I'm told the ESRB refused to rate this new trailer for Dead Space because of the gore. Considering that the ESRB seems to have become a non-goverment organization with governmental authority (like the American Medical Association), I take it this means the trailer is semi-officially banned in the U.S.? At least the EU allowed it.
Since the devs studied a ton of horror movies while making the game and because the game will include different types of scares, it's probably a safe bet that the music and audio will alternate in the game like in the trailer. At times, it will be loud and discordant. Other times, it will be soft and creepy. That's just a guess, though.
Anyway, refusing to rate something is like refusing to talk to someone. It's childish. It's a child's way of avoiding an issue, rather than confronting it and working your way through it. If that is what happened, the ESRB needs to grow up. But I suppose the ESRB might have just been overloaded by all the E3 trailers and such, and they knew this one would take time to debate. I try to give people the benefit of the doubt.
On another note, I've added two games to my watch list: Fallout 3 and Rise of the Argonauts. I decided to add Rise of the Argonauts after watching this interview. The devs talk about making a HUD unnecessary and ensuring that every skill and item is felt, rather than merely known.