The recovery process of a Japanese-Chinese bilingual aphasic adult who had immigrated from China was investigated. The patient, a 48-year-old male, was born in Japan and immigrated into the north part of China at 3 years old. Until the age of eight the patient had spoken Japanese. After world war II, he had lived with a Chinese foster family where he learned Chinese. When the patient was 35 years old, he returned to Japan and relearned Japanese by studying at elementary school for one year. After relearning Japanese the patient managed restraunt for 10 years and had no difficulty in conversation with Japanese customers. At the age of 48, the patient suffered from a stroke which resulted in severe motor aphasia for both Japanese and Chinese language. After several months, both languages were recovered somewhat, with greater improvement in the use of Chinese. The auditory comprehension and reading ability of Chinesecharacters (kanji) recovered moderately. Recovery of Japanese character reading was poor. The recovery of spoken and written language was very poor in both languages. Auditory comprehension of spoken words was tested in four categories : food, vehicle, fruit and daily necessities. The patient evidenced the greatest comprehension in food, which included use of language related to his restraunt occupation.

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     A case review of prosopagnosia was carried out. One hundred and fourteen cases, eighty five males and twenty nine females, satisfied the definition of prosopagnosia. Incidence of different etiologies, visual field defect, accompanied neuropsychological symptoms, and anatomical findings were analysed as a function of sex.
Significant differneces were found in incidence of strokes in male and female prosopagnostics (55% versus 19%, X²=7.00, P<0.01). In additon, female prosopagnostics were significantly more often accompanied by impaired recognition of unknown faces than male prosopagnostics (X²=4.94, P<0.05). While female prosopagnostics had only one and half times more frequently left homonymous hemianopsias than right ones, male prosopagnostic had six times more frequently. High incidence of strokes in male patients supports the theory of male vulnerability to strokes in visual associative cortex. On the other hand, frequent association of prosopagnosia with impaired recognition of unknown face and bilateral distribution of hemianopsia in female patients suggests different lateralization of functions underlying facial recognition in males and females.

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     The long-term progress of a case of word deafness with severe jargon aphasia was reported. The patient was a 34-year-old right-handed man who suffered a serious fall in 1982 which left him unconscious. The hematoma was evacuated immediately. A CT scan demonstrated a lowdensity area in the left superior temporal gyrus, middle temporal gyrus, middle frontal gyrus and hydrocephalus. After 24 months post-onset the patient came to our clinic for the first time, at which time he had no word comprehension. Speech audiometry of both ears revealed that patient was unable to discriminate any monosyllabic words. Pure tone audiometry revealed normal range in the left ear. Ambient sound recognition was comparatively preserved. Reading aloud and understanding of letters were only moderately impaired.
    After combined lip-reading and aural training for 1 year, the patient's auditory comprehension recovered from 20% to 85%. His listening score recovered from 0% to 40%. Next word-finding therapy was begun. Results showed a marked improvement in his word-finding score.
    From this case it is suggested that word deafness shows qualitative recovery over a long period. Some patients with word deafness associated with aphasia show improved lip-reading ability.
    It must be emphasized that long-term training may be necessary for some young adult cases.

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     We reported a case of transcortical mixed aphasia due to subcortical hemorrhage from arterio-venous malformation in the left parietooccipital lobe. The subject was a 28-year-old righthanded man admitted to our hospital because of sudden onset of consciousness disturbance. CT scan revealed a hematoma in the subcortical area of the left parietooccipital lobe. Removal of the nidus and hematoma was performed by emergency operation. By 3 weeks after the operation, the patient was alert and had no paresis. Howeves, he suffered right homogenous hemianopia and aphasia. His spontaneous speech was remarkably reduced, and he often had echolalia. His object naming, word fluency, verbal comprehension, reading and writing were all severely disturbed. This contrasted with full preservation of repetition of phonemes and sentences (5~6 words). CT scan 2 months later revealed a lesion in the left parietooccipital lobe. In the CBF (cerebral blood flow) study, xenon-enhanced CT showed a low-flow area in the entire left hemisphere except for the left perisylvian speech areas. We thereby concluded from the clinicoanatomical point of view that the transcortical mixed aphasia may be caused by isolation of the perisylvian speech areas due to disconnecion from surrounding areas.

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     In order to learn how unilateral brain damage influences recognition of emotional facial expressions, we administered three studies : (1) discrimination tasks for emotional faces and for meaningless figures, for normals, a left-brain-damaged (LBD) group and a right-brain-damaged (RBD) group ; (2) a comprehension task and naming task for emotional faces by the RBD group ; (3) for our ward staff, an investigation to determine the RBD patients' apprehension of emotional messages in daily communication.
    Results showed that some RBD patients had difficulty with discrimination, comprehension and naming of emotional faces, and that RBD patients who had difficulty with discrimination of emotional faces may be unable to apprehend emotional messages in daily communication. These results suggest that RBD may cause- a deficit of recognition of emotion, and lead to specific communication impairment.

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    A 68 year-old right handed woman lived in Singapore for 17 years from the age of 9, and spoke Japanese with her family, and English at school. She was working at a trading company after her return to Japan at the age of 26. She usually spoke Japanese but her English was also fluent. She has been teaching English to high-school students since she retired from her company.
    In May 1988. the patient was admitted to our hospital because of the abrupt onset of speech loss. First, she was able to speak nothing but showed good understanding. As she recovered, her English speaking ability was always better than her Japanese. In the standard language test of aphasia, she showed good results with easy problems but as the complexity of the problems increased, her results worsened.
    Further investigations have been reported in Europe and America for polyglot aphasia. Three main recovery rules of polyglot aphasia have been reported. First, Ribot's theory that native language recovers fastest, second, Pitre's theory that familial factor is the most important and third, Minkowsky's theory that language recovers when emotional factors are present. In our case the progress of the recovery process was different compared with these rules of recovery of a polyglot aphasia in Europe and America, as her English recovered faster than her native language, and no familial or emotional factors were present.
    This result shows the possibility of a fundamental difference in the recovery process between Japanese aphasia and aphasia in Europe and America.

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     In this report, 97 operated cases out of a total of 107 cases of brain tunors including gliomas and meingiomas were studied in order to discuss aggravation and improvement of neuropsychological symptoms before and after surgery. Results of neuropsychological evaluation were as follows : 1) With left frontal tumors, there were numerous cases in which improvement was revealed, probably due to reducation of perifocal edema. However, about half of the cases of this type revealed no improvement and the tumor invaded the speech area. 2) With left temporal tumors, there were many cases in which aggravation of language disturbances, especially writing, was observed. 3) On the other hand, with right hemisphere tumors, fewer cases were observed of speech disturbances before surgery. But with right temporal tumors, some cases revealed aggravation post-operation. 4) In no cases was there observed any improvement in cases of bilateral frontal tumore, especially were the tumor invaded the corpus-callosum, in which cases operations were generally incomplete in tumor removel. These results suggest that indication of surgery and range of tumor resection should be decided giving careful consideration to cases where the tumor invades the speech area, especially with left temporal tumors.

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