U Obertacke

Orthopädisch-Chirurgische Zentrum, Cham Regen, Bavaria, Germany

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Publications (214)384.4 Total impact

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    ABSTRACT: Background: Logbooks are widely used to set learning outcomes and to structure and standardize teaching in clinical settings. Experience shows that logbooks are not always optimally employed in clinical training. In this article, we have summarized our own experiences as well as results of studies into twelve tips on how to successfully implement logbooks into clinical settings. Methods: We conducted both a workshop concerning the importance of logbook training to exchange experiences in teaching practice, organization, didactic knowledge and a literature research to compare our own experiences and add additional aspects. Results: Tips include the process of developing the logbook itself, the change-management process, conditions of training and the integration of logbooks into the curriculum. Conclusions: Logbooks can be a valuable tool for training in clinical settings, especially when multiple sites are involved, when you take our tips into consideration.
    No preview · Article · Feb 2016 · Medical Teacher
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    ABSTRACT: Introduction: Ligamentous lesions are concomitant to dislocated distal radius fractures in a high percentage. The purpose of this study was to evaluate the relevance of intracarpal lesions. Methods: Seventy eight of an original cohort of 104 distal radius fractures (74 %) were studied over a follow-up period of one year after surgery with complete data (X-rays, CT, MRI, follow-up X-rays and questionnaire). Results: Most of our radius fractures (AO 23 type: A 39, B 9, C 30) present additional lesions: 97 %. One-year evaluation showed an average Castaing score of 4.5 ± 2.5 points, means a "good" result of a scale of 0-27. Fifty five of seventy eight had an "excellent" or "good" result (<6 points). No patient had more than 12 points ("fair"). Conclusions: The dislocated distal radial fracture implies severe and complex injury to the whole wrist, mostly concerning intracarpal concomitant lesions (MRI). Surgical therapy of dislocated radius fractures followed by 6 weeks relief through thermoplastic splint seems to be sufficient to achieve good 1-year results. MRI-detectable carpal lesions at the time of the radial fracture are common, but only a few of them seem to decompensate later, give symptoms and became of therapeutic relevance.
    No preview · Article · Nov 2015 · Archives of Orthopaedic and Trauma Surgery
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    ABSTRACT: Purpose Recent data suggest diminished post-operative quadriceps muscle strength after tourniquet application during total knee arthroplasty (TKA). The metabolic effects of the commonly utilized intraoperative tourniquet with consecutive ischaemia on the skeletal muscle cells were unknown. Ubiquitin proteasome system represents one of the main pathways involved in muscle protein breakdown contributing to muscle atrophy. Therefore, the purpose of the present study was to quantify the acute effects of the tourniquet application during TKA on the (1) concentrations of free/conjugated ubiquitin, (2) total ubiquitin-protein ligase activity, (3) proteasome-dependent and (4) proteasome-independent peptidase activities in the cells of vastus medialis. Methods The randomized, controlled, monocentric trial included 34 patients scheduled to undergo primary TKA. Each patient was randomly assigned to the tourniquet (n = 17) or non-tourniquet group (n = 17) after receiving a written consent. Muscle biopsies of (5 × 5 × 5 mm) 125 mm3 were obtained from vastus medialis immediately after performing the surgical approach and exactly 60 min later. After preparation of the muscle tissue specimen, the concentrations of the free/conjugated ubiquitin (Ub) were measured by western blot analyses. The ubiquitination was determined as biotinylated Ub incorporated into the sum of the cytosolic proteins and expressed as total ubiquitin-protein ligase activity (tUbPL). The quantification of the proteasome-dependent and proteasome-independent peptidase activities was performed with peptidase assays. Results Tourniquet application did not influence the concentration of the free/conjugated Ub. There were no differences in tUbPL activities between groups and time points. Tourniquet-induced ischaemia resulted in statistically significant higher proteasome-dependent (caspase-like p = 0.0034; chymotryptic-like p = 0.0013; tryptic-like p = 0.0036) and proteasome-independent (caspase-like p = 0.03; chymotryptic-like p = 0.0001; tryptic-like p = 0.0062) peptidase activities. Conclusion Tourniquet application did not affect the free/conjugated Ub as well as tUbPL significantly, emphasizing the sophisticated regulation of ubiquitination. The proteasome-dependent peptidase activities were significantly upregulated during tourniquet application, suggesting an increase in protein degradation, which in turn might explain the skeletal muscle atrophy occurring after TKA. These findings add further knowledge and should raise the awareness of surgeons about the effects of tourniquet-induced ischaemia at the molecular level. Additional high-quality research may be warranted to examine the short- and long-term clinical significance of the present data. Level of evidence I.
    No preview · Article · Nov 2015 · Knee Surgery Sports Traumatology Arthroscopy
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    ABSTRACT: Background: Since 2006 the practical year in the Mannheim Reformed Curriculum Medicine (MaReCuM) is divided into four quarters: the two required subjects (surgery and internal medicine), one elective and one of four offered fields in ambulatory medicine. Therefore students can more intensively focus on their preferences in the practical year. In the present article we describe the provided surgical training sites, the organisation of the practical year, the surgical training itself and the quality management. We provide answers to the following questions: does dividing the practical year into quarters have a (negative) influence on the grades of final exams; how interested, motivated and satisfied are students in the different (surgical) quarters of the practical year and in which quarter(s) can new generation staff be recruited?Methods: We used results of the final exams of three cohorts of the traditional Mannheim track and three cohorts of MaReCuM, as well as the results of the Mannheim Questionnaire of Satisfaction with Training Conditions in the Practical Year of Medical Education from the regular evaluation of three practical year cohorts within two years. Conclusions: Dividing the practical year into quarters is possible and can be organised together with the new "mandatory subject" ambulatory medicine. The introduction of quarters has no negative effects on the results of final exams. The assignment in the surgical field from students' perspectives with regard to motivation, interest, knowledge and satisfaction with training is comparable to surgical electives. Therefore recruitment of new staff is possible either in the surgical elective or in the surgical area of ambulatory medicine.
    No preview · Article · Oct 2015 · Zentralblatt für Chirurgie
  • F. Bludau · T. Reis · F. Schneider · S. Clausen · F. Wenz · U. Obertacke

    No preview · Article · Sep 2015 · Der Radiologe
  • T. Reis · F. Bludau · G. Welzel · F. Schneider · E. Sperk · C. Neumaier · U. Obertacke · F. Wenz

    No preview · Conference Paper · Jun 2015
  • Source
    T. Reis · E. Sperk · G. Welzel · F. Schneider · F. Bludau · U. Obertacke · F. Wenz

    Preview · Article · Apr 2015
  • K. Schüttpelz-Brauns · U. Obertacke · J. Kaden · C. I. Hagl
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    ABSTRACT: Although the need for hand hygiene (HH) is generally accepted, studies continue to document inadequate compliance. Medical students are taught about the importance of HH to prevent nosocomial infections, and receive training in the correct procedures for HH. However, personality traits (social orientation and achievement orientation) may influence HH compliance. People with high social orientation feel socially responsible and act cooperatively, and people with high achievement orientation are ambitious and competitive. To evaluate the relationship between HH compliance and personality traits of medical students. The HH compliance of 155 students was observed during objective standardized clinical examinations (OSCEs). Social orientation and achievement orientation were measured using the corresponding scales of the Freiburg Personality Inventory - Revised. Social orientation did not differ between students with high HH compliance and students with low HH compliance [F(1) = 3.87, P = 0.052, η(2) = 0.045]. For achievement orientation, a moderate effect was found between low and high HH compliance [F(1) = 11.242, P = 0.001, η(2) = 0.119], and students with high HH compliance were found to be more achievement orientated than students with low HH compliance. Achievement orientation plays a major role during OSCEs, while social orientation is less emphasized. To the authors' knowledge, this is the first study to show that HH compliance is associated with achievement orientation in achievement situations. Copyright © 2014 The Healthcare Infection Society. Published by Elsevier Ltd. All rights reserved.
    No preview · Article · Dec 2014 · Journal of Hospital Infection
  • Susanne Fröhlich · Udo Obertacke

    No preview · Article · Oct 2014 · Orthopädie und Unfallchirurgie - Mitteilungen und Nachrichten
  • D Sachse · C Beiter · F Bludau · U Obertacke · U Schreiner
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    ABSTRACT: Introduction: Traumatic fractures of the neck of the femur are rare injuries in younger patients between 15 and 50 years old. The short-term and long-term complications may cause substantial problems, in particular non-union and avascular necrosis (AVN) of the head of the femur. In the literature (and from some experts) the impression is occasionally given that there might be "proven" successful therapeutic procedures. Methods: For this purpose we retrospectively analysed follow-up-data from our own patients in the years 2003-2007 and compared them with the literature. We identified 23 of a total of 376 patients with a femoral neck fracture as a cohort being younger than 50 years. 17 of those 23 patients were treated with an internal fixation. We were able to collect and analyse complete clinical and radiological data of 11 of these 17 patients 4.2 years after surgery. Results: The mean interval between accident and surgery was 22 hours. Only one of the patients developed an AVN after internal fixation of the fracture and was implanted a total hip replacement 18 months postoperatively. There was no non-union of the femoral neck The clinical outcome after 4.2 years was very good. The mean Harris Hip Score was 95 points (of a max. of 100 pts.). Conclusions: The osteosynthesis of femoral neck fractures in younger patients showed good results and a low risk of AVN and non-union. Therefore the internal fixation of the femoral neck fracture should be preferred for the younger patients instead of a primary total hip replacement.
    No preview · Article · Feb 2014 · Zeitschrift fur Orthopadie und Unfallchirurgie
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    ABSTRACT: Die Ergebnisse nach operativ behandelten dislozierten, distalen Radiusfrakturen sind begrenzt. Dabei korrelieren die radiographischen Ergebnisse nicht gut mit den funktionellen Ergebnissen. Diese Tatsache legt die Vermutung nahe, dass radiographisch nicht darstellbare, zusätzliche karpale Primärläsionen dafür verantwortlich sind. Die vorliegende Studie soll klären, inwieweit karpale begleitende Läsionen mit dislozierten distalen Radiusfrakturen assoziiert sind.Es wurde eine konsekutive Serie von 104 Patienten mit dislozierten distalen Radiusfrakturen eingeschlossen. Das verletzte Handgelenk wurde radiographisch, computertomographisch und MR-tomographisch in Hinblick auf zusätzliche Verletzungen untersucht.Radiographisch zeigten sich nach AO 51/104 Frakturen als Typ A, 10/104 als Typ B und 39 als Typ C. CT-morphologisch waren nur 5 der 51 Typ-A-Frakturen reine metaphysäre Frakturen. MR-tomographisch wiesen alle als Typ A klassifizierten Frakturen ligamentäre Verletzungen auf. Die MRT-Untersuchung ergab 77/104 akute Läsionen des TFCC und 19/104 skapholunäre Bandrupturen.Die Ergebnisse der Studie stützen die Hypothese, dass jede dislozierte distale Radiusfraktur eine zusätzliche Läsion radiographisch nicht erkennbarer karpaler Strukturen mit sich bringt.
    No preview · Article · Jan 2014 · Der Unfallchirurg
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    ABSTRACT: Introduction: The changes in medical licensing regulations introduced in Germany in 2012 require the development of specific catalogues, termed logbooks, that define the practical skills medical students should acquire in different specialties. In conjunction with another change in medical education, which allows medical students to freely select any German university hospital or academic teaching hospital for their one-year internship, these catalogues are a prerequisite for ensuring comparable training standards throughout Germany. The German licensing regulations provide no details regarding the contents or form of the logbooks but only mention a "training programme" in very general terms. A logbook is commonly understood to define clear learning objectives to be accomplished during a specified interval (4 months). The conference of German medical faculties proposed a basic logbook for compulsory training modules (surgery and internal medicine) that is intended to serve as a model (formally and contentwise) for those who develop similar catalogues for elective training modules. Here we present our logbook for an elective training module in orthopaedic surgery and traumatology. Material and method: The logbook presented here is based on the catalogue of learning outcomes in orthopaedic surgery and traumatology developed by an expert board of the medical teaching study group of the German Society of Orthopaedic Surgery and Traumatology (DGOU) in 2011. The objectives defined for the one-year internship are of necessity divided into orthopaedic surgery and traumatology skills that must be acquired by all medical students and those that are optional (compulsory and elective modules). Using a set of predefined criteria, the authors developed the catalogue of learning outcomes (logbook) presented here. The catalogue outlines the competencies to be acquired in an elective orthopaedic surgery and traumatology module, leaving it to each medical faculty to work out the details. Where applicable, comprehensive skills across a number of (compulsory and elective modules) learning objectives are arranged in such a way that they can be taught at different levels of complexity. Results: The logbook covers 15 skill domains from different specific components of orthopaedic surgery and traumatology. Where these skills overlap with those also required in compulsory modules (e.g., surgery), the required level of complexity may be lower for students in the elective module. The text is supplemented by figures with synopses of the major issues and summaries for easy reference. Conclusion: With the recent changes in German licensing regulations for physicians, it has become necessary to set up a logbook of uniform learning outcomes to assist medical students and their teachers alike. The authors have developed such a logbook of elective training modules in orthopaedic surgery and traumatology to be taught during the one-year undergraduate internship of German medical students.
    No preview · Article · Dec 2013 · Zeitschrift fur Orthopadie und Unfallchirurgie
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    ABSTRACT: Intraoperative radiotherapy (IORT) using the INTRABEAM(®) system promises a flexible use regarding radiation protection compared to other approaches such as electron treatment or HDR brachytherapy with (192)Ir or (60)Co. In this study we compared dose rate measurements of breast- and Kypho-IORT with C-arm fluoroscopy which is needed to estimate radiation protection areas. C-arm fluoroscopy, breast- and Kypho-IORTs were performed using phantoms (silicon breast or bucket of water). Dose rates were measured at the phantom's surface, at 30cm, 100cm and 200cm distance. Those measurements were confirmed during 10 Kypho-IORT and 10 breast-IORT patient treatments. The measured dose rates were in the same magnitude for all three paradigms and ranges from 20μSv/h during a simulated breast-IORT at two meter distance up to 64 mSv/h directly at the surface of a simulated Kypho-IORT. Those measurements result in a circle of controlled area (yearly doses >6 mSv) for each paradigm of about 4 m±2 m. All three paradigms show comparable dose rates which implies that the radiation protection is straight forward and confirms the flexible use of the INTRABEAM(®) system.
    Full-text · Article · Nov 2013 · Zeitschrift für Medizinische Physik
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    ABSTRACT: Die objektive Feststellung von Sicherheit im Krankenhaus bedarf einer eigenen Definition und ist nicht mit Parametern der Betriebssicherheit, wie in anderen Bereichen, messbar. Die Erfassung und Quantifizierung sog. vermeidbarer unerwünschter Ereignisse (VUE) macht Sicherheit messbar(er). VUE treten im Rahmen von Krankenhausbehandlungen zu 9,2 % auf, die Sterblichkeit bei diesen Ereignissen liegt bei 0,1 %. Die subjektive Bewertung und das mediale Interesse an solchen unerwünschten Ereignissen korreliert jedoch selten mit objektiv messbaren Sicherheitsparametern. VUE wie Komplikationen, Fehler, Versagen und Verstöße sollten sorgsam definiert und klar unterschieden werden. Kumulativ liegt die Komplikationshäufigkeit perioperativ (weltweit) sicher über 10 %. Die Sicherheit im Zusammenhang mit Operationen wird eingriffsbezogen am meisten durch Wundinfektionen (Sicherheit 98 %) und nosokomiale Infektionen (Sicherheit 97 %) gefährdet. Die Sicherheit vor Problemen in Anästhesie, Bluttransfusion und sog. Indexereignisse (z. B. Patienten-/Seitenverwechslung) ist deutlich höher. Objektiv kann ein Krankenhaus nach den meisten Parametern als sicher für die Patienten angesehen werden. Checklisten verbessern nachweislich die Sicherheit. Meldesysteme (für kritische Ereignisse), Schulungen und Trainings- und Verhaltensänderungen könnten die Sicherheit möglicherweise verbessern, die Effekte sind allerdings schwer messbar.
    No preview · Article · Oct 2013 · Der Unfallchirurg
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    ABSTRACT: Patient safety in hospitals is difficult to define and is not measurable by operational safety parameters as in other fields. So-called adverse events (AE) are a collective of complications, failures, mistakes, errors and violations. Estimations of at least 9.2 % AEs in surgery with 0.1 % fatalities are given worldwide but there are no correlations between objective quantification of AEs and subjective or public perception of safety during the perioperative period. Patient safety during this period is mostly endangered by wound infections (safety 98 %) and nosocomial infections (safety 97 %). In spite of these facts, safety parameters for problems in anesthesia, blood transfusion, in retaining surgical instruments and so-called index events, such as patient and side identification errors are much higher. Patient safety is maintained in hospitals by objective means (surgical). Checklists have been proven to improve safety and critical incidence reporting, training and changing of attitudes could have further advantages but they are difficult to measure.
    No preview · Article · Oct 2013 · Der Unfallchirurg
  • F Bludau · R Schmidt · F Schneider · T Reis · F Wenz · U Obertacke · R Kayser
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    ABSTRACT: The Kypho-IORT procedure is a recently developed surgical technique to combine intraoperative radiotherapy with cement augmentation of the vertebra for spinal metastases. The technical feasibility and the operation principle of this new method have been described. In the following article the refinement of the standard operation procedure and the technical development of the method are described. Not only the procedural improvements but also the learning curves of the inaugurators are pointed out. Moreover, the article presents the measures which were necessary to educate trainees during surgical master classes in this new method and to transfer the method. The learning success was quantified by recording the accuracy reached by the trainees in the key procedure during hands-on cadaver exercises. Improvements of the standard operation procedure could be successfully transferred in a second master class. The method of Kypho-IORT and the demonstrated way of postgraduate education is feasible to instruct trainees. The Kypho-IORT procedure can be learnt and performed safely by running through the surgical master class.
    No preview · Article · Sep 2013 · Der Orthopäde
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    ABSTRACT: Hintergrund Für die Behandlung von symptomatischen Wirbelkörpermetastasen stehen operative und strahlentherapeutische Verfahren zur Verfügung. Die hier vorgestellte Methode zeigt eine Kombination aus intraoperativer Radiotherapie (IORT) mit einer Kyphoplastie zur Behandlung von Wirbelkörpermetastasen. Methode und Resultate Mit der Kypho-IORT sind symptomatische Wirbelkörpermetastasen zwischen BWK3 und LWK5 behandelbar. Unter Intubationsnarkose wird ein extra- oder bipedikulärer Zugang zum Wirbelkörper wie bei einer herkömmlichen Kyphoplastie gewählt. Anschließend wird über Spezialhülsen der Bestrahlungsapplikator eingeführt und über einen Röntgengenerator (Intrabeam®, Carl Zeiss Surgical, Oberkochen, Deutschland) die intraoperative Bestrahlung durchgeführt. Die Bestrahlungsdosis beträgt je nach Studienprotokoll 8 Gy in 5–10 mm Tiefe (50 kV Röntgenstrahlung). Anschließend wird ein herkömmliches Kyphoplastieverfahren (Fa. Medtronic, USA) durchgeführt und der betroffene Wirbelkörper mit Zement stabilisiert. Schlussfolgerung Das vorgestellte Verfahren zeigt einen neuen Weg zur Behandlung von Wirbelkörpermetastasen auf und stellt eine lohnende Alternative zum bisher etablierten Vorgehen dar.
    No preview · Article · Sep 2013 · Der Orthopäde
  • R Kayser · S A Ender · E Asse · E Wilhelm · F Adler · R Schmidt · F Wenz · U Obertacke · F Bludau
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    ABSTRACT: Operative and radiotherapeutic procedures are available for the treatment of symptomatic vertebral metastases. The method for treatment of vertebral metastases presented in this article involves a combination of intraoperative radiotherapy (IORT) and kyphoplasty. Kyphoplasty-IORT allows treatment of symptomatic vertebral metastases between vertebrae T3 and L5. With the patient under intubation narcosis an extrapedicular or bipedicular access to the vertebra is selected as for conventional kyphoplasty. This is followed by insertion of special sheaths of the radiation applicator and radiation therapy is intraoperatively administered via a radiation generator (Intrabeam®, Carl Zeiss Surgical, Oberkochen, Germany). The radiation dose is 8 Gy at a depth of 5-10 mm depending on the study protocol (50 kV X-radiation). Following radiation a conventional kyphoplasty procedure (Medtronic, USA) is carried out and the vertebra stabilized with cement. The procedure presented demonstrates a new approach to treatment of vertebral metastases and represents a valuable alternative to previously established methods.
    No preview · Article · Jul 2013 · Der Orthopäde
  • R Gologan · S Aziriu · U Obertacke · U Schreiner
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    ABSTRACT: BACKGROUND: Injuries due to domestic violence are a frequent occurrence in emergency departments. Although domestic violence has been well analyzed from the sociological point of view, medical data concerning patterns of injuries are rare. METHODS: Victims of domestic violence who presented at the emergency department of a maximum care hospital were included in the study. Sociodemographic data and patterns of injuries were documented. RESULTS: Of the patients who presented at the emergency room 1.4 % suffered injuries due to domestic violence and 70 % were women who had been predominantly attacked by the (ex) partner. The male victims were predominantly attacked by friends. In 88 % the head and neck were involved. Male patients were attacked with objects (as a kind of weapon) more frequently than women. A migration background was documented in 45 % of the female and 30 % of the male patients. CONCLUSION: Patterns can be easily recognized: the victims were predominantly female and were attacked by the (ex) partner. Injuries were localized to the upper part of the body. No excessive violence with life-threatening or fatal injuries was observed.
    No preview · Article · Jun 2013 · Der Unfallchirurg
  • Dr. R. Gologan · S. Aziriu · U. Obertacke · U. Schreiner
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    ABSTRACT: Hintergrund Häusliche Gewalt ist eine Unterform vorkommender Gewaltformen. Die soziologischen Aspekte häuslicher Gewalt sind gut erforscht und publiziert. Im Hinblick auf körperliche Verletzungsfolgen von häuslicher Gewalt lassen sich nur wenige Daten finden. Patienten und Methode Aus dem Patientengut einer unfallchirugischen Notaufnahme eines Hauses der Maximalversorgung wurden Opfer häuslicher Gewalt identifiziert. Es wurden persönliche und soziodemographische Daten sowie Daten zum Verletzungsmuster erfasst. Ergebnisse Opfer häuslicher Gewalt waren 1,4 % der in der Notaufnahme vorstelligen Patienten; 70 % waren Frauen, die überwiegend (68 %) durch den (Ex-)Lebenspartner Gewalt erfuhren; 30 % waren Männer, welche überwiegend (46 %) von Bekannten Gewalt erfuhren. Ein Migrationshintergrund lag bei 45 % der Frauen und 38 % der Männer vor. Am häufigsten wurden der Kopf und Hals (88 %) verletzt. Zu 94 % lag eine stumpfe Gewalteinwirkung vor. Männer wurden tendentiell häufiger mit Gegenständen angegriffen. Schlussfolgerung Es sind Muster erkennbar: Betroffene sind überwiegend Frauen und häufiger Menschen mit Migrationshintergrund. Die (überwiegend stumpfe) Gewalt wird innerhalb einer Partnerschaftsbeziehung, seltener in direkter Verwandtschaftslinie verübt. Die Richtung der Gewalt zielt auf den Kopf. Exzessive Gewalt mit lebensgefährlichen Verletzungen wurde nicht beobachtet.
    No preview · Article · Jun 2013 · Der Unfallchirurg

Publication Stats

3k Citations
384.40 Total Impact Points


  • 2005-2014
    • Orthopädisch-Chirurgische Zentrum
      Cham Regen, Bavaria, Germany
    • Klinikum Landshut
      Landshut, Bavaria, Germany
  • 2002-2014
    • Universität Heidelberg
      • • Department of General, Visceral and Transplantation Surgery
      • • Orthopedic and Trauma Surgery Center
      • • Psychosomatic and General Clinical Medicine
      • • Department of Orthopedics and Traumatology
      Heidelburg, Baden-Württemberg, Germany
  • 2002-2013
    • Universität Mannheim
      Mannheim, Baden-Württemberg, Germany
  • 1987-2012
    • University Hospital Essen
      • Klinik für Unfallchirurgie
      Essen, North Rhine-Westphalia, Germany
  • 2011
    • Universitätsklinikum Freiburg
      Freiburg an der Elbe, Lower Saxony, Germany
  • 2010
    • Universitätsmedizin Mannheim
      Mannheim, Baden-Württemberg, Germany
  • 2008-2010
    • Goethe-Universität Frankfurt am Main
      • Klinik für Unfall-, Hand-, und Wiederherstellungschirurgie
      Frankfurt am Main, Hesse, Germany
  • 2004
    • University of Miami Miller School of Medicine
      • Ryder Trauma Center
      Miami, Florida, United States
  • 1989-2002
    • Justus-Liebig-Universität Gießen
      • Department of Internal Medicine
      Giessen, Hesse, Germany
  • 1987-1999
    • University of Duisburg-Essen
      Essen, North Rhine-Westphalia, Germany
  • 1996
    • Ludwig Boltzmann Institute for Experimental and Clinical Traumatology
      Wien, Vienna, Austria
  • 1992
    • Freie Universität Berlin
      • Department of Anesthesiology and Operative Intensive Care Medicine
      Berlín, Berlin, Germany