This article summarizes the era from when Paul Broca had first introduced his aphasia case study and theory in 1861 to clinical-neuroanatomical approach which was widely known until early twentieth century. The article also comprises the cognitive-neuropsychological approach which appeared after the cognitive revolution in 1956. It investigated and compared the definition, classification method and the primary research object of aphasia in the perspectives of clinical-neuroanatomical approach and cognitive-neuropsychological approach. Each approach has its own advantages and disadvantages. Therefore, it is inappropriate to only support for a certain approach but better if two approaches are incorporated together and used effectively in certain situations. In order for the best research and treatment for the aphasic patients, clinical practitioners who prefer clinical-neuroanotomical approach and researchers who prefer cognitive-neuropsychological approach should participate together to incorporate the two approaches.

OBJECTIVE: To develop Korean version of Frenchay Aphasia Screening Test (K-FAST) and to standardize K-FAST in normal adult population in Korea. METHOD: The 'river scene' of stimulus set in original version of FAST was adapted for K-FAST. English version of the test instructions and scoring methods were translated into Korean and reverse-translation was performed by English- Korean bilinguals. The test structures and language domains (comprehension, expression, reading, and writing) were unchanged and possible maximum score was 30 points. We standardized K-FAST in 240 normal adult populations (male 102, female 138) whose ages were above 44. Basic personal information was collected through an interview and we performed Edinburgh handedness inventory (EHI), K- MMSE and K-FAST. Subjects who had history of brain disease, cognitive communicative disorders, or K-MMSE scores less than 2 percentile of same age group were excluded. K-FAST scores were analyzed according to the age and education groups. RESULTS: Mean EHI, K-MMSE, and K-FAST scores in total subjects were 9.4+/-1.2, 25.9+/-2.8, 25.4+/-3.3 points, respectively. Post-hoc analysis of K-FAST scores according to age groups classified into 3 age groups, 45~64, 65~74, and > or =74 years and education groups into 0, 1~9, > or =10 years of total education. K-FAST scores decreased significantly as increase of age (r=-0.441, p=0.000) and decrease of total years of education (r=0.580, p=0.000). CONCLUSION: Newly adapted K-FAST can be used for screening of aphasia in Korea and the standardized data according to age and education levels may provide useful reference values for interpretation of the results of K-FAST.
Adult ; Aphasia ; Brain Diseases ; Communication Disorders ; Female ; Functional Laterality ; Humans ; Korea ; Mass Screening ; Reference Values ; Research Design ; Stroke

OBJECTIVE: To investigate whether the dual route model is applicable to Korean word reading in acquired dyslexia after stroke. METHOD: Sixty-two year old patient with dyslexia after left inferior temporal and occipital lobe infarct was evaluated according to the lexical processing. After evaluation of general cognitive and language function, visual perception, semantic, and lexical stages were assessed. RESULTS: Visual perception was appropriate, and semantic categorization and picture-word matching tasks were 80.6% and 78.6% correct, respectively. Lexical decision task showed no significant differences within word classes, except shorter reaction time in reading words of Korean origin than those of chinese origin (p <0.05). The patient was able to read only 39.8% of tested words, and he could not read all the non-words. Reading of high frequency word was superior (65.4%) to that of low frequency words (10.9%) and semantic errors were not remarkable (p <0.05). CONCLUSION: The patient showed characteristics of recovery from deep to phonologic dyslexia with impairment of grapheme to phoneme conversion (GPC) route. These findings support that dual route model is applicable to Korean word reading.
Asian Continental Ancestry Group ; Dyslexia ; Dyslexia, Acquired ; Humans ; Language Disorders ; Occipital Lobe ; Reaction Time ; Semantics ; Stroke* ; Visual Perception

Background: Tenofovir disoproxil fumarate (TDF)-induced nephrotoxicity is related to high plasma tenofovir concentrations. Tenofovir alafenamide (TAF) is a tenofovir prodrug with 90% lower plasma tenofovir concentrations. The aim of this study was to evaluate changes in tenofovir-induced nephrotoxicity in Human Immunodeficiency Virus (HIV)-positive patients who switched from TDF to TAF. Materials and Methods: We identified all HIV-positive patients who switched from elvitegravir/cobicistat/emtricitabine/TDF to elvitegravir/cobicistat/emtricitabine/TAF at a tertiary hospital. We assessed tubulopathy and renal dysfunction before TDF administration, at the time TAF was used following at least 3 months of TDF use, and 3 months after TAF administration. Tubulopathy was defined by the presence of at least three abnormalities in fractional excretion of phosphate, fractional excretion of uric acid, urinary β2-microglobulin, urinary N-acetyl-β-D-glucosaminidase, glucosuria or proteinuria. Renal dysfunction was defined as decreased by more than 25% in the estimated glomerular filtration rate (eGFR) relative to baseline. Results: In 80 patients, the mean eGFR was 96.8 mL/min/1.73 m 2 before administration of TDF, 81.2 (P <0.001) at the time of change to TAF, 90.9 (P <0.001) after TAF administration.Renal dysfunction occurred in 19 patients (23.8%) after TDF use for a median 15 months, 11 (57.9%) of these patients recovered from renal dysfunction after TAF administration.Six patients (7.5%) had tubulopathy before TDF administration, 36 (45.0%) after TDF administration (P <0.001), 12 (15.0%) after TAF administration (P = 0.002). Conclusion Tenofovir-induced nephrotoxicity in HIV-positive patients receiving TDF was mostly reversible after changing to TAF. Thus, TAF-containing regimens can be administered safely to HIV-positive patients with tenofovir-induced nephrotoxicity.