[A 78-year-old woman who had an onset of seizure and right hemiparesis at the age 77]

We report a 78-year-old woman who had an onset of convulsion and right hemiparesis at the age 77. She had been well until October 28th of 1990 when she suddenly developed a seizure starting in her right face with secondary generalization. She was admitted to Saitama Kyodo Hospital where neurologic examination revealed confusion with slight right hemiparesis; deep reflexes were exaggerated on the right side; otherwise neurologic examination was unremarkable. Cranial CT scan revealed an iso-density mass in the left motor area with extensive edema extending into left anterior frontal as well as parietal regions; by contrast enhancement, a homogeneous enhancement of the tumor was noted. She was treated with glycerol and phenytoin, and she became alert two days after her admission. The diagnosis of metastatic brain tumor was entertained; extensive malignancy survey was performed, however, no primary tumor was found. As neurosurgical procedure was refused, she was discharged on December 16th of 1990. She noted worsening of her right hemiparesis in the end of February, 1991, and she was admitted again on March 18th of 1991. On neurologic examination, she was disoriented to time and place; she was apparently demented. Her right hemiparesis was more advanced and she was unable to walk. Her hospital course was complicated by disturbance of consciousness and pneumonia, and she died on August 22nd of 1991. The patient was discussed in a neurological CPC. Opinions were divided between meningioma and a metastatic brain tumor. Other possibilities raised included malignant lymphoma and glioblastoma multiforme. As edema was very extensive on CT, many participants thought that it might be a metastatic brain tumor.(ABSTRACT TRUNCATED AT 250 WORDS)

Carboplatin-based combination chemotherapy for testicular cancer: relationship among administration dose of carboplatin, renal function and myelosuppression

Carboplatin (CBDCA), a derivative of cis-diamminedichloroplatinum, has low renal and neural toxicity. The dose-limiting factor of this agent is myelosuppression. We experienced various degrees of myelosuppression, when the dose of CBDCA was determined by the body surface area (BSA) in CBDCA-based combination chemotherapy for testicular cancer. Calvert demonstrated that the dose of CBDCA administered should be adjusted by renal function, because CBDCA was excreted through the glomerulus. We report the relationship among 3 factors; the administration dose of CBDCA, renal function and the degree of myelosuppression. We treated 6 patients with testicular cancer. A total of 22 courses of CBDCA-based combination chemotherapy was performed. The area under the curve (AUC) was calculated by the following formula, which was demonstrated in Calvert's study. CBDCA dose = AUC x (GFR + 25), GFR; glomerular filtration rate. The degree of myelosuppression was examined. All chemotherapy courses were divided into 2 and 3 groups according to BSA and AUC, respectively. WBC and Plt reduction rates and nadir counts were significantly correlated with AUC, and showed no significant relationship to the dose determined by BSA. This study revealed that the degree of myelosuppression was closely related with AUC, which reflects the renal function.

[Does a tracheal bifurcation shift upward due to increased intraabdominal pressure during laparoscopic surgery?]

To evaluate the influence of increased intraabdominal pressure on a position of tracheal bifurcation, we measured the distance from the tracheal bifurcation to the tip of the endotracheal tube which is fixed on a patient's mouth during a laparoscopic surgery. The distance decreased from 3.5 +/- 1.9 to 3.1 +/- 1.9 cm (P < 0.05) at mean intraabdominal pressure of 8.7 mmHg. This result suggests that the ventilation may become difficult due to the occlusion of the tip of the endotracheal tube by a tracheal bifurcation or due to inadvertent single lung ventilation under inappropriately deep intubation.

Control of ciliary activities of Schistosoma mansoni miracidia using Triton-extracted parasites

Extraction with 0.04% (w/v) Triton X-100 for 3 min removed the cell membrane from the locomotory cilia of Schistosoma mansoni miracidia while leaving the motile apparatus apparently intact. Immediately after Triton-extracted miracidia were treated by the reactivating solution containing ATP and magnesium ions (Mg2+) at pH 8.1, nearly 100% of Triton-extracted miracidia showed the ciliary beating and swam forward in a manner resembling that of a normal miracidium. In the standard reactivating solution (2 mM ATP, 2 mM Mg2+, pH 8.1), Triton-extracted miracidia swam at a speed of 580 microns/sec; the comparable value for live miracidia in dechlorinated tap water was 2,200 microns/sec. The swimming velocity of Triton-extracted miracidia was dependent on ATP and Mg2+ concentration, pH, and salinity. In a solution containing 0.9% NaCl, Triton-extracted miracidia were not reactivated. Among the nucleotides tested, only ATP was found to induce a significant amount of ciliary motility. In terms of divalent cation specificity, only Mg2+ was capable of producing normal motility. Barium and calcium ions (at 0.5 mM CaCl2) also were capable of activating ciliary motility but were less effective stimulants than Mg2+. However, in 1 mM CaCl2, no ciliary reactivation was observed and cilia became detached from the body surface of the miracidia. Vanadium inhibited ATP-reactivated ciliary beating of Triton-extracted miracidia.

Response of truncated glucagon-like peptide-1 and gastric inhibitory polypeptide to glucose ingestion in non-insulin dependent diabetes mellitus. Effect of sulfonylurea therapy

Gastric inhibitory polypeptide (tGIP) and truncated glucagon like peptide-1 (GLP-1) are potent gastrointestinal insulinotropic factors (incretin), are most released after a meal or ingestion of glucose in man and animals. To investigate whether sulfonylurea (SU) affects the secretion of incretin, the modulation of plasma GIP and tGLP-1 levels following glucose ingestion in non-insulin-dependent diabetic type 2 patients with or without SU therapy was studied. A 75-G oral glucose tolerance test (OGTT) was carried out on 9 healthy subjects (controls) and 18 patients with non-obese type 2, 9 of whom were treated by diet alone (NIDDM-diet) and the other 9 with SU (glibenclamide 2.5 mg or gliclazide 40 mg) once a day (NIDDM-SU). Plasma GIP was measured by radioimmunoassay (RIA) with R65 antibody, and GLP-1 was measured by RIA with N-terminal-directed antiserum R1043 (GLP-1NT) and C-terminal-directed antiserum R2337 (GLP-1CT). Following OGTT, plasma glucose, GIP, GLP-1NT, and GLP-1CT in type 2 patients increased more markedly than in controls, despite the lower response of insulin. However, there were no significant differences in plasma levels of these peptides between the NIDDM-diet and NIDDM-SU groups. Therefore, it is unlikely that SU is involved in the high response of GIP and GLP-1s to OGTT in type 2 patients.

Dose response of plasma insulin and glucagon to intravenous n-butyrate infusion in sheep

n-Butyrate (0, 1, 2, 4, 8, 16, 32, and 64 mumol.kg BW-1.min-1) was infused i.v. for 30 min to investigate the physiological effects of n-butyrate on plasma insulin and glucagon responses in sheep. Blood n-butyrate concentrations during n-butyrate infusion increased (P < .01) with increasing infusion rates. At the greater infusion rates of n-butyrate, plasma glucose concentrations increased (P < .01) during infusion, and then they decreased (P < .05) to less than the preinfusion values. Plasma insulin concentrations increased (P < .01) dose-dependently during n-butyrate infusion at rates of > or = 2 mumol.kg BW-1.min-1. Plasma glucagon concentrations increased (P < .05) during n-butyrate infusion at rates of 32 and 64 mumol.kg BW-1.min-1. It is possible that, in sheep, n-butyrate may have a physiological role in controlling insulin secretion; however, it does not seem to have a role in glucagon secretion.

An adult case of lymphangiomatosis of the mediastinum, pulmonary interstitium and retroperitoneum complicated by chronic disseminated intravascular coagulation

Pulmonary lymphangiomatosis is a rare clinical and pathological entity which is distinct from lymphangiomyomatosis and from pulmonary lymphangiectasis. We report a case of a 20 year old man with diffuse lymphangiomatosis involving the mediastinum, lungs and retroperitoneum. The patient's intrathoracic lymphangiomatosis produced restrictive and obstructive impairment of his pulmonary function, but did not result in chylothorax or chylopericardium, which are two common manifestations of the disease. The patient's clinical course was remarkable for the concomitant development of chronic disseminated intravascular coagulation (DIC). Lymphangiomatosis involving both the mediastinum and pulmonary parenchyma is rare, and DIC is a very unusual complication of lymphangiomatosis.

[Two cases of superficial siderosis of the central nervous system. Findings of the cerebrospinal fluid, magnetic resonance imaging and positron emission tomography]

Two cases (case 1, a 45-year-old man; case 2, a 68-year-old man) of superficial siderosis of the central nervous system are presented. Main neurological symptoms were anosmia, sensorineural deafness, dysarthria, ataxia, and pyramidal tract signs. Lumbar puncture revealed bloody cerebrospinal fluid (CSF) in both cases. In case 1, the CSF became watery clear after administration of hemostatic medicines. T2-weighted magnetic resonance images showed cerebellar atrophy and marginal hypointensity of the brainstem, cerebellum, and the entire spinal cord. T2-weighted images of the cranial nerves showed hypointensity of the VIII nerves which were clinically impaired as compared with normointensity of the VII nerves which presented no clinical symptom. These findings may reflect difference in the degree of hemosiderin depostion between the VII and VIII nerves. While case 1 had a borderline score of WAIS-R (IQ79), case 2 showed overt dementia (performance IQ65). Positron emission tomography showed that cerebral blood flow and cerebral oxygen metabolism were reduced in the basal temporal lobes in both cases.

Genetic association of the very low density lipoprotein (VLDL) receptor gene with sporadic Alzheimer's disease

A specific isoform of apolipoprotein E has been associated with the accelerated rate of disease expression of sporadic Alzheimer's disease (AD) and late-onset familial AD (FAD). An earlier age at onset has also been demonstrated in familial AD patients with mutations in the amyloid precursor protein (APP) gene (APP717 and APP670/671)13 carrying the APOE epsilon-4 allele compared to those who do not, but not in familial AD patients with APP692 or 693 mutations, or in chromosome 14-linked familial AD patients. Hypothesizing that receptors for apoE-containing lipoproteins act as a potential risk factor for AD, we performed an association study using a polymorphic triplet (CGG) repeat in the gene for the VLDL receptor (VLDL-R), a receptor for apoE-containing lipoproteins. The frequency of the 5-repeat allele was significantly higher in all of the Japanese sporadic AD patients (P < 0.02) than in the Japanese controls. Moreover, the odds ratio was significantly increased in the AD patients homozygous for the 5-repeat allele (OR = 2.1, 95% CI = [1.1-4.2]). Multiple logistic regression analysis reveals that the relative risk conferred by the presence of two copies of the 5-repeat allele and at least one copy of the APOE epsilon-4 allele is 8.7 (95% CI = [2.9-25.8]). Our results suggest that the VLDL-R gene is a susceptibility gene for AD.

Surface-coil magnetic resonance imaging of the internal auditory canal and the inner ear. Preliminary report

Parasagittal surface-coil magnetic resonance imaging of the internal auditory canal and the inner ear was performed. We used T2-weighted fast spin-echo sequences to visualize the inner ear and the individual nerves in the internal auditory canal with high contrast in a short acquisition time. Computer-assisted quantitative measurement of the nerves was performed to estimate the cross-sectional areas and the diameters of the nerves. The average diameters of the facial nerve, the cochlear nerve, and the vestibular nerve of normal-hearing individuals were, respectively, 1.1 +/- 0.2 mm (mean +/- SD), 1.2 +/- 0.2 mm, and 1.5 +/- 0.2 mm. In the cerebellopontine angle, the average diameter of the eighth nerve was 1.8 +/- 0.2 mm. Two patients with unilateral and bilateral hearing loss were also presented. In the patient with unilateral deafness, the cochlear nerve of the diseased side was not identified and the eighth cranial nerve diameter was smaller than that of the normal side. In the patient with bilateral deafness, fibrosis of the inner ear and atrophy of the eight nerve were demonstrated in the ear with posttraumatic deafness. The present method may represent a new approach to the assessment of pathologic processes involving the inner ear and the nerves in the internal auditory canal.

Structural and thermotropic properties of calcium-dimyristoylphosphatidic acid complexes at acidic and neutral pH conditions

Two kinds of calcium-dimyristoylphosphatidic acid (DMPA) complexes at acidic and neutral pH conditions were prepared in the following ways. The complex at pH 4 was obtained by adding Ca2+ to DMPA dispersion in pure water. On the other hand, the complex at pH 7.4 was obtained by adding Ca2+ to DMPA dispersion in the presence of NaOH. The stoichiometries of Ca2+ ion to DMPA molecule are 0.5-0.67 and approximately 1 for the complexes at pH 4 and 7.4, respectively. Static x-ray diffraction shows that the hydrocarbon chains of the Ca(2+)-DMPA complex at pH 4 at 20 degrees C are more tightly packed than those of the complex at pH 7.4 at 20 degrees C. Furthermore, the complex at pH 4 at 20 degrees C gives rise to several reflections that might be related to the ordered arrangement of the Ca2+ ions. These results indicate that the structure of the complex at pH 4 is crystalline-like. In the differential scanning calorimetry (DSC) thermogram, the complex at pH 7.4 undergoes no phase transition in a temperature range between 30 and 80 degrees C. On the other hand, in the DSC thermogram for the complex at pH 4, a peak appears at 65.8 degrees C in the first heating scan. In the successive second heating scan, a transition peak appears at 63.5 degrees C. In connection with the DSC results, the structural changes associated with these phase transitions were studied with temperature-scan x-ray diffraction. In the first heating scan, although a peak appears at 65.80C in the DSC thermogram, the hydrocarbon chain packing gradually converts from an orthorhombic lattice to a hexagonal lattice near 52 degree C, and successively the chain melting phase transition occurs near 670C. In the second heating scan, the hydrocarbon chains are packed in a hexagonal lattice over the whole temperature range and the chain melting phase transition occurs near 63.5 degree C. Therefore,the Ca2+-DMPA complex at pH 4 has a metastable state. The metastable state transforms to a stable state by maintaining the complex at pH 4 for about 90 h at 200C.

Isolation, characterization and chromosomal mapping of an actin gene from the primitive red alga Cyanidioschyzon merolae

Based on the results of cytological studies, it has been assumed that Cyanidioschyzon merolae does not contain actin genes. However, Southern hybridization of C. merolae cell-nuclear DNA with a yeast actin-gene probe has been suggested the presence of an actin gene in the C. merolae genome. In the present study, an actin gene was isolated from a C. merolae genomic library using a yeast actin-gene probe. The C. merolae actin gene has no intron. The predicted actin is composed of 377 amino acids and has an estimated molecular mass of 42 003 Da. Southern hybridization indicated that the C. merolae genome contains only one actin gene. This gene is transcribed at a size of 2.4 kb. When Southern hybridization was performed with C. merolae chromosomes separated by pulsed-field gel electrophoresis, a band appeared on unseparated chromosomes XI and XII. A phylogenetic tree based on known eucaryote actin-gene sequences revealed that C. merolae diverged after the division of Protozoa, but before the division of Fungi, Animalia and Chlorophyta.

Experimental models for carcinogenesis in the house musk shrew, Suncus murinus, Insectivora

Animal carcinogenicity studies have mainly been performed on rodents. From the phylogenetic point of view, animals closer to humans must be included in these studies. Insectivora are considered to be the most primitive placental mammals and much closer to the early primates than rodents. Among the insectivora, the house musk shrew (Suncus murinus, family Soracidae), has been bred under laboratory condition. This animal is small having a short life span, and a comparatively low incidence of spontaneous tumor provides a useful animal model for tumor induction studies. We have examined the carcinogenicity of several chemicals known to produce tumors in rodents and found shrews, in general, to be sensitive to these chemicals but often showed different targets compared to rodents, and some chemicals tested were demonstrated not to be carcinogenic. Here we describe the carcinogenic studies performed in our laboratory and review other works including the occurrence of spontaneous tumors in shrews. Shrew carcinogenesis may fill up the gap of knowledge existing between the rodents and human beings.

Resistance against multiple plant viruses in plants mediated by a double stranded-RNA specific ribonuclease

Many plant viruses have single-stranded RNAs as their genomes. During the course of replication, genomic RNAs and their complementary template RNAs are likely to form double-stranded (ds) RNA at least transiently. To attack replication intermediates of many plant RNA viruses specifically, we introduced a yeast-derived ds-RNA specific RNase gene called pac 1 into plants. The transformed plants showed a decrease in lesion numbers when they were challenged with tomato mosaic virus, and a delay in the appearance of symptoms when inoculated with cucumber mosaic virus or potato virus Y.

Successful screening for early esophageal cancer in alcoholics using endoscopy and mucosa iodine staining

BACKGROUND

Epidemiologic studies have provided evidence that alcohol abuse is an important risk factor for esophageal carcinoma. However, no systematic screening program has been established yet in the early detection of esophageal cancer in high risk populations of heavy drinkers.

METHODS

A cohort of 629 male alcoholics (54 +/- 8 years old) were consecutively and systematically screened by endoscopy combined with iodine staining and targeted biopsy at the National Institute on Alcoholism (Kanagawa, Japan). For mucosal carcinomas, endoscopic esophageal mucosal resection (EEMR) was used to serve confirmatory diagnostic and therapeutic purposes.

RESULTS

Iodine-unstained lesions, distinctly demarcated, white, and 5 mm or larger in greatest dimension, were observed on the esophageal wall in 162 patients (25.8%). Thirty-six such unstained lesions in 21 of 629 patients, with an unexpectedly high rate of 3.3%, turned out to be squamous cell carcinomas of the superficial type. According to some established criteria, EEMR was performed in 17 of these patients, 3 of whom were given additional irradiation. Esophagectomy was performed in two patients, chemotherapy combined with irradiation in one, whereas still another was followed endoscopically. The cancer invasion was confined within the epithelium in eight patients, to the proper mucosal layer in nine, and to the submucosa in four. Multiple logistic regression revealed that the risks for distinct iodine-unstained lesions and superficial esophageal carcinoma increased independently for users of stronger alcoholic beverages, i.e., whiskey or shochu (odds ratio [OR] = 1.47 and 2.94, respectively) compared with lighter beverages, i.e., sake or beer and 30+ cigarettes/day (OR = 1.68 and 3.85, respectively).

CONCLUSION

Routine application of this program for these high risk individuals yielded an unusually high rate of detection of esophageal carcinoma.

Molecular cloning and expression of rat and mouse B61 gene: implications on organogenesis

ECK is a member of EPH receptor protein-tyrosine kinase subfamily and human B61 has been identified as the ligand for ECK recently. In order to better understand the roles of B61-ECK signalling pathway in mammalian development, we have cloned rat and mouse B61 cDNA and examined the expression pattern during rat development. Sequence analysis has revealed that there is a considerable degree of identity among rat, mouse and human B61 (98.0% between rat and mouse, 86.3% between rat and human in amino acid level). Examination of B61 mRNA expression by in situ hybridization analysis revealed tight association of B61 with endothelial cells at an early stage and epithelial cells in various tissues including lung, kidney, intestine, skin at later stage of organogenesis. In the developing skeletal system, B61 is expressed in periosteum, perichondrium and hypertrophic chondrocytes and osteoblasts. In the developing nervous system, expression of B61 is restricted in the neurons of dorsal root ganglia. These expression profiles of B61 in epithelial cells of various organs, developing skeletal system and dorsal root ganglia match those of ECK. Our data suggest that B61 plays pivotal roles in organogenesis, especially vasculogenesis/angiogenesis and epithelial cell proliferation/differentiation.

Results with the currently used cochlear implant

Over the past 7 years we have implanted the Nucleus multichannel cochlear implant in 60 patients with severe hearing impairment. The postoperative speech recognition of adult postlingually deaf patients was satisfactory. Adult prelingually deaf patients exhibited poorer speech perception than postlingually deaf patients. However, some patients showed better results than expected. The prelingually deaf patients needed a longer rehabilitation period than the postlingually deaf patients. There was considerable variation in performance among the prelingually deaf patients. As for juvenile deaf patients, some showed good speech perception ability, but postoperative rehabilitation took longer. The cooperation of doctors, audiologists, speech therapists, schoolteachers, and family members was essential, and the creation of a cochlear implant center for children is desirable to obtain better rehabilitation. On the questionnaire given to the cochlear implant patients, some complained about their hearing in a noisy environment or while listening to television or music. The present cochlear implant system obviously needs further improvement.

Surgical difficulties and postoperative problems associated with cochlear implants

Since 1987 we have implanted 60 severely hearing-impaired adults with the Nucleus Minisystem-22 cochlear implant. In most cases, the surgical procedures were performed with satisfactory results and very few postoperative problems. The complications associated with cochlear implant surgery include difficulty in drilling the ossified cochlea, electrode displacement, and insufficient insertion of the electrode. Postoperative problems include dizziness, tinnitus, facial nerve spasm, receiver-stimulator migration or extrusion, infection of the scalp flap, and facial nerve palsy. In most cases, these complaints did not develop into serious conditions.

Immunohistochemical detection of alpha 1-antitrypsin, alpha 1-antichymotrypsin, transferrin and ferritin in ameloblastoma

An immunohistochemical study was performed to investigate the presence of alpha-1-antitrypsin (alpha 1-AT), alpha-1-antichymotrypsin (alpha 1-ACT), transferrin and ferritin in 32 ameloblastomas and to evaluate the co-expression of these antibodies. Histologically, we recognized the following 6 patterns in the series of 32 ameloblastomas and at least 2 patterns in variable proportions were present in each of our cases: follicular pattern (21 cases, 66%), plexiform pattern (17 cases, 53%), cystic pattern (21 cases, 66%), acanthomatous pattern (10 cases, 31%), granular cell type (2 cases, 6%), and hyalinized stromal pattern (20 cases, 63%). Neoplastic epithelia of cystic pattern were divided into superficial cell, basal cell and whole layer to compare the immunohistochemical localization. The results made on the various patterns of ameloblastomas were as follows: (1) alpha 1-AT positivity in plexiform, cystic and hyalinized stromal patterns was significantly higher than that of alpha 1-ACT (P < 0.05). (2) The incidence of transferrin in follicular and plexiform patterns was markedly higher than that of ferritin in the same patterns (P < 0.025 and P < 0.01). Transferrin strongly stained metaplastic squamous cells of acanthomatous pattern and basal cells of cystic epithelium. (3) Granular cells reacted with transferrin and ferritin. (4) In follicular and acanthomatous patterns, coexpression of alpha 1-AT and alpha 1-ACT, alpha 1-AT and transferrin, or alpha 1-ACT and transferrin was higher than that of another combination. On the other hand, co-expression of alpha 1-AT and transferrin in plexiform and cystic patterns was higher than that of other antibodies. These results of co-expression of 4 antibodies used in the present study, suggest that the histogenesis of follicular and acanthomatous patterns is different from that of plexiform and cystic patterns.

Milk consumption decreases activity of human serum alkaline phosphatase: a cross-sectional study

Since the Japanese have not reached the recommended daily allowance (RDA) for calcium (600 mg), milk is recommended as a Ca-rich food to increase Ca intake and prevent osteoporosis in Japan. To determine whether milk consumption influences Ca/bone metabolism in the Ca-deficient population, relationships between milk consumption and serum alkaline phosphatase (Al-P) activity were analyzed in 3,098 premenopausal and 1,182 postmenopausal women and 13,141 men aged 30 to 69 years. Milk consumption was classified into no/yes groups by a self-administered questionnaire that asked "Do you drink a glass of milk (180 to 200 mL) or more everyday?". Regardless of age or sex, the "yes" group had a lower activity of serum Al-P than the "no" group. Milk consumption decreased the activity to a greater degree in women, especially perimenopausal/postmenopausal women, than in men. These results were confirmed in a multivariate analysis considering age, body mass index (BMI), and smoking and drinking habits as confounding factors. Although menopause obviously increased serum Al-P activity in perimenopausal women, it could not influence the effects of milk consumption on the activity. These results suggest that milk has osteostatic effects on humans via a mechanism different from that of estrogens. Milk consumption, even one glass per day, may be an easy and effective strategy for prevention of osteoporosis in the Ca-deficient population, especially perimenopausal/postmenopausal women.

Cortical activation during sound stimulation in cochlear implant users demonstrated by positron emission tomography

Three patients with prelingual deafness and six patients with postlingual deafness using multichannel cochlear implants were examined by positron emission tomography using 15O-labeled water. Changes in regional cerebral blood flow (rCBF) were measured during three different sound stimuli: 1) with no sound stimulation, with the speech processor of the cochlear implant system switched off, 2) hearing white noise, and 3) hearing sequential Japanese sentences. In postlingually deaf patients, speech stimulation caused a significantly greater rCBF increase compared with noise stimulation in the left immediate auditory association area and the bilateral auditory association areas. In these patients, speech sound is thought to be processed by means of auditory cortices analogous to those in normal subjects. In contrast, in prelingually deaf patients, speech sound induced much less rCBF increase in auditory association cortices; this finding suggested underdevelopment of the neural network for complex sound analysis and speech sound recognition.