Annoyance from industrial noise: indicators for a wide variety of industrial sources.

In the study of noises generated by industrial sources, one issue is the variety of industrial noise sources and consequently the complexity of noises generated. Therefore, characterizing the environmental impact of an industrial plant requires better understanding of the noise annoyance caused by industrial noise sources. To deal with the variety of industrial sources, the proposed approach is set up by type of spectral features and based on a perceptive typology of steady and permanent industrial noises comprising six categories. For each perceptive category, listening tests based on acoustical factors are performed on noise annoyance. Various indicators are necessary to predict noise annoyance due to various industrial noise sources. Depending on the spectral features of the industrial noise sources, noise annoyance indicators are thus assessed. In case of industrial noise sources without main spectral features such as broadband noise, noise annoyance is predicted by the A-weighted sound pressure level L(Aeq) or the loudness level L(N). For industrial noises with spectral components such as low-frequency noises with a main component at 100 Hz or noises with spectral components in middle frequencies, indicators are proposed here that allow good prediction of noise annoyance by taking into account spectral features.

Twelve-year experience with two courses of adjuvant single-agent carboplatin therapy for clinical stage I seminoma.

PURPOSE: During the past 30 years, radiation therapy with 28 to 30 Gy for para-aortic and ipsilateral iliac node areas was the standard adjuvant treatment for clinical stage I seminoma after orchiectomy. However, late effects of radiotherapy prompted a search for alternative adjuvant treatment approaches, including surveillance and application of carboplatin. In this retrospective analysis, we evaluated the efficacy and toxicity of two adjuvant single-agent carboplatin courses in 107 patients who were diagnosed with clinical stage I seminoma at our study centers between 1988 and 1999. PATIENTS AND METHODS: All 107 patients (median age, 39 years; range, 24 to 63 years) received two postoperative adjuvant cycles of carboplatin (400 mg/m(2)). The pathologic tumor stage was pT1 in 84 patients, pT2 in 18 patients, and pT3 in five patients. Whole blood count and serum chemistry were evaluated weekly during treatment to assess hematologic and nonhematologic toxicity. RESULTS: Six patients died from tumor-unrelated causes. The remaining 101 patients are currently alive and free of disease after a median follow-up of 74 months (range, 5 to 145 months). A detailed analysis of hematologic toxicity showed only World Health Organization (WHO) grade 1 leukocytopenia in 10.7% of all cycles and WHO grade 2 leukocytopenia in 2.1% of all cycles. CONCLUSION: Regarding the absence of tumor recurrences in our retrospective analysis and the favorable toxicity profile with no episodes of long-term toxicity, we suggest that two adjuvant courses of single-agent carboplatin for clinical stage I seminoma patients might be equivalent to radiotherapy.

[Is orthotopic ileal neobladder an acceptable form of urinary diversion from the viewpoint of the patient?]. / Stellt die orthotope Ileumneoblase eine für die Patienten akzeptable Form der Harnableitung dar?

In 19 patients with bladder cancer who required cystectomy, an orthotopic ileal bladder was created. The patients were followed up for an average of 36 months (12-60 months). In this study we present the early and late postoperative complications, the survival data, quality of life assessment, data from urodynamic investigations, metabolic changes and the situation in the upper tracts. Postoperative complications requiring reoperation occurred in 11% in the early postoperative and in 27.7% in the late postoperative phase. Two of 19 patients died from cancer 18 and 26 months after cystectomy. A further patient had an urethral recurrence and the cancer is progressing further. Questionnaires showed that 80% of our patients were satisfied with their new bladder. Eighty percent were continent during the day and at night. Stress incontinence (II-III) occurred in only 2 patients (12%). All patients were impotent, but in 5 SCAT therapy made intercourse possible. The metabolic acidosis required oral alkalization in 60%. Dilatation of the upper urinary tract was seen in 6% of the renal units. We conclude from our experience that an orthotopic ileal neobladder is an excellent method of urinary diversion after cystectomy.

[Carboplatin monotherapy in clinical stage I of seminoma. An acceptable alternative?]. / Carboplatinmonotherapie im klinischen Stadium I des Seminoms. Eine akzeptable Alternative?

Between 1/1990-8/1997 two courses of single agent Carboplatin had been given to 36 patients with clinical stage I seminoma. Within an median follow up period of 52 months (17-88) 29 out of 34 patients were analyzed retrospectively. During this period no recurrences had been noted and nobody of our patients died (0% relapsrate, 100% survival-rate). The Carboplatin-therapy was well tolerated. Myelosuppression after chemotherapy was mild (WHO grade I). The experienced acute toxic side effects (max. grade II WHO) during and after chemotherapy had been nausea (37%), vomiting (14%) and mild hairloss (11%). Until now no long term side effects were noticed. A standardized questionnaire had been used to evaluate the impairment of quality life after single agent carboplatin therapy. After a minimum of one year follow up averagly 79% (62-92%) of the asked patients showed no impairment of their quality of life, whereas 19% (8-38%) of the people experienced mild impairment of their quality of life. Because of the shown low recurrence rate, the minimal toxicity and no relevant impairment of the quality of life single agent carboplatin therapy will be an alternative approach for clinical stage I seminoma.