Blood flow through arteries represents a very complex, fluid-structure interaction (FSI) problem. Strong coupling between the blood and artery is due to the relatively low stiffness of the artery compared to that of blood. Hence, the pressure exerted by the flowing blood on the artery wall can result in considerable deformations of the artery, and vice-versa, arterial deformations can in turn affect the blood flow. In the present work, the finite volume method is employed to solve the problem where compressible fluid, representing blood, flows in healthy arteries as well as in unhealthy, i.e., partly stiffened arteries. The stiffening of the arterial wall is assumed to be the first key stage in the development of atherosclerosis. The comparison between various deformation profiles of healthy and unhealthy arteries demonstrates significant and measurable differences, in particular in the radial direction. This is hoped to help toward establishing procedures for early diagnosis of the disease.

Versicherungsmedizin. 2000 Sep 1;52(3):119-24.
Early diagnosis of multiple sclerosis
Flachenecker P, Toyka KV.
Neurologischen Klinik und Poliklinik, Universitat Wurzburg.

The diagnosis of multiple sclerosis is primarily based on clinical criteria considering the dissemination of neurological symptoms in time and space. Laboratory tests (magnetic resonance imaging, examination of cerebrospinal fluid, and evoked potentials) are important to confirm the diagnosis and assess disease activity. With the improvement of these methods, MS could be diagnosed at a very early stage of the disease allowing for the prompt initiation of immunotherapies. An early diagnosis and prediction of the future course of MS are also important for adequate counselling of the predominantly young patients about their professional plans. However, in the early stages of MS, prediction of disability remains difficult even if the patient is definitely diagnosed to suffer from MS.

Nervenarzt. 1997 Mar;68(3):259-69.
Early and differential diagnosis of 1,000 patients examined in a memory clinic
Heuft G, Nehen HG, Haseke J, Gastpar M, Paulus HJ, Senf W.
Klinik fur Psychotherapie und Psychosomatik, Rheinische Landes- und Hochschulklinik, Essen.

The results from 1000 patients included in a consecutive sample of older persons showing signs of "age-related memory deficits" clearly demonstrate the necessity for a wide spectrum of differential diagnostic competence. The patients included in the study were diagnosed in succession by an interdisciplinary team of psychiatrists, neurologists, geriatric medical specialists, psychologists and gerontologists. The diagnostic process for clarification of DSM-III-R and ICD-10 criteria are discussed in detail. In all, 49.6% of the patients were diagnosed as suffering from dementia of the Alzheimer type, 31% from vascular dementia and 10% from a mixed form. In all, 12.5% of the patients were somatically ill and 31.4% displayed other psychiatric conditions, 50% of which were evaluated as being treatable with psychotherapy. The results are primarily discussed for their relevance to the reality of current treatment.

Presse Med. 1993 Jun 19;22(22):1033-8.
Early diagnosis of silent atherosclerosis and detection of cardiovascular risk factors. A new strategy for the approach of cardiovascular prevention
Simon A, Segond P, Giard AM, Demure B, Gitel R, Levenson J.
Centre de Medecine preventive cardiovasculaire et Unite INSERM U 28, Hopital Broussais, Paris.

The authors present a new strategy for cardiovascular disease prevention based on risk factor detection in occupational medicine and silent atherosclerosis detection in a specialized investigation centre. Employees from several firms in the Paris region were searched, in their working place, for cardiovascular risk factors, including blood cholesterol measurement. The subjects at risk thus selected underwent non-invasive explorations aimed at an early detection of silent atherosclerosis. Extracoronary plaques in the carotid, aorta and femoral arteries were detected by high-resolution ultrasonography, and coronary calcifications by ultrafast CT. The prevalence of arterial lesions and their relationship with risk factors were analysed in a subgroup of 208 untreated male subjects with high blood cholesterol level: 74 percent of these subjects had extracoronary plaques and 65 percent had coronary calcifications. This high prevalence of silent arterial lesions suggested that hypercholesterolaemia, even when moderate, has an early but inconsistent atherogenic effect. Moreover, extracoronary plaques and coronary calcifications were related to risk factors other than blood lipids, and among these factors age was predominant. The simultaneous detection of extracoronary and coronary lesions has demonstrated that extracoronary ultrasonography of several arteries is a good diagnostic test predicting the presence of coronary calcifications in the absence of coronary symptoms. Detection of silent atherosclerosis in subjects at risk therefore is an original and helpful complement to risk factor detection. It should better refine and individualize the diagnosis of risk and evaluate the effects of preventive cardiovascular treatments on atherosclerosis.

Arch Pathol Lab Med. 1989 Oct;113(10):1101-10.
Lipoprotein analysis. Early methods in the diagnosis of atherosclerosis.
Rosenfeld L.
Department of Pathology, New York University Medical Center.

Before 1950, there was no clear perception of the interrelationship of serum lipids, atherosclerosis, and coronary heart disease. Since then, research laboratories have made conflicting claims for the most useful measurement of the serum lipid levels in detecting and managing coronary heart disease. Emphasis has been placed in turn on the measurement of levels of serum cholesterol, lipoproteins, triglycerides, and, currently, cholesterol and lipoproteins again. Physical separation and characterization of serum lipoproteins by ultracentrifugation and electrophoresis resulted in two classification systems for lipoproteins based on hydrated density and electrophoretic mobility, respectively. Two operational by-products were the atherogenic index, an empirical formula supposed to correlate with coronary heart disease, and a phenotype system for classification of the lipoproteinemias. Current National Heart, Lung, and Blood Institute criteria for atherosclerosis risk implicate elevated levels of cholesterol and low-density lipoprotein cholesterol, and decreased levels of high-density lipoprotein cholesterol. Although triglycerides are closely associated with cholesterol in lipoprotein molecules and are positively associated with cardiovascular disease, there is no strong evidence of elevated levels of plasma triglycerides as an independent risk factor in coronary heart disease. Elevated levels of triglycerides can help identify persons with increased risk of cardiovascular disease from other causes, but screening for hypertriglyceridemia is not recommended. Apolipoproteins and lipoprotein Lp(a) are briefly discussed.