Investigating the perception of soundscapes through acoustic scene simulation.

This paper introduces a new experimental protocol for studying mental representations of urban soundscapes through a simulation process. Subjects are asked to create a full soundscape by means of a dedicated software tool, coupled with a structured sound data set. This paradigm is used to characterize urban sound environment representations by analyzing the sound classes that were used to simulate the auditory scenes. A rating experiment of the soundscape pleasantness using a seven-point bipolar semantic scale is conducted to further refine the analysis of the simulated urban acoustic scenes. Results show that (1) a semantic characterization in terms of presence/absence of sound sources is an effective way to characterize urban soundscape pleasantness, and (2) acoustic pressure levels computed for specific sound sources better characterize the appraisal than the acoustic pressure level computed over the overall soundscape.

[Rectal prolapse resection by trans-anal approach and stapling technique]. / Utilisation d'une agrafeuse linéaire coupante dans l'exérèse par voie basse des prolapsus rectaux.

We are introducing a simplified cure, derived from Alteimeier's intervention, of rectal prolapse by perineal way resection using a linear cutting stapler. It's a reproducible, quick and easy technique, which permits the elderly patients to come back in their middle of life rapidly with few complications.

Separate and combined effects of a benzodiazepine (alprazolam) and noise on auditory brainstem responses in man.

Auditory brainstem responses (ABRs) were recorded in 60 male or female, anxious or anxiety-free university students, before and after separated or simultaneous intake of alprazolam and exposure to noise. A significant increase of the latencies of the ABRs was found when subjects took alprazolam. This effect is consistent with the presence of gamma-aminobutyric acid (GABA), one of the neurotransmitters at terminals of cochlear efferent fibres A significant increase of the latencies was observed after noise alone. In subjects taking alprazolam when they are exposed to noise, the effect of noise on the ABR latencies is reduced, but not abolished. The effects of alprazolam on the ABR are consistent with the presence of GABA in the medulla and pons. Significant effects of noise upon III-V and I-V intervals suggest that auditory 'fatigue' may involve a retrocochlear component. Differences due to sex appear to be abolished by anxiety.

Artificial buzzing lips and brass instruments: experimental results.

Experimental results of a special artificial trombone player are presented: A mechanical device is a substitute for the musician. Wind instruments, and particularly the brass, are self-sustained oscillators. The oscillations are induced by a mechanical oscillator (the lips of the player) acting as a valve which modulates the flow. Measured mechanical parameters of the artificial buzzing lips for different "embouchures of the player" are presented, and analyzed in connection with the played frequencies obtained for the same "embouchures." The results are obtained with two resonator systems (a mouthpiece alone and a trombone with its mouthpiece).

[Effects, on early auditory evoked potentials, of road traffic noise, of benzodiazepine and their combination]. / Effects, sur les potentiels évoqués auditifs précoces, d'un bruit de trafic routier, d'une benzodiazépine et de leur conjugaison.

In this study, 30 young men and 30 young women (with the same proportion of anxious persons in each group) were submitted, in random order, to: i) a road traffic noise of 75 dBA for 15 min; ii) this same noise for 15 min, having ingested 0.25 mg of alprazolam (Xanax*) 1 h before; iii) uniquely 0.25 mg of alprazolam. The auditory brainstem evoked potentials (ABEP) were taken before and after exposure to noise (for the non-noise case, we respected the same time schedule). The alprazolam had an effect on the cochlea and can be considered as a noise adaptation factor on the auditory pathways explored by the ABEP.

[Level of anxiety and effects of moderate noise on early auditory evoked potentials]. / Niveau d'anxiété et effets de bruits modérés sur les potentiels évoqués auditifs précoces.

Thirty men and 30 women, 20-25 years old, and selected for presence or absence of anxiety were exposed successively for 15 min to four different noises at the same continuous equivalent level LAeq = 75 dB. Auditory brainstem evoked potentials were recorded before and after exposure to each noise. No difference was found between these noises as to their effects upon evoked potentials. After exposure to noise a significant lengthening of L1, L3 and L5 latencies was observed in men; in women a significant lengthening of L3 and L5 latencies was also present. At the same time, I-V and III-V intervals were significantly increased, without any sex-linked difference, and without any change in I-III interval. L3 and L5 latencies are significantly longer in men than in women; lengthening by noise of L1 and L3 latencies was found significantly longer in men than in women; lengthening by noise of I-V interval was found significantly more important in anxious subjects, without any sex-linked difference. L3 lengthening was also found significantly longer in anxious men than in anxiety-free ones.

[Effects of moderate noises on early auditory evoked potentials in man, in relation to age]. / Effets de bruits modérés sur les potentiels évoqués auditifs précoces, chez l'homme, en fonction de l'âge.

Thirty men and thirty women, the first half of them 40-50 years old, and the other half 15-20 years old, were exposed successively for 15 min to four different noises at the same continuous equivalent level LAeq = 75 dB. Auditory brainstem evoked potentials were recorded before and after exposure to each noise. No difference was found between these noises as to their effects upon evoked potentials. After exposure to noise, a significant lengthening of L1, L3 and L5 latencies was observed in men. No significant lengthening was observed in women, although a lengthening of latencies was present in a majority of them. The three latencies, L3 and L5 latencies in particular, were found significantly longer in men than in women. L1 and L5 latencies were significantly more lengthened by noise in men than in women. In both sexes, L5 latencies were found significantly longer in older subjects; the same was true of L3 latencies in male subjects. Noise did not significantly modify intervals between peaks. I-V interval was found significantly longer in older male and female subjects; the same was true of I-III intervals in men.

Pathologic assessment of tumor regression after preoperative chemoradiotherapy of esophageal carcinoma. Clinicopathologic correlations.

BACKGROUND: The benefits of preoperative chemotherapy and radiation for esophageal carcinoma are under investigation. A pilot study was undertaken to determine if pathologic assessment of tumor regression correlated with disease free survival. METHODS: Ninety-three resected specimens from patients treated with cis-dichloro-diamino cisplatin and irradiation before surgery were examined on semiserial sections. Patients selected for surgery were all Status 1 according to the World Health Organization (WHO) classification. Histologic typing was based on the WHO classification. Tumor regression grade (TRG) was quantitated in five grades: TRG 1 (complete regression) showed absence of residual cancer and fibrosis extending through the different layers of the esophageal wall; TRG 2 was characterized by the presence of rare residual cancer cells scattered through the fibrosis; TRG 3 was characterized by an increase in the number of residual cancer cells, but fibrosis still predominated; TRG 4 showed residual cancer outgrowing fibrosis; and TRG 5 was characterized by absence of regressive changes. Survival curves were estimated according to the Kaplan-Meier method. A quantification of the relationship between treatment failure and confounding variables (age, tumor location, tumor size, esophageal wall involvement by residual cancer and/or regressive changes, histology, treatment, adequacy of surgery, pathologic lymph node status, and tumor regression grade) was done using Cox's proportional hazards model. RESULTS: Forty-two percent of specimens were TGR 1-2; 20%, TGR 3; and 33%, TGR 4-5. Univariate analysis found that tumor size, pathologic lymph node status, tumor regression grade, and esophageal wall involvement were highly correlated with disease free survival (P < 0.05). After multivariate analysis, only tumor regression (i.e., TRG 1-3 versus TRG 4-5) remained a significant (P < 0.001) predictor of disease free survival. CONCLUSIONS: This study highlights the importance of tumor regression in the survival of patients with esophageal carcinoma treated with preoperative chemoradiotherapy. These findings suggest that tumor regression grade should be considered when evaluating therapeutic results.

Cardiovascular effects of impulse noise, road traffic noise, and intermittent pink noise at LAeq = 75 dB, as a function of sex, age, and level of anxiety: a comparative study. I. Heart rate data.

This study aimed at comparing for their cardiovascular effects: a pile-driver noise (P), a gunfire noise (G), a road traffic noise (T), an intermittent pink noise (R). All noises were presented at the same LAeq = 75 dB for 15 min each. Some 120 subjects were divided into 8 subgroups of 15 subjects each: OM (men between 40 and 50 years of age), OF (women, same age range), YM (men, between 15 and 20 years of age), YF (women, same age range), AM (typically anxious men, 20-25 years of age), AF (typically anxious women, same age range), NM (typically anxiety-free men, same age range), and NF (typically anxiety-free women, same age range). Heart rate (HR), digital pulse level, and arterial blood pressure were surveyed before, during, and after exposure to each of the four noises. As regards HR, in subjects at rest, within 5 min preceding exposure to any of the four noises, no differences in prestimulus HR was observed for conditions, age, sex, or anxiety. When the noise was on, the overall HR response was one of increase in all subjects except in OF with G and R noises. In all cases, men provided significantly more important HR responses to noise than women did, indicated by increase in HR, whatever the age. Significantly different HR responses to the different noises were produced by YM and OM. As to the importance of the HR responses induced by them (from the most important to the lesser), noises rank as follows: T, P, G, and R.(ABSTRACT TRUNCATED AT 250 WORDS)

Cardiovascular effects of impulse noise, road traffic noise, and intermittent pink noise at LAeq = 75 dB, as a function of sex, age, and level of anxiety: a comparative study. II. Digital pulse level and blood pressure data.

In a previous paper, in which the experimental conditions of the present research are fully described (Parrot et al., this issue), heart rate (HR) was studied in 60 male and in 60 female subjects in response to a pile-driver noise (P), a gunfire noise (G), a road traffic noise (T), and an intermittent pink noise (R), all noises being emitted at the same LAeq = 75 dB for 15 min. Digital pulse level (PL) responses were concomitantly surveyed by the use of pulse oximetry, allowing continuous arterial oxygen saturation (SaO2) readings. An index of pulse reactivity (PRI) could be calculated. Arterial blood pressure was measured 7 times from the beginning to the end of each trial. At rest, within the last minutes preceding each exposure to any of the 4 noises, no difference for conditions or for age in prestimulus PL was observed. In all cases, sex is a highly significant source of variation: Mean resting SaO2 values are higher in women than in men. Mean SaO2 at rest was also found to be significantly higher in anxious (Am) than in anxiety-free (Nm) men. When the noise was on for 15 min, increase in PL prevailed to be in most cases in men. In contrast, decrease or near-zero changes prevailed in 1 case out of 2 in the female subgroups. In all groups, the mean PRIs are significantly higher in men. In no case did the age factor prove to be a significant source of PRI variation.(ABSTRACT TRUNCATED AT 250 WORDS)

[Intraoperative colonic irrigation in emergency colorectal surgery]. / L'irrigation colique per-opératoire en chirurgie colo-rectale d'urgence.

Bowel preparation is frequently impossible in various acute colonic diseases, such as left-sided colonic obstruction. The goal of intraoperative colonic irrigation is to obtain, during surgery, a bowel preparation offering the possibility of primary resection with immediate anastomosis, when pre-operative bowel preparation has not been feasible. Technical aspects of intra-operative colonic irrigation are described. Indications for this method are presented: left-sided obstructing carcinomas, diverticulitis, more rarely inflammatory stenosis or functional obstruction.

[Therapeutic problems caused by rupture of large hepatic adenoma with central location. Apropos of 3 cases]. / Problèmes thérapeutiques liés aux ruptures de volumineux adénomes hépatiques de siège central. A propos de 3 observations.

We report three cases of young female patients (26, 30, 36 years) with intraperitoneal hemorrhage associated with a rupture of a liver cell adenoma. Their topography was central or with central extension. Three patients had taken oral contraceptives, for a period of 10 years, before diagnosis in two cases and for only three weeks in the remaining patient. The diagnosis of hemoperitoneum from a liver tumor was established on initial symptoms and ultra sonographic examination. Angiography and CT were the most valuable investigations. The control of hemorrhage was obtained by hepatic artery ligation (2 cases) and angiographic embolization (1 case). We observed one patient with liver adenomatosis, uncommon lesion consisting of numerous adenomas in an otherwise normal hepatic parenchyma. In emergency major hepatic resection for an adenoma, in central localization, is too a high risk procedure for a benign tumor. Control of hemorrhage should be the aim of treatment, best achieved by alternative treatment, such as hepatic artery ligation of angiographic embolization, highly effective in our experience. Resection may be delayed for a residual tumor.

[Mechanical obstruction of the duodenum after surgery of the abdominal aorta]. / Occlusions mécaniques du duodénum après chirurgie de l'aorte abdominale.

The authors report two cases of duodenal obstruction occurring after insertion of an aorto-iliac prosthesis. This form of mechanical obstruction is much rare than the other forms of post-operative mechanical intestinal obstruction. While the need for surgery is often evident, precise diagnosis before the procedure is seldom obtained. CT scan appears to be the investigation of choice. This complication could be prevented by an epiploplasty covering the graft implant region.

Retrograde dissections of the aortic arch after exclusion-bypass of the descending thoracic aorta: a report of three cases.

We report three cases of fatal retrograde dissection of the aortic arch after exclusion-bypass with metal clamps according to Carpentier's thromboexclusion method. All three patients were male, aged 59, 66, and 73 years. Initial operative indications were chronic dissections in two cases and atheromatous aneurysm of the descending thoracic aorta in the other. Two of these patients were operated on in an emergency setting for a ruptured aneurysm. In all three cases, an extraanatomic bypass between the ascending aorta and abdominal aorta was performed as the first step: The proximal clamp was then placed distal to the origin of the left subclavian artery. Death occurred two hours, 12 hours, and eight days after operation, respectively. Autopsy revealed retrograde dissection initiating in the aortic arch and reaching the aortic ring as the cause of death. Pathological examination of aortic specimens confirmed that the dissections began just proximal to the site of clamping. To explain this complication, two etiologic factors, occurring either alone or together, have been postulated: postoperative hypertension and trauma to the aortic wall from the clamp.