Faculty Bibliography

''I felt I was sure to get AIDS, sure I'd die from it,'' the young doctor recalls now. ''Then I assured myself that I was not the first person to stick himself and that no one else has gotten AIDS that way. Still, when I had a cold or wasn't feeling well, it was in the back of my mind.'' As I walked through the rooms I was reminded of a friend who is a medical student. She is apprehensive about dealing with AIDS patients, although she realizes the fear is probably irrational. What she does, she told me, is take on a role as an actress does, never letting the patient see her fear. ''It's not my place,'' she said , ''to add to their burden.'' Maybe the Bellevue doctor who stuck himself with the AIDS-contaminated needle put the risks in better perspective when he said, ''I'm even more apprehensive about someone with drug-resistant tuberculosis who coughs in my face than I am about touching a patient with AIDS.''

In the Jan. 6 issue of Science, being released today, the National Institutes of Health and the Davis researchers reported they had succeeded in transmitting simian AIDS from diseased rhesus monkeys to normal rhesus monkeys. They did it by injecting samples of whole blood or filtered plasma, a liquid portion of blood, into the monkeys. The new research extends earlier studies in which the researchers transmitted the disease from two animals at the Davis center to four rhesus monkeys at the Bethesda center. In those studies, the researchers used samples derived from organs of monkeys with simian AIDS and sent them from Davis to Bethesda for injection there. The new study also extends an experiment done earlier at the New England Primate Research Center in which macaques developed simian AIDS after inoculation with material derived from a lymphoma cancer in macaques. In the experiment, which was reported in the Sept. 10 issue of The Lancet, a British journal, a small number of macaques did not develop a lymphoma as had other macaques injected with similar material. The researchers said that they did not know why lymphomas developed in some animals and simian AIDS in others after inoculation with the material

turning out too many physicians? Is there an impending ''doctor glut?'' Will patients' lives be threatened by unnecessary treatment? If so, should some medical schools be closed? Which ones? Who decides? Now a medical leader who firmly believes in the threat of a ''doctor glut'' has proposed a drastic solution - government action. The proposal is one of the most direct, perhaps harshest and most difficult to implement fairly, and it was put forward the other day by Dr. James F. Glenn in his inauguration speech as president of the Mount Sinai Medical center. In his speech, Dr. Glenn called on public officials to help develop a policy to ration the education of physicians as one means of holding down the rocketing costs of health care. It was time, Dr. Glenn said, to provoke discussion about the issue among medical educators and the public officials who regulate health care and the licensing of physicians. Because different analyses yield different answers, many people are likely to agree with Dr. [Thomas C. Chalmers], the former president of Mount Sinai, in his belief that the ''doctor glut'' phenomenon had not been studied well enough. ''We need a lot more data,'' Dr. Chalmers said, to determine a variety of factors that could affect medical manpower, Dr. Chalmers said. What, for example, might happen if more doctors began working 40- hour weeks instead of the 60 to 80 that are now customary for so many?

The theory behind the immunization experiment is simple enough: The vaccine is known to prevent hepatitis B in more than 95 per cent of the recipients. Therefore, wide use of the vaccine should reduce hepatitis B infection to very low levels, preventing in most cases both the acute and chronic forms of hepatitis. If, as certainly seems to be the case, hepatitis B is a necessary prerequisite of most cases of hepatocellular carcinoma, the vaccine may ultimately block the development of the cancer

The substance previously found in the brains of victims of degenerative disorders such as kuru, Creutzfeldt- Jakob disease and Alzheimer's disease is amyloid, which until now most doctors considered simple waste products. The amount of amyloid present in Alzheimer's disease appears to be roughly correlated with severity of the symptoms. Dr. Stanley B. Prusiner, who headed the seven-member research team, said in an interview: ''It is an astounding finding because we never would have dreamed that amyloid and prions were the same. The implications of the findings may be enormous.'' The researchers concluded that the clumps of prion rods and amyloid deposits were indistinguishable in many respects. But because there were some differences when the researchers looked at electron microphotographs of amyloid and the clumps of prion rods, they said the possibility that something other than prions might form the amyloid deposits could not be excluded. Chemical tests are planned to clear up the confusion

The vaccine being used in the experiment, one developed for use against hepatitis B, is already known to be effective in preventing this seriously disabling and often fatal liver infection. But the vaccine is believed to be effective, too, in preventing the chronic liver disease that can follow hepatitis B infection. The theory behind the immunization experiment is simple enough: The vaccine is known to prevent hepatitis B in more than 95 percent of the recipients. Therefore wide use of the vaccine should reduce hepatitis B infection to very low levels, preventing in most cases both the acute and chronic forms of hepatitis. If, as certainly seems to be the case, hepatitis B is a necessary prerequisite of hepatocellular carcinoma, the vaccine should ultimately block the development of the cancer. In this country both hepatocellular carcinoma and hepatitis B are rare. The situation is presumed to be related to comparatively high levels of sanitation and hygiene, which help control the spread of hepatitis B. The relative rarity of hepatocellular carcinoma in this country is believed to reflect the lack of hepatitis B here

Dr. [Walter Dowdle] emphasized that the new findings that emerged from that meeting should not be greeted with undue alarm. ''AIDS is not a mysterious disease that is going to sweep the whole world,'' he said. ''It is increasing, but not at a rate alarming for the general public.'' Have AIDS cases been diagnosed in the Soviet Union and Eastern Europe and the reports been suppressed? Participants interviewed said they did not know the answer. Some speculated that the incidence of AIDS in the Soviet bloc countries might be truly low, because travel restrictions limit the opportunity for exposure to outsiders who might pass on the disease. The 2,753 AIDS cases reported from the United States make it the country with by far the largest reported incidence of the disease. However, recent health statistics from New York have hinted that the so-called ''doubling phenomenon,'' in which the number of new cases doubles about every six months, may be easing off. ''What this means, we're really not sure,'' Dr. Dowdle said. ''But we certainly hope it means something.'' In 1960, three doctors from the Manchester Royal Infirmary reported in The Lancet the case of a 25- year-old man who had been ill with various infections since 1957. From retrospective reasoning, it now appears, he could have had AIDS. In a letter in The Lancet of Nov. 12, 1983, the same doctors called attention to their earlier report. ''Perhaps AIDS is not a new disease,'' they wrote. ''Rare examples may in the past have masqueraded under various diagnoses.''

One such danger is the blockage of blood flow by large plaques, depriving the heart, brain and other organs of oxygen and other vital nourishment. Another is that pieces of the plaques in an artery in one part of the body can break off, float through the blood and lodge in arteries elsewhere, blocking the flow of blood. Strokes result if the starved cells are in the brain, and gangrene develops if the dead cells are in the leg, for example. Such studies, he said, might focus more on the femoral and carotid arteries, the main arteries to the legs and brain respectively. Because these arteries are in more easily accessible areas of the body, changes in the size of the plaques are easier to document in them than in the arteries of the heart. ''Resolving the fate of the fatty streak and the origin of the plaque is the major current issue'' in studying the development of arteriosclerosis, Dr. [Henry C. McGill Jr.] said

The protein is called T.P.A., for tissue plasminogen activator, because it stimulates the body's blood system to dissolve clots. Blood clots are believed to set off many heart attacks. Hopes for Future Application Many physicians have expressed excitement about research into the use of T.P.A. to treat heart attacks because they hope someday it may be used in emergency rooms and ambulances to stop heart attacks at their earliest stages, before they kill or cause permanent damage. According to Dr. Desire Collen of the University of Leuven in Belgium who was one of the researchers who spoke here, in the 1970's very high amounts of T.P.A. were found in tests of cells taken from skin cancers called malignant melanomas. T.P.A. from such cells was used in treating the seven heart attack patients. Dr. Collen said research at the University of Leuven had shown that the T.P.A. produced by gene-splicing techniques could not be distinguished from the T.P.A. produced by the melanoma cancer cells. He said that although the risks of a T.P.A. recipient's developing cancer could not be quantified, the risk had to be ''very, very small.''