M W Beckmann

Friedrich-Alexander Universität Erlangen-Nürnberg, Erlangen, Bavaria, Germany

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Publications (457)614.63 Total impact

  • [Show abstract] [Hide abstract]
    ABSTRACT: Aim: Certification of breast centers helps improve the quality of care but requires additional resources, particularly for documentation. There are currently no published data on the actual staff costs and financial resources required for such documentation. The aim of this study was to determine the time and resources required to document a patient with primary breast cancer from diagnosis to the end of follow-up, to establish a database for future strategic decisions. Material and Methods: All diagnostic and therapeutic procedures of patients with primary breast cancer were recorded at the University Breast Center of Franconia. All time points for documentation were evaluated using structured interviews. The times required to document a representative number of patients were determined and combined with the staff costs of the different professional groups, to calculate the financial resources required for documentation. Results: A total of 494 time points for documentation were identified. The study also identified 21 departments and 20 different professional groups involved in the documentation. The majority (54 %) of documentation was done by physicians. 62 % of all documentation involved outpatients. The results of different scenarios for the diagnosis, therapy and follow-up of breast cancer patients in a certified breast center showed that the time required for documentation can be as much as 105 hours, costing € 4135. Conclusion: This analysis shows the substantial staffing and financial costs required for documentation in certified centers. A multi-center study will be carried out to compare the costs for certified breast centers of varying sizes with the costs of non-certified care facilities.
    Geburtshilfe und Frauenheilkunde 08/2014; 74(8):743-751. · 0.85 Impact Factor
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    ABSTRACT: Purpose: To determine the accuracy of sonographic weight estimation (WE) for small-for-gestational-age (SGA) fetuses, and to further differentiate the evaluation between symmetric and asymmetric SGA fetuses. Materials and Methods: The accuracy of WE in SGA fetuses (n = 898) was evaluated using 14 sonographic models and was further differentiated between symmetric (n = 750) and asymmetric (n = 148) SGA fetuses. SGA fetuses were considered to be asymmetric with a head circumference to abdominal circumference ratio above the 95th percentile. The accuracy of the different formulas was compared using means of percentage errors (MPE), medians of absolute percentage errors (MAPE), and proportions of estimates within 10 % of actual birth weight. Results: Results for the subgroup of asymmetric SGA fetuses differed significantly from the subgroup of symmetric SGA fetuses. MPE values were closer to zero with most of the formulas in the asymmetric SGA group. Apart from the Siemer, Shepard, Merz and Warsof equations, all formulas showed an underestimation of fetal weight in asymmetric SGA fetuses. In contrast, in the symmetric SGA group, all of the formulas commonly used for fetuses in a normal weight range showed a systematic overestimation of fetal weight. Overall the best accuracy was achieved by using the Sabbagha equation (MPE 1.7 %; SD 9.0 %; MAPE: 6.0). Conclusion: An accurate WE in SGA fetuses is feasible using the Sabbagha formula. However, one has to be aware of the significant differences in WE between symmetric and asymmetric SGA fetuses.
    Ultraschall in der Medizin (Stuttgart, Germany : 1980). 07/2014;
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    ABSTRACT: Aim: Effective pain management during labour is important because pain affects the birth experience. Epidural analgesia is effective but often it may not be possible; however, inhaled analgesia offers another option. Use of inhaled nitrous oxide and oxygen for pain management in labour is well established in obstetrics but is still not used much in Germany. This study aimed to investigate the acceptance of the inhaled analgesia of inhaled nitrous oxide and oxygen by midwives and pregnant women during labour. Material and Methods: In this observational study carried out between April and September 2013, a total of 66 pregnant women received inhaled nitrous oxide and oxygen during labour on request and after prior assessment of suitability. After the birth, all of the women and the responsible midwives were interviewed about their experience and satisfaction with the inhaled analgesia. Results: A statistically significant reduction of pain was achieved with nitrous oxide and oxygen. The inhaled analgesia was mostly used by women who refused epidural analgesia. The likelihood of using inhaled nitrous oxide and oxygen again was reported as higher for patients who tolerated it well (p = 0.0129) and used it in the second stage of labour (p = 0.0003) and when bearing down (p = 0.0008). Conclusion: Inhaled nitrous oxide and oxygen is an effective method for pain management during labour and is accepted well by women in labour and by midwives.
    Geburtshilfe und Frauenheilkunde 07/2014; 74(7):656-660. · 0.85 Impact Factor
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    ABSTRACT: BACKGROUND: ATP-binding cassette (ABC) transporters play various roles in cancer biology and drug resistance, but their association with outcomes in serous epithelial ovarian cancer (EOC) is unknown. METHODS: The relationship between clinical outcomes and ABC transporter gene expression in two independent cohorts of high-grade serous EOC tumors was assessed with real-time quantitative polymerase chain reaction, analysis of expression microarray data, and immunohistochemistry. Associations between clinical outcomes and ABCA transporter gene single nucleotide polymorphisms were tested in a genome-wide association study. Impact of short interfering RNA-mediated gene suppression was determined by colony forming and migration assays. Association with survival was assessed with Kaplan-Meier analysis and log-rank tests. All statistical tests were two-sided. RESULTS: Associations with outcome were observed with ABC transporters of the "A" subfamily, but not with multidrug transporters. High-level expression of ABCA1, ABCA6, ABCA8, and ABCA9 in primary tumors was statistically significantly associated with reduced survival in serous ovarian cancer patients. Low levels of ABCA5 and the C-allele of rs536009 were associated with shorter overall survival (hazard ratio for death = 1.50; 95% confidence interval [CI] =1.26 to 1.79; P = 6.5e-6). The combined expression pattern of ABCA1, ABCA5, and either ABCA8 or ABCA9 was associated with particularly poor outcome (mean overall survival in group with adverse ABCA1, ABCA5 and ABCA9 gene expression = 33.2 months, 95% CI = 26.4 to 40.1; vs 55.3 months in the group with favorable ABCA gene expression, 95% CI = 49.8 to 60.8; P = .001), independently of tumor stage or surgical debulking status. Suppression of cholesterol transporter ABCA1 inhibited ovarian cancer cell growth and migration in vitro, and statin treatment reduced ovarian cancer cell migration. CONCLUSIONS: Expression of ABCA transporters was associated with poor outcome in serous ovarian cancer, implicating lipid trafficking as a potentially important process in EOC.
    JNCI Journal of the National Cancer Institute 06/2014; · 14.34 Impact Factor
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    ABSTRACT: Background. Evidence is accumulating that circulating tumor cells (CTC) out of peripheral blood can serve as prognostic marker not only in metastatic but also in early breast cancer (BC). Various methods are available to detect CTC. Comparisons between the different techniques, however, are rare. Material and Methods. We evaluate two different methods for CTC enrichment and detection in primary BC patients: the FDA-approved CellSearch System (CSS; Veridex, Warren, USA) and a manual immunocytochemistry (MICC). The cut-off value for positivity was ≥1 CTC. Results. The two different nonoverlapping patient cohorts evaluated with one or the other method were well balanced regarding common clinical parameters. Before adjuvant CHT 21.1% (416 out of 1972) and 20.6% (247 out of 1198) of the patients were CTC-positive, while after CHT 22.5% (359 out of 1598) and 16.6% (177 out of 1066) of the patients were CTC-positive using CSS or MICC, respectively. CTC positivity rate before CHT was thus similar and not significantly different (P = 0.749), while CTC positivity rate immediately after CHT was significantly lower using MICC compared to CSS (P < 0.001). Conclusion. Using CSS or MICC for CTC detection, we found comparable prevalence of CTC before but not after adjuvant CHT.
    BioMed Research International 04/2014; · 2.88 Impact Factor
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    Human Molecular Genetics 04/2014; Hum Mol Genet.(23(7)):1934-46.. · 7.69 Impact Factor
  • M W Beckmann, I Linde, C Bütof, R Kreienberg, P Gass
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    ABSTRACT: The Guidelines programme of the German Society of Gynaecology and Obstetrics (DGGG) is an executive part of the DGGG Guidelines Commission. It includes in-house planning and organisation of all guidelines as well as representation outside of the DGGG. This article does not concern the development of the guidelines as much as it concerns the planning, organisation, registration, editing and publication of the guidelines in context of the DGGG Guidelines programme. It targets interested parties, especially authors and coordinators of guidelines.
    Geburtshilfe und Frauenheilkunde 03/2014; 74(3):251-259. · 0.85 Impact Factor
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    ABSTRACT: Mammography is the central diagnostic method for clinical diagnostics of breast cancer and the breast cancer screening program. In the clinical routine complementary methods, such as ultrasound, tomosynthesis and optional magnetic resonance imaging (MRI) are already combined for the diagnostic procedure. Future developments will utilize investigative procedures either as a hybrid (combination of several different imaging modalities in one instrument) or as a fusion method (the technical fusion of two or more of these methods) to implement fusion imaging into diagnostic algorithms. For screening there are reasonable hypotheses to aim for studies that individualize the diagnostic process within the screening procedure. Individual breast cancer risk prediction and individualized knowledge about sensitivity and specificity for certain diagnostic methods could be tested. The clinical implementation of these algorithms is not yet in sight.
    Der Radiologe 02/2014; · 0.47 Impact Factor
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    ABSTRACT: Background: The aim of this study was to evaluate how many embryos will develop if more than 3 2-pronuclei-stage oocytes (2-PNOs) are cultured at the patient's request and in accordance with the Germany Embryo Protection Law. Methods: A total of 106 cycles of patients undergoing their 1st, 2nd or 3rd cycle of IVF or ICSI treatment in 2010 were prospectively included in the study. In each individual case, a decision was taken prior to treatment about the number of 2-PNOs to be cultured after each cycle. Results: Ninety female patients were treated for a total of 106 cycles. A mean of two to six 2-PNOs were cultivated for a period of between 3 and 6 days for each patient. After culture, no viable embryo was identified for 5 patients (4.7 %), a single viable embryo was identified for 37 cycles (34.7 %), and 2 viable embryos were identified for 52 cycles (48.8 %). Eleven patients (10.3 %) had 3 viable embryos after a further 11 cycles and 1 patient had 4 viable embryos in a single cycle. Ten of the patients with 3 embryos each opted to have all 3 embryos transferred in the same cycle. This meant that a single embryo from one patient with 3 viable embryos and a single embryo of the patient with 4 viable embryos were cryopreserved after culture. The pregnancy rate was 19 % per embryo transfer and 25 % per blastocyst transfer (20 pregnancies in total). All cryopreserved embryos were transferred in a subsequent cycle. Discussion: Based on this study it is possible to make a statement about the number of viable embryos which should be cultivated to obtain, at best, two embryos for transfer without running an unacceptably high risk of producing too many embryos which would then need to be cryopreserved. Only 12 patients (13.3 %) had more than 2 viable embryos. The number of supernumerary pre-implantation-stage embryos was acceptably low (only 2 patients had additional viable embryos, 2.2 %). This means that it is possible to fulfil the wishes of individual patients while complying with the German Embryo Protection Law.
    Geburtshilfe und Frauenheilkunde 02/2014; 74(2):157-160. · 0.85 Impact Factor
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    ABSTRACT: Purpose: The aim of the present study was to compare the safety and efficacy of the Kiwi OmniCup system with conventional vacuum delivery. Methods: A retrospective study of operative vaginal deliveries was done for 4682 births. The procedures included 217 operative vaginal deliveries (4.6 %), 79 of which were done using conventional vacuum extraction (37 %) and 138 using the Kiwi system (63 %). Results: Use of the Kiwi system was associated with a significant reduction in episiotomies (61 vs. 76 % in the control group; p < 0.05). The rates of successful completion of birth were comparable for the two systems (94 % with the Kiwi system and 99 % with conventional vacuum delivery). Cup detachment occurred significantly more often in the Kiwi group (p < 0.005), requiring a change to a different method of birth significantly more often. It was necessary to change the procedure significantly more often from the mid-pelvis (p < 0.05). The incidence of maternal and foetal injuries was similar for the two systems. Conclusions: With regard to obstetric efficacy and safety and foetal and maternal injuries, the Kiwi system is an acceptable alternative to the conventional vacuum cup. The advantages of the Kiwi system are its significantly lower episiotomy rate and its ease and rapidity of use.
    Geburtshilfe und Frauenheilkunde 02/2014; 74(2):146-151. · 0.85 Impact Factor
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    ABSTRACT: We report on a case of sebaceous carcinoma of the breast as a rare histological special subtype of breast cancer. Because these tumors are uncommon, differential diagnostic considerations and the exclusion of Muir-Torre syndrome are emphasized. Finally possible mechanisms of development and therapeutic strategies for this carcinoma are discussed.
    Der Pathologe 01/2014; · 0.62 Impact Factor
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    ABSTRACT: Die Mammographie ist die zentrale diagnostische Methode der klinischen symptombezogenen Abklärung von Brusterkrankungen und des Brustkrebsscreenings. In der klinischen Diagnostik wird sie heute schon oft durch zusätzliche Untersuchungsmethoden wie dem Ultraschall, der Tomosynthese und ggf. auch der MRT-Bildgebung unterstützt. Zukünftige Entwicklungen gehen in die Richtung, dass diese Kombination aus 2 oder mehr Untersuchungsverfahren entweder in Hybrid- (Aufnahme mehrerer unterschiedlicher Bildmodalitäten in einem einzigen Gerät) oder in Fusionsmethoden (Zusammenführung und Registrierung von Bilddaten aus verschiedenen Modalitäten) technisch professionalisiert werden. Des Weiteren könnten an subgruppenbezogene Erkrankungsrisiken und individuelle Sensitivitäten und Spezifitäten angepasste Diagnostikkombinationen für eine Screeningdiagnostik Gegenstand künftiger Studien sein. Wir stellen die aktuellen Entwicklungen auf diesen Gebieten und deren momentane Relevanz für die klinische Praxis und Entwicklungspotenzial für die Zukunft dar.
    Der Radiologe 01/2014; 54(3). · 0.47 Impact Factor
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    ABSTRACT: Background. Evidence is accumulating that circulating tumor cells (CTC) out of peripheral blood can serve as prognostic marker not only in metastatic but also in early breast cancer (BC). Various methods are available to detect CTC. Comparisons between the different techniques, however, are rare. Material and Methods. We evaluate two different methods for CTC enrichment and detection in primary BC patients: the FDA-approved CellSearch System (CSS; Veridex, Warren, USA) and a manual immunocytochemistry (MICC). The cut-off value for positivity was ≥1 CTC. Results. The two different nonoverlapping patient cohorts evaluated with one or the other method were well balanced regarding common clinical parameters. Before adjuvant CHT 21.1% (416 out of 1972) and 20.6% (247 out of 1198) of the patients were CTC-positive, while after CHT 22.5% (359 out of 1598) and 16.6% (177 out of 1066) of the patients were CTC-positive using CSS or MICC, respectively. CTC positivity rate before CHT was thus similar and not significantly different (P = 0.749), while CTC positivity rate immediately after CHT was significantly lower using MICC compared to CSS (P < 0.001). Conclusion. Using CSS or MICC for CTC detection, we found comparable prevalence of CTC before but not after adjuvant CHT.
    BioMed research international. 01/2014; 2014:491459.
  • Der Onkologe 01/2014; 20(4). · 0.13 Impact Factor
  • S. Hautmann, G. Mehlhorn, M. Koch, M.W. Beckmann
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    ABSTRACT: HPV (humanes Papillomavirus) ist ein Hauptrisikofaktor für die Entstehung des Vulva- und Vaginalkarzinoms. Eine Zunahme der HPV-Infektionen könnte mit einer Zunahme beider Karzinomentitäten korrelieren. Eine Impfung gegen HPV ist seit einigen Jahren verfügbar.Ziel der Recherche war es, eine Übersicht über die aktuelle Datenlage bezüglich epidemiologischer und ätiologischer Faktoren des Vulva- und Vaginalkarzinoms zu präsentieren.Es wurde eine Recherche der vorhandenen Literatur in etablierten medizinischen Datenbanken (Medline, Cochrane Database) sowie ein Review der vorhandenen epidemiologischen und ätiologischen Daten durchgeführt.Innerhalb der letzten Jahrzehnte kam es zu einer Zunahme der HPV-Infektionen bei jungen Frauen und dadurch zu einer steigenden Inzidenz der HPV-induzierten Karzinome von Vulva und Vagina. Dies betraf die Gesamtpopulation, jedoch insbesondere auch jüngere Frauen. Das Wissen um die Epidemiologie und die Ätiologie des Vulva- und Vaginalkarzinoms ist nicht nur wichtig für die Therapieentscheidung und die Therapieart, sondern auch von Bedeutung hinsichtlich des postoperativen Managements der Patientin im Sinne einer Risikostratifizierung. Eine besondere Bedeutung haben v. a. die rezidiv-gefährdeten Patientinnen mit einem HPV-negativen Vulvakarzinom oder einer differenzierten VIN (d-VIN).Das Wissen um die Zunahme der HPV-Infektionen und die dadurch steigende Inzidenz der HPV-induzierten Vulva- und Vaginalkarzinome sollte aktiv in die Früherkennung durch eine obligate und genaue Inspektion von Vulva und Vagina mit einbezogen werden. Inwieweit die HPV-Impfung Einfluss auf epidemiologische Größen wie die Inzidenz und Prävalenz der Vulva- und Vaginalkarzinome nehmen wird bleibt in den kommenden Jahren abzuwarten. Dies ist stark abhängig von der Entwicklung der Durchimpfungsrate der Bevölkerung auch in Deutschland.
    Der Onkologe 01/2014; 20(4). · 0.13 Impact Factor
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    ABSTRACT: Wir berichten über den Fall eines sebaziösen Karzinoms als sehr seltenen histologischen speziellen Subtyp des Mammakarzinoms. Aufgrund der Rarität derartiger Tumoren werden insbesondere differenzialdiagnostische Überlegungen beleuchtet sowie der Ausschluss einer Assoziation mit dem Muir-Torre-Syndrom beschrieben. Zuletzt folgt eine kurze Diskussion mit Überlegungen hinsichtlich der möglichen Entstehung des Tumors sowie bzgl. der Therapie.
    Der Pathologe 01/2014; 35(1). · 0.62 Impact Factor
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    ABSTRACT: Several advancements over the last decade have triggered the developments in the field of breast cancer risk research. One of them is the availability of the human genome sequence along with cheap genotyping possibilities. Another is the globalization of research, which has led to the growth of research collaboration into large international consortia that facilitate the pooling of clinical and genotype data of hundreds of thousands of patients and healthy control individuals. This review concerns with the recent developments in breast cancer risk research and focuses on the discovery of new genetic breast cancer risk factors and their meaning in the context of established non-genetic risk factors. Finally the clinical application is highly dependent on the accuracy of breast cancer risk prediction models, not only for all breast cancer patients, but also for molecular subtypes, preferably for those which are associated with an unfavorable prognosis. Recently risk prediction incorporates all possible risk factors, which include epidemiological risk factors, mammographic density and genetic risk factors.
    Geburtshilfe und Frauenheilkunde 12/2013; 73(12):1228-1235. · 0.85 Impact Factor
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    ABSTRACT: Introduction: A newly adapted clip system for intramammary marking during ultrasound-guided core needle biopsy for suspicion of breast cancer is described and evaluated here. Material and Method: Fifty patients with suspicion of breast cancer (cT2) had ultrasound-guided core needle biopsy using a newly adapted clip marker system (HistoCore™ and O-Twist Marker™). Subsequently, ultrasound follow-up and tomosynthesis scans were done to determine the location of the marker clips. Results: No dislocation of the marker clip was detected on ultrasound in 45 of 50 patients (90 %), and 5 patients (10 %) had a maximum dislocation of 5 mm along the x-, y- or z-axis. Tomosynthesis scans demonstrated precise placement without dislocation of the clip markers in 48 patients (96 %); 2 patients (4 %) had a maximum dislocation of 3 mm along the x-, y- or z-axis. Conclusion: The newly developed clip marker system, a combination of a single-use breast biopsy needle and a precise, length-adapted intramammary marker clip, represents a further improvement in oncological therapy. This is of particular importance for patients requiring subsequent neoadjuvant chemotherapy, as in cases with complete tumour remission, there is no target point for preoperative, ultrasound-guided wire marking.
    Geburtshilfe und Frauenheilkunde 11/2013; 73(11):1135-1138. · 0.85 Impact Factor
  • P Mallmann, M W Beckmann, G Emons
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    ABSTRACT: The S2k guideline "Diagnostics and Therapy for Cervical Cancer" published in 2008 is currently being revised to the S3 level. Current developments in epidemiology, surgical therapy, radiochemotherapy and drug therapy will be presented. The S2k guideline "Diagnostics and Therapy for Endometrial Cancer" will also be up-dated this year. The revised recommendations on early diagnosis and diagnostics, therapy for precursors, surgical therapy, adjuvant therapy and therapy for recurrences and metastases will be presented.
    Geburtshilfe und Frauenheilkunde 09/2013; 73(9):908-910. · 0.85 Impact Factor
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    ABSTRACT: Introduction: The German DRG system is annually adapted to the changing services provided. For the further development, the self-governing body and its DRG Institute (InEK) depend on participation of the users. Methods: For one of the DRG evaluation projects initiated by DGGG, cost and performance data for the year 2011 from 16 hospitals were available. After plausibility checks and corrections, analyses for service and cost homogeneity were performed. In cases of inadequate DRG-representation attributes were sought that would make an appropriate reimbursement possible. Conspicuities and potential solutions were checked for clinical plausibility. Results: 44 concrete modification proposals for further development of the G-DRG system were formulated and submitted in due time to the InEK. In addition, 3 modification proposals were addressed to the German Institute for Medical Documentation and Information (Deutsches Institut für Medizinische Dokumentation und Information, DIMDI) for further development of the diagnosis classification ICD-10-GM. For all modification proposals care was taken to minimise misdirected incentives and to reduce the potential for disputes with the cost bearers and their auditors services in settlements. Discussion: The publication of the G-DRG system 2014 shows which modification proposals have been realised. Essentially, an appropriate redistribution of the resources among the gynaecological and obstetrics departments is to be expected. The financial pressure that is caused by the generally inadequate financing of hospitals will not be reduced by a further development of the G-DRG system.
    Geburtshilfe und Frauenheilkunde 08/2013; 73(8):776-782. · 0.85 Impact Factor

Publication Stats

2k Citations
614.63 Total Impact Points

Institutions

  • 2001–2014
    • Friedrich-Alexander Universität Erlangen-Nürnberg
      • • Department of Obstetrics and Gynaecology, School of Midwifery
      • • Department of Diagnostic Radiology
      Erlangen, Bavaria, Germany
  • 1999–2014
    • Universitätsklinikum Erlangen
      • Department of Obstetrics and Gynaecology
      Erlangen, Bavaria, Germany
    • University of Bonn
      Bonn, North Rhine-Westphalia, Germany
  • 1994–2012
    • Heinrich-Heine-Universität Düsseldorf
      • Frauenklinik
      Düsseldorf, North Rhine-Westphalia, Germany
    • University Hospital Frankfurt
      Frankfurt, Hesse, Germany
  • 2011
    • HELIOS Klinikum Berlin-Buch
      Berlín, Berlin, Germany
  • 2001–2002
    • Universitätsklinikum Düsseldorf
      Düsseldorf, North Rhine-Westphalia, Germany
  • 1996–2000
    • University of Cologne
      • Institute for Genetics
      Köln, North Rhine-Westphalia, Germany
    • RWTH Aachen University
      • Department of Gynaecology and Obstetrics
      Aachen, North Rhine-Westphalia, Germany
  • 1991–1995
    • University of Chicago
      • Department of Obstetrics & Gynecology
      Chicago, IL, United States
  • 1993
    • The University of Chicago Medical Center
      • Department of Obstetrics and Gynecology
      Chicago, Illinois, United States
    • University of Freiburg
      • Institute of Medical Biometry and Medical Informatics
      Freiburg, Baden-Württemberg, Germany
  • 1992
    • Goethe-Universität Frankfurt am Main
      Frankfurt, Hesse, Germany
  • 1991–1992
    • University of Illinois at Chicago
      • Department of Obstetrics and Gynecology (Chicago)
      Chicago, IL, United States