Faculty Bibliography

[REAGAN], now 74, tolerated major surgery well four years ago when surgeons at George Washington University Hospital opened his chest and removed a bullet that had lodged near his heart after an assassination attempt. Since then, Reagan's doctors have repeatedly described his condition as excellent. Nevertheless, the operation comes as a surprise. It is needed because Reagan's doctors yesterday found a large polyp, probably of the villous adenoma type, while performing a standard medical procedure called a colonoscopy. The colonoscopy was done to remove a benign polyp in Reagan's colon, or large intestine, that was discovered last March, and also to look for other polyps. To physicians knowledgeable about intestinal polyps but not connected with Reagan's case, the fact that the polyp was too large to be removed during the colonoscopy suggested the possibility that it might be a sessile one, that is, attached directly to the intestinal wall at the base of the polyp and not attached by a stalk. If the polyp had been attached by a stalk to the intestinal wall, as many are, then it probably could have been removed by the snare in the colonoscope, no matter what its size

In removing a painless benign growth from President Reagan's colon tomorrow, his doctors at the Bethesda Naval Medical Center will be finishing a job they started earlier. Last year they removed a tiny benign polyp from the President's colon and last March they found another, the one that is to be removed. It was by using such a tube in routine medical checkups last year and last March that doctors detected a tiny polyp in Mr. Reagan's colon at each examination. A portion of each polyp was removed and subsequent pathological tests done with the aid of a microscope showed that both were benign, or noncancerous. In the most recent examination in March, doctors found evidence of blood in Mr. Reagan's stool. Additional tests were done after the President ate a meat-free diet for several days. These tests were done to determine whether the laboratory results had been so-called ''false positives'' as a result of blood in meat

Mr. [William J. Schroeder] is walking in the halls with assistance. Dr. William C. DeVries, the surgeon who heads the artificial heart implant program at the hospital, said yesterday that he believed Mr. Schroeder's speech was better than it had been before he moved to an apartment across the street from the hospital in April. Mr. [Murray P. Haydon] still requires assistance from the respirator for ''rare periods'' lasting ''only a few hours,'' Mrs. [Donna Hazle] said. But for the most part over the last four weeks he has been breathing without its help, she said. She described Dr. DeVries's team as happy about Mr. Haydon's progress and said no date had been set for him to move from the coronary care unit to a room elsewhere in the hospital

AT least 43 people died recently after eating a Mexican-style cheese containing the bacteria Listeria monocytogenes, one of the most mysterious of all microbes. The outbreak primarily affected California residents and is still under investigation. It highlights how much even the most sophisticated doctors have yet to learn about this microbe and all the others that cause the myriad infectious diseases. Many experts mistakenly believed that infectious diseases would no longer be important after the advent of antibiotics and immunizations. In reporting a recent outbreak of listeriosis involving 49 people in Massachusetts, Federal epidemiologists raised questions about the ability of pasteurization, even when properly carried out, to kill a large number of Listeria monocytogenes bacteria in contaminated raw milk. There are three general ways that milk can be contaminated. A cow infected with listeria or other micro-organisms may deliver contaminated milk. Or, if the cow has infected teats, the milk may be delivered sterile but becomes contaminated as a result of a milker's handling of the infected teats. Finally, contamination may occur at any point from the time it is pasteurized to the time it is drunk

Dr. James Livesay, the principal investigator, said in an interview that his team was using the laser technique as an experimental adjunct to coronary bypass surgery to increase blood flow through a larger area of the coronary arteries than would otherwise be possible. The coronary arteries are those that nourish the heart; damage due to arteriosclerosis leads to heart attacks. He said the team was carefully selecting patients for the laser technique. Such patients include those who have diffuse arteriosclerotic damage to their coronary arteries. In these cases, the laser can remove plaques in arteries that are too small to be bypassed by the conventional surgery; it can also remove large plaques that surgeons would otherwise have to excise with their fingers and scalpels

Although there is debate about the interpretation of the findings, one arthritis expert, Dr. Gerald Weissmann of New York University, said the researchers had made ''a real observation'' and ''it must be thought about seriously.'' Although the new report called the MRL/l model ''the best available animal model for human rheumatoid arthritis,'' some other researchers disagree. One, Dr. Ronald Wilder, who works with an induced animal model of rheumatoid arthritis at the National Institutes of Health in Bethesda, Md., said the Alabama group had ''clearly overstated the case'' for the MRL/l model. Nevertheless, Dr. Wilder called the MRL/l strain ''a valuable model for joint destruction'' and he said that there was an urgent need for experts to meet to evaluate the relative merits of different types of animal models for rheumatoid arthritis. ''No one model has all the features'' of rheumatoid arthritis and several models are needed, Dr. Wilder said

The scientists, led by Dr. Edward H. Kass at the Harvard Medical School and Brigham and Women's Hospital, found that two fibers contained in some tampons - polyester foam and polyacrylate rayon - have a powerful ability to absorb magnesium. Such a concentration of magnesium can enhance production of a bacterial toxin, TSST-1, for toxic shock syndrome toxin 1, that causes toxic shock syndrome. Further studies linked more cases of toxic shock syndrome to one brand of tampon, Rely, than to other brands, causing Procter & Gamble of Cincinnati, the manufacturer of Rely tampons, to remove the product from the market that year. Rely tampons were the only brand that included polyester foam, which Dr. Kass said was more powerful in binding magnesium than polyacrylate rayon. Polyacrylate rayon continued in use. In the course of its research, Dr. Kass's team began looking for clues to tampon-related toxic shock syndrome by exposing a broth that usually supports staphylococcal growth to the various fibers and other components of tampons and to whole tampons in the laboratory

Murray P. Haydon, who was described as the ''perfect'' candidate for the artificial heart when he received it Feb. 17, suffered a stroke late Monday night but made ''a dramatic recovery'' in the hours thereafter, his doctors said yesterday. ''If we get a good patient, we'll certainly do the patient right now'' and that the team would make it clear to future candidates that there is ''a high likelihood of a stroke,'' Dr. [William C. DeVries] said. He also said that a judgment could not be made on only five patients. ''We may not know the answer to this until we have done 100,'' Dr. DeVries said. Yesterday Dr. Gary Fox, a neurologist, said Mr. Haydon was about ''95 to 98 percent recovered'' from the effects of the stroke. ''He seems to be pretty much neurologically intact,'' Dr. Fox said

Mr. [Murray P. Haydon] needs the mechanical respirator ''only for reassurance purposes,'' Dr. [Allan M. Lansing] said, adding that the results of key tests measuring his respiratory function and the amounts of oxygen and carbon dioxide in his blood were ''excellent.'' ''He has gained a bit more movement in his right hand,'' the doctors said, and ''at times, Mr. [William J. Schroeder] is attempting to vocalize through one or two syllable words.'' ''We have no other explanation,'' Dr. Lansing said, discounting the possibility that the reaction was because of the mechanical heart. ''If so, we should have seen it long ago.''

In selecting a broadly based group, those chosen ''were not known to us as advocates of the artificial heart, and I was astounded by this strong endorsement,'' Dr. [Claude Lenfant] said. ''Therefore, we have to take it very seriously,'' he added. The committee urged more study of the ethics of how people would adjust to life on the devices. The quality of life on an artificial heart might seem ''more attractive despite its significant imperfections'' to those people who have been debilitated by chronic heart disease, and the adjustment might be more difficult for victims of acute heart attacks who ''with catstrophic suddenness'' find themselves living with such a device. The panelists said ''it may become appropriate to consider turning off the artificial heart even though the device is functioning well,'' explaining, ''At times the condition of the patient will be such that continued use of the device serves no useful purpose.''