The bifacial Keilmesser is the type fossil of the late Middle Paleolithic Keilmessergruppen or Micoquian of central and eastern Europe. The tool is variable in shape but standardized regarding shaping sequences and morphological components. In this study we examine whether these components, a base and back opposite a sharp edge, are related only to bifacial tools or if they form a functional tool concept that was applied as well to simple edge retouched and to unifacially shaped flake tools. This study is based on a dataset of 29 3D-scanned artifacts from central Germany, for which the geographic origin, paleoenvironment, and chronological context are known in order to reduce variability introduced by these factors. With new luminescence dates, we can provide a chronological time frame for the collected and excavated artifacts to between 55 and 40 ka. We analyze variability caused by function, blank type, shaping, intensity of retouch, and typology, using 3D geometric morphometrics, Thickness Mapping, edge angle analysis, and multivariate principal component analysis based on conventional technological attributes and indices. We show that the unifacially shaped scrapers with a Keilmesser-like morphology can be classified as a unifacial variant of the bifacial Keilmesser. We interpret simple scrapers with a Keilmesser-like morphology as a special, simplistic variant of Keilmesser where the blank already fulfills the functional requirements of prehensile and active parts. With some caution related to sample size, an additional sample of Micoquian handaxes appears to be a related, but more symmetric tool concept in our data set.

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Septic shock is not only a circulatory shock but is also a cardiac shock, the consequence of a potentially reversible heart impairment known as septic cardiomyopathy. Disturbances of macrocirculation as well as microcirculation, an individually heterogeneous reduction of cardiac function, and an extensive impairment of demand-oriented regulation of heart function characterize the septic shock state. Bacterial toxins, inflammatory mediators, and a disseminated intravasal coagulopathy are responsible for these disturbances; for the impairment of cardiac regulation, the interaction of endotoxin with the cardiac pacemaker current I(f) also plays a role. Circulatory shock as well as septic cardiomyopathy should be quantified: The lowering of systemic vascular resistance characterizes the extent of circulatory shock, and the reduction of relative cardiac output in relation to afterload characterizes the extent of septic cardiomyopathy. The intensity of circulatory as well as of cardiac impairment correlates with an unfavorable prognosis. Treatment of septic circulatory shock and of septic cardiomyopathy is predominantly symptomatic; first causal approaches are under investigation.

In contrast to patients with sepsis or severe sepsis, ICG elimination was found to be significantly impaired in patients with septic shock. Furthermore, a significant predictive value of ICG-PDR and -R15 on the day of admission for the need for subsequent renal replacement therapy (n = 12) was observed. In addition, reduced ICG elimination was associated with a longer stay in an intermediate or intensive care unit. However, ICG elimination on admission could not predict 30-day mortality (n = 14) or requirement of mechanical ventilation (n = 20).

30 pre- and postoperative lateral cephalograms of patients with mandibular prognathism are used to evaluate the soft tissue profile prognosis given by the "dentofacial planner". As a result, the horizontal displacement of SLS (sulcus labrale superius) and Pg' (soft tissue pogion) in patients with a normal vertical dimension and additional LMF (labiomental fold) in persons with a marked overbite are calculated well. The horizontal changes of the other points analyzed as well as all vertical changes are not predicted satisfactorily in the momentary version 4.22 A (febr. 1989), which will be improved by the company.

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