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H S Hirsch

Publications and source records attributed to H S Hirsch.

3 recordsLinked to original sources

Temporal dynamics of pitch strength in regular-interval noises: effect of listening region and an auditory model.

Recently, it was demonstrated that the pitch strength of a stimulus denoted "AABB" differed from rippled noise (RN) despite the fact that their long-term spectra and autocorrelation functions are identical (Wiegrebe et al., 1998). Rippled noise is generated by adding a delayed copy of Gaussian noise back to itself; AABB is generated by concatenating equal-duration, Gaussian-noise segments where every segment is repeated once. It was shown that a simple model based on a two-stage integration process separated by a nonlinear transformation explains the pitch-strength differences quantitatively. Here, we investigate how the spectral listening region influences pitch-strength differences between RN and AABB. Bandpass filtering the two stimuli with a constant bandwidth of 1 kHz revealed a systematic effect of center frequency. For relatively high pitches (corresponding to delays, d, of 4 or 5.6 ms, pitch strength differences between AABB and RN were absent when the pass band was between 0 and 1 kHz. When the pass band was between 3.5 and 4.5 kHz, pitch-strength differences were substantial. For lower pitches (d equal to or longer than 8 ms), AABB had a substantially greater pitch strength independent of the filter center frequency. The model presented in Wiegrebe et al. (1998) cannot capture these effects of center frequency. Here, it is demonstrated that it is possible to simulate the RN-AABB pitch-strength differences, and the effect of listening region, with a computer model of the auditory periphery. It is shown that, in an auditory model, pitch-strength differences are introduced by the nonlinear transformation possibly associated with half-wave rectification or mechanoelectrical transduction. In this experimental context, however, the nonlinearity has perceptual relevance only when the differences in short-term fluctuations of AABB and RN are preserved in auditory-filter outputs. The current experiments relate the purely functional model introduced in the preceding paper to basic properties of the peripheral auditory system. The implication for neural time constants of pitch processing is discussed.

Adult↗

Total joint replacement: a cost-effective procedure for the 1990s.

Total hip and knee replacement have been shown to be beneficial procedures not only by traditional clinical studies but by modern outcome measures as well. The cost-effectiveness of total joint arthroplasty compares favorably with non-surgical treatments for patients with advanced arthritis of the hip and knee. While cooperation is necessary among all participants in the health care system to provide total joint replacement in a cost-efficient manner, dramatically short lengths of hospitalization and limitation of surgical implant selection are unlikely to provide any real cost savings. Total hip and knee replacement as currently performed will continue to offer cost-effective relief to patients with advanced arthritis of their major weight-bearing joints.

Arthroplasty, Replacement, Hip↗

The posterior cruciate ligament in total knee surgery. Save, sacrifice, or substitute?

To determine the role of the posterior cruciate ligament in total knee arthroplasty, 242 consecutive primary total knee arthroplasties were included in 1 of 3 sequential groups. Group I included 77 Press Fit Condylar total knee replacements in which the posterior cruciate ligament was completely released from its tibial attachment. In Group II, there were 80 Press Fit Condylar total knee replacements in which the posterior cruciate ligament was retained. Group III consisted of 85 total knee replacements with a posterior cruciate-substituting device (Insall-Burstein II). All patients were observed at least 2 years and evaluated by the Knee Society's Clinical and Functional Scoring System, including a radiographic evaluation. No differences were found between the posterior cruciate ligament sacrificed group and the posterior cruciate ligament preserved group. The 1 significant difference among the 3 groups was in range of motion (ROM). Groups I and II averaged 103 degrees and 104 degrees motion respectively, whereas Group III, the posterior cruciate-substituting group, averaged 112 degrees (p = 0.001). In addition, only in Group III was the lower 95% confidence limit of the mean ROM > 90 degrees. These findings suggest that preserving the posterior cruciate ligament does not consistently lead to improved functional ROM. The posterior cruciate ligament-substituting device historically has demonstrated excellent survivorship and appears to offer greater ROM.

Adult↗