[The complex regional pain syndrome (CRPS) as differentiation from psychogenic disturbances]. / Das komplexe regionale Schmerz- syndrom (CRPS) in Abgrenzung psychogener Störungen.

In the course of recent years, after the conception of dystrophic disturbances of the extremities had been reassessed, the CRPS has been making increasing demands on medical treatment and assessment in all insurance classes. There is common agreement that the syndrome can also be triggered by minor trauma. A decisive factor for the expert opinion is first of all the presentation of definite proof that there is actually a dystrophic disturbance present on the affected extremities. The patients concerned frequently suffer from a co-morbidity with accompanying psychological disturbances. For a lot of patients, primary organic effects caused by the injury can be excluded, whereas psychogenically determined symptoms can be found. This leads to significant consequences for the medical assessment under the insurance aspect in the individual case. The differential diagnosis may turn out to be difficult and in individual cases will require the use of the entire available technical diagnostics equipment and the involvement of psychological expert opinions.

[Psychological sequelae of accidents. A problem in accident and liability insurance]. / Psychische Folgeschäden nach Unfällen. Ein Problem in der Unfall- und Haftpflichtversicherung.

Active and successful management predominantly depends on good and trustful cooperation between the claims manager, the field representatives of the administration and the injured or damaged person. Only the early assessment and prompt and purposeful claims handling can minimize the risk of an unexpected claims development. In the early stage, particularly probands with acute psychological maldevelopment can still be helped effectively. The introduction of an adequate therapy is beneficial to the afflicted person and at the same time lowers the final developing costs. As early as in 1918, Horn stated that the early occupational reintegration, apart from granting compensation, positively affects the process of the psychological disturbance. In general, no substantial restriction on the quality of life occurs if the injuries of a physical and mental type have been treated successfully and if occupational reintegration has taken place. However, if a continuous performance loss remains in occupational life due to a chronic psychological disturbance and if the damaged person does not achieve his/her ability to work again, even the contribution of high compensation payments does generally not improve the quality of life.

[Dislocation injury of the cervical spine. Which factors are responsible for persistence of complaints?--A study of 112 patients in expert assessment]. / Die Distorsionsverletzung der Halswirbelsäule. Welche Faktoren bedingen Beschwerdepersistenz?--Eine Studie an 112 gutachterlich untersuchten Probanden.

A retrospective study of 112 patients reveals that persisting symptoms are frequently found in the victims of car accidents and in combination with psychogenic factors. As far as insurance claims are concerned, we suggest orthopedic and neurologic analysis at an early stage.

Inhibition of Ca2+-induced noradrenaline release from central noradrenergic neurons by morphine.

Morphine inhibited the noradrenaline release from slices of rat brain cortex induced by introduction of Ca2+ ions after superfusion with Ca2+-free K+-rich solution. The degree of inhibition was inversely related to the Ca2+ concentration used for stimulation.