To evaluate whether a significant statistical correlation exists between earlobe crease (EC) and coronary heart disease (CHD), 1000 Japanese adult patients (573 males, 427 females) were examined for the presence or absence of EC, clinical or angiographic evidence of CHD, and the following coronary risk factors: male sex, age over 50 years, obesity, hypertension, diabetes mellitus, cigarette smoking, and hyperlipidemia. Patients were divided into two groups according to clinical evidence of CHD: 237 patients with angina pectoris and/or myocardial infarction (CHD+ group); 720 patients without evidence of CHD (CHD- group). Coronary angiography was performed on 200 patients from this sample population; these patients were also divided into two groups: 119 patients with greater than 50% luminal narrowing of at least one major coronary artery (stenosis+ group); 81 patients with no significant atherosclerotic changes in the coronary arteries (stenosis- group). EC was present in 58 of 237 CHD+ patients (24.5%) but in only 35 of 720 CHD- patients (4.8%; P less than 0.001); it was present in 31 of 199 stenosis+ patients (26.1%) but in only 3 of 81 stenosis- patients (3.7%; P less than 0.01). EC was also found to correlate significantly with some coronary risk factors; the correlations between the presence of EC and the presence of CHD and coronary risk factors were investigated by multivariate analysis. In a multivariate setting, the existence of CHD and an age of over 50 years was significantly related to the presence of EC. To investigate the relationship between EC and advancing age, all patients were separated into age-groups.(ABSTRACT TRUNCATED AT 250 WORDS)

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To characterize acidification by the distal nephron of the intact kidney independent of alterations in buffer availability, we subjected isolated rat kidneys perfused with glucose as the sole substrate to stepwise acidification of the perfusate. In response to progressive perfusate acidification with hydrochloric acid, a maximal pH gradient between urine and perfusate, which averaged 1.71 +/- 0.12, was achieved at a mean perfusate pH of 6.89 +/- 0.04. The maximum pH gradient was increased when sulfuric acid rather than hydrochloric acid was used to acidify the perfusate, and it was decreased by 0.67 when amiloride (10(-5) M) was added to the perfusate. Thus, hydrogen ion transport by the distal nephron of the intact rat kidney appears to be amenable to study, and it responds similarly to the hydrogen ion pump of anuran urinary epithelia. Kidneys from animals subjected to a variety of dietary regimens were studied in a response to stepwise perfusate acidification with hydrochloric acid. Ammonium excretion averaged 0.49 +/- .03 mumoles/min and did not differ significantly between any of the dietary groups. Chronic acidosis and the ingestion of either a low or high salt diet had no influence on the maximal pH gradient. Neither a low nor a high potassium diet affected the pH gradient, suggesting that the difference in urine pH between these two conditions in vivo is the result of differences in ammonia production. Ingestion of a high bicarbonate diet significantly decreased the pH gradient to 1.20 +/- 0.09. Thus, an adaptive change in distal nephron hydrogen ion transport occurs in the rat kidney in response to chronic ingestion of alkali.

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