44 (1320

The governing equations for isothermal drying of slabs of hygroscopic porous material are analyzed to develop a method for the approximate calculation of drying rate curves. Gradual decrease in surface moisture content is incorporated in the model by considering the effect of the desorption isotherm. The proposed method enables one to estimate drying rate curves for any conditions without solving drying equations when the dependence of moisture diffusivity and the desorption isotherm are given as functions of moisture content. Accuracy of the drying rates calculated by the method is examined by comparing with numerical solutions of the drying equations. When one of the internal and superficial mass transfer resistances is dominant, approximate drying rate curves show very good agreement with numerical solutions. When both resistances are comparable, the method underestimates drying rates with errors of less than 6%.

Heat transfer enhancement in a rectangular duct with a semicylindrical turbulence promoter was experimentally studied for a high Prandtl number fluid. The measurements of mass transfer coefficient and wall shear stress as well as flow visualization were performed in order to investigate how the performance of a heat transfer enhancement promoter is influenced by its inclination angle and by the clearance between the promoter and the wall surface. When the inclination angle is 0°, the variation of performance with clearance is closely related to the extent of heat transfer enhancement in the region of slipping flow. In this case, the clearance exhibiting the maximum performance is almost equal to the film thickness for a smooth duct without a promoter. As the inclination angle increases, what influences the variation of performance with clearance gradually shifts to the extent of heat transfer enhancement in the region of circulating and reattaching flows, and the clearance exhibiting the maximum performance decreases. There is no remarkable difference in the maximum performance between inclination angles examined here. It is, however, desirable to set the inclination angle to 30°, since the distribution of the local mass transfer coefficient for this angle is less curved than those for other angles.

We consider the Riesz product with a constant coefficient and odometer action over infinite product spaces. By studying the ratio set we can conclude the type of the above dynamical systems is III1.

To investigate the mechanism of heat transfer augmentation, numerical computations of turbulent flow and heat transfer in a parallel plate channel, attached transversely with turbulence promoters at regular intervals on the lower surface, have been performed by using a simple turbulence model and the Galerkin finite element method. It has been revealed that, in the optimum case, a vortex of peculiar structure is formed behind each turbulence promoter, and it plays a significant role in enhancing the heat transfer rate; and the maximum augmentation effect reaches about 13% when taking the pumping power into account, while it is 67% when neglecting the pumping power. It also turns out that the optimum interval of turbulence promoters is about 10 times the promoter diameter, and the optimum Reynolds number is about 9000.

矩形流路内に単独設置された半円柱乱流促進体による伝熱促進において促進体の傾斜角や壁面-促進体間クリアランスが促進効果に及ぼす影響を解明するため, 高プラントル数流体を用いて物質移動係数と壁面剪断応力の測定及び流れの可視化を行った.傾斜角0° の場合, 伝熱促進性能はスリップ流れ域における伝熱係数の増減に大きく左右され, 最大性能を示すクリアランス (最適クリアランス) は平滑流路での境膜厚さとほぼ等しくなる.傾斜角の増加に伴って伝熱促進性能は再付着・循環流域での伝熱係数の増減の影響を受けるようになり, 最適クリアランスは減少していく.また本実験の範囲では各傾斜角が示す最大性能に顕著な違いはみられないが, 伝熱係数の分布が最も均一となる傾斜角30°の場合が促進体形状として最適である.

The occurrence of thrombotic complications is commonly associated with poor prognosis in patients with malignancy. However, the prognostic significance of the subclinical activation of the clotting system, frequently observed in cancer patients, is unknown. The purpose of the present study was to evaluate the value of the pre-thrombotic state for predicting survival of lung cancer patients. This investigation comprised 70 lung cancer patients without clinical or laboratory diagnosis of intravascular coagulation. There were 49 cases with non-small and 21 with small cell carcinomas. Samples taken in controls were available for comparison. The clotting system was assessed measuring thrombin-antithrombin III complex (TAT) and plasmin-alpha 2-plasmin inhibitor complex (PAP). The independent value of these clotting markers to predict survival was evaluated in relation with previously well-established prognostic factors for lung cancer patients. Plasma concentration of each parameter was significantly higher in cancer patients as compared to that of controls. The plasma level of PAP was a predictor of survival independently from the stage of disease, sex, age, histological type, performance status, tumor size and the presence of distant metastasis. Discriminant analysis of PAP plasma concentration identified 2 groups with significant difference in survival rate in all patients, cases in advanced stages of disease and in those with small and non-small cell lung cancer. The results of the present study showed prognostic significance of the subclinical activation of the clotting system, particularly of the fibrinolytic pathway, in lung cancer. Newly developed markers of fibrinolysis might be potentially applicable for predicting outcome in malignancy.