Faculty Bibliography

Professor [Raymond Dedonder] said that after months of fruitless negotiations with American officials over recognition of the institute's contributions to AIDS research and related commercial rights, the institute was suing to have its ''rights recognized in the name of the scientific ethic.'' ''They didn't receive a patent because they didn't have a working blood test,'' Dr. [Robert Gallo] said. Professor Dedonder asserted that in filing for the patent on the blood test, Dr. Gallo's team of researchers ''did not even give any citation of the work done by the French scientists.''

Now, on returning to Africa as a medical reporter for The New York Times, I am reminded of what I often heard on my first trip: ''Africa always offers something new.'' And indeed, a new menace, AIDS, confronts much of the continent now. If the number of cases continues to rise unabated, and if effective preventions and treatments are not found soon, AIDS might become as much of a scourge in Africa as smallpox once was. Shortages of the technology that American and other Western doctors consider indispensible to their practice is evident throughout Africa. Dr. Michael Cinnamond, a surgeon from Ireland returning as a visiting professor in Lusaka, asks Dr. K. Mukelabai, the dean of the University of Zambia Medical School, if two infants still share one incubator. ''Sometimes more,'' Dr. Mukelabai says. ''Things are not perfect.'' So far, a total of 15,172 cases have been reported in the United States. No one knows what the numbers of AIDS cases are in Africa. A physician who wanted to measure the impact of AIDS where he practiced in Africa said he had considered having his team examine each patient in his hospital on one day, then having doctors in Europe test a blood specimen from each patient. But the doctor did not carry out the plan, he said, because he was ''too frightened, and preferred not to know what is going on.''

Generally forgotten today is Dr. [Moriz Kaposi]'s description of an ''8- to 10-year-old boy from Zurich'' who died within a year of the development of skin lesions. Dr. Kaposi suspected the child was afflicted with Kaposi's. And several experts on this cancer interviewed were astonished to learn of Dr. Kaposi's original descriptions of the rapid course of the disease and of his mention of the child as being a victim. Drug Treatments That Don't Work There may be no more dramatic way of observing the change in Kaposi's sarcoma in Africa than through the experience of Dr. [Anne C. Bayley] of University Teaching Hospital, who seems to carry on a kind of missionary spirit that she says motivated her to go to medical school. She has seen most cases of the disease treated at the hospital. In 1982, when she read the first reports of untreatable Kaposi's sarcoma in AIDS patients in the United States, she said she was startled. The reports did not make sense, she told herself: ''This isn't the Kaposi's sarcoma I see in [Lusaka]. Don't the Americans know how to treat it? I can get rid of Kaposi's. They must be using the wrong drugs.'' As the months went on, colleagues baffled by the deteriorating condition of several patients asked her: ''Why are they so ill?'' In many, Dr. Bayley found evidence of Kaposi's sarcoma or AIDS. Now, she notes, that question is ''almost the diagnostic feature.''

Yet the frequency of the presence of the AIDS virus in blood donors makes it ''imperative'' that African countries develop a strategy for a safe and reliable blood bank system, Dr. [J. Desmyter] said. With rare exception, donor blood in Africa is not tested for evidence of the AIDS virus, a process that demands expertise and technology that many countries cannot afford. ''If we are concerned about the public health of the peoples in Africa and all over the world, we cannot pretend that AIDS is not here,'' Dr. [Robin Weiss] said, ''and any individuals or countries that hope that by ignoring AIDS it will go away would be putting their people to hostage and suffering.'' The African group also urged that scientists who have reported high rates of infection among certain tribes and areas in African countries should correct their reports because many of the test results reflected ''a high false positivity rate.'' The reports, the Africans contended, give the impression that Africa is suffering ''an alarming epidemic'' of AIDS

[Robert Gallo] has written that other members of the retrovirus family to which the AIDS virus belongs originated in Africa. Retroviruses are so named because they reverse some normal cell-construction processes. He said he 'could not conceive of AIDS coming from elsewhere into Africa.' [William A. Haseltine] has testified before Congress that, as well as can be determined now, AIDS 'began about 20 years ago' and 'we now know that a spread of the disease in the United States and Europe was preceded by a massive spread of disease in Central Africa.' He made the point on the basis of extrapolation from various scientific articles, not from direct evidence. Although now predominant among American and European researchers, the idea that AIDS began in Africa is by no means universal among them. Dr. Peter Piot, professor of microbiology at the Institute of Tropical Medicine in Antwerp, Belgium, says it is not certain where the disease started and that proving Africa as the place of origin would be difficult. [Robert J. Biggar] headed another team of American and Kenyan scientists who reported finding evidence of the AIDS virus in widely varying percentages among six distinctly different regions of Kenya. The frequency was highest, at 50 per cent of 99 samples, among the Turkana people living in the remote areas of northern Kenya where little if any AIDS has been reported. The frequency was lowest, at 8 per cent of 99 samples, among the Masai. Over all, 22 of the 592 samples showed evidence of the AIDS virus. Finding an effective treatment, if not a cure, and a way to prevent AIDS unquestionably are high priorities for scientists. Though finding the origin of AIDS may contribute to this quest, nearly all those interviewed in Africa said they had given more thought to the cases they might have missed than to speculation about origin. 'AIDS is the talk of the town,' said Dr. Evarist Njelesani, who directs medical services in the Zambian Ministry of Health in Lusaka. He added that he could recall a few cases that now appear to have been AIDS that occurred in Ndola where he worked in 1981 and 1982

Dr. G. Hunsmann and three other doctors who work in Gottingen, West Germany and Ndola, Zambia reported last month in a British medical journal, The Lancet, on tests of 4,000 Africans in seven countries. ''It would seem that the epidemic of AIDS in Africa started at about the same time as, or even later than, the epidemics in America and Europe,'' they said. ''Our results do not support the hypothesis that HTLV-III virus originated in Africa.'' Finding an effective treatment, if not a cure, and a way to prevent AIDS unquestionably are high priorities for scientists. Though finding the origin of AIDS may contribute to this quest, nearly all those interviewed in Africa said they had given more thought to the cases they might have missed than to speculation about origin. 'AIDS Is the Talk Of the Town' ''AIDS is the talk of the town,'' said Dr. Evarist Njelesani, who directs medical services in the Zambian Ministry of Health in Lusaka. He added that he could recall a few cases that now appear to have been AIDS that occurred in Ndola where he worked in 1981 and 1982. ''We have lots of priorities within Africa and our highest is to learn where the disease is there,'' Dr. Assaad went on. ''To study in real depth where the disease started is a low priority in the W.H.O. program but is a fit subject for individual scientists. The only thing we know for sure about AIDS is that the disease as described by C.D.C. appeared nearly simultaneously in the United States, the Caribbean, and Africa.''

In another study, prepared earlier and being published in the United States in The Journal of the American Medical Association, several Belgian physicians working in Rwanda and Belgium together with American scientists from the National Cancer Institute in Bethesda, Md., also reported finding high incidence evidence of AIDS infection among prostitutes; they said they found the virus in 80 percent of a group of 84 prostitutes surveyed in Rwanda. The scientists concluded that ''female prostitutes are highly susceptible to infections'' with the AIDS virus and ''could be an important reservoir of the AIDS agent among the heterosexual population of central Africa.'' In a study of 90 prostitutes in Kenya by a team of Kenyan, American and Canadian doctors 49, or 54 percent, were infected by the AIDS virus and more than three-fourths of these women had evidence of significant illness such as swollen lymph nodes throughout their bodies. The figure for the prostitutes compared with 3, or 9 percent, of 35 sexually active men who attended a medical clinic and two, or 5 percent, of 42 medical personnel who served as a comparison group for study purposes. Number of AIDS Cases May Be Much Higher The figures cited for AIDS cases in Rwanda, as in other African countries, must be regarded as minimal because not all AIDS victims seek medical treatment; physicians do not recognize all cases of AIDS as such; intensive care units either do not exist or rarely meet American standards; few autopsies are performed in most African countries; most doctors in Africa have less chance to compare notes with their colleagues practicing elsewhere, even in the same country; and it is difficult to keep up with medical advances because American and European scientific journals do not circulate widely in Africa. Some other studies have found about 10 percent of healthy adults in parts of central Africa, including areas of Rwanda, Zaire, Zambia and Uganda, to have AIDS virus antibodies in their blood, a sign of probable ongoing infection with the virus. These studies, cited the Journal of the American Medical Association, also have found that ''heterosexual contact is probably the predominant mode of transmission of the AIDS agent'' in Africa, and that AIDS patients here are far more likely than others to have a history of multiple heterosexual partners and visits to prostitutes

To Dr. [Peter Greenwald], the problem is akin to the one that cancer researchers faced three decades ago when they developed chemotherapy programs. ''We don't have full information about what population groups are most likely to benefit or not, so we pick out high risk groups like'' that in China, Dr. Greenwald said. As more dietary factors and compounds are identified in laboratory and animal experiments as potentially effective against cancer, researchers can expect to narrow their focus and better fashion such studies. But for now, Dr. Greenwald said, much of the selection process in dietary preventions of cancer reflects a kind of informed guesswork. In the meantime, he said, ''If only one or two studies come out positive it would be a very big step forward.'' ''I'd be surprised,'' Dr. Greenwald said.

In his library research, [Johnson L. Thistle] noted that MTBE remains liquid in the body. He first tested the effects of MTBE by dissolving gallstones in test tubes. Then he implanted multiple human gallstones in a dog's gallbladder and tested the speed with which the ether solvent dissolved them. So Thistle enlisted the aid of Dr. Gerald R. May, a radiologist at the Mayo Clinic, to do his first human experiment in March 1983. The patient was a 64-year-old woman who refused surgery. With the MTBE therapy her gallstones dissolved in seven hours. Since then, Mayo Clinic officials have approved the therapy as an investigational procedure. When a person with gallstones is referred to Thistle for the new dissolution therapy, the doctor first determines if the gallstones are causing the symptoms the patient has, and, if so, how severe they are. Many people who have gallstones also have symptoms of belching, nausea, and intolerance to fatty foods, but these symptoms and gallstones may be unrelated

The findings were the first concerning a Jarvik-7 removed from a patient who had suffered strokes while being sustained by the device, and they have caused researchers to rethink the way the Jarvik-7 is snapped together inside the body. When a prototype of a revised design is ready, though, it is likely that humans again will have to try it experimentally. Although the artificial heart pioneers at the University of Utah implanted various models of the Jarvik-7 in more than 100 animals, strokes occurred in only three. In each case, they were caused by clumps of bacteria that had broken away from artificial hearts that had become infected, not by blood clots or bleeding. Dr. Don B. Olsen, head of the University of Utah artificial heart unit, said he had implanted artificial hearts in 15 calves, and ''none of those had blood clots.'' One reason that implants in animals did not identify blood clots as a major complication, Dr. Olsen said, is that the human blood system differs markedly from those of the calves, sheep and goats in which the device was tested. Some critics have suggested testing the device on primates, which have circulatory systems similar to those of humans, but that would involve redesigning the Jarvik-7 because it is too big to fit in primate chests. Experiments on primates also might come under attack by animal rights groups because the researchers would have to tie the animals to chairs so they would not yank out the hoses placed in their abdomens to carry the air that powers the device. In any event, primate tests would be very costly, since the animals are expensive to buy and keep