Faculty Bibliography

Something, possibly an undetected virus, appears to be overwhelming and making the immune system ineffective. The problem is staggering because the immunity breakdown makes AIDS patients vulnerable to every type of microbe. For unknown reasons, victims suffer chiefly from two unusual types of cancers as well as a variety of chronic infections that are characterized as ''opportunistic'' because they seem to occur only when the immune system malfunctions. Yet, for all the tragedy AIDS has caused - and the suffering has been enormous - it has also become the subject of what is known in medicine as an ''experiment of nature.'' For example, from studies of the pneumococcal bacteria that caused epidemics of pneumonia, DNA was identified as the chemical basis of heredity. Dr. Fred T. Valentine, an immunologist who has been investigating AIDS since cases first appeared at Bellevue-New York University Medical Center two years ago, speculated that whatever causes AIDS ''might activate or destroy a type of immunological regulatory cell whose function and identity are yet to be discovered.''

The new study examined 122 men ranging in age from 61 to 88 years. Their average age was 70, thereby extending earlier findings made among younger men, aged 34 to 43, by Dr. Gerald B. Phillips of St. Luke's- Roosevelt Hospital Centre and Columbia. Both institutions are in New York. ''Of the 15 subjects with the highest estradiol levels, 13 had coronary heart disease, whereas of the 15 subjects with the highest cholesterol levels, only three had coronary heart disease,'' Dr...

Dr. William P. Castelli, who heads the Framingham Heart Study, said the new finding ''adds to our knowledge but it will take some doing to figure out the mechanism.'' He added, ''It excites many more questions than it answers, but it will encourage us to start looking in other directions.'' ''An immense effort has been devoted to the reduction of cholesterol levels in the blood by diet and by drugs,'' he said, ''and it must now be concluded that these efforts have had no detectable influence on the course or development of coronary heart disease.'' In turn, dietary proponents have rebutted Dr. [John McMichael]'s theory. ''We had another doctor test the hormones, too, and he got the same answers Dr. [Gerald B. Phillips] did,'' Dr. Castelli said. ''We really made the game hard, and Gerry passed the acid test.''

The new scientific information ''certainly doesn't mean that HTLV causes AIDS,'' Dr. [James Curran] emphasized. Nevertheless, he said the new findings were ''important'' because evidence of exposure to the virus had not been detected in the United States in individuals other than those who have had an unusual type of cancer of the blood called Tcell leukemia. The discrepancy ''doesn't make sense'' yet, Dr. Curran said, but such information would be important to the investigation if substantiated. One way to show that a virus causes a disease is to measure changes in the amounts of antibodies that the body produces before and after the onset of an illness. In the case of AIDS, such tests have shown some correlation, Dr. Curran said, ''but not nearly as much as you would predict'' if the virus caused the disorder

Surgeons have been chided for being too chauvinistic in their approach to treating suspicious cancers of the genital system in women and men. Most surgeons say that ''no ovary is too good to leave in and no testis too bad to take out,'' Dr. Prout, Dr. Marc B. Garnick and Dr. George P. Cannellos wrote in the textbook ''Cancer Medicine,'' edited by James F. Holland and Emil Frei 3d. Many doctors, believing that an enlarged testicle is caused by an infection called epididymitis, are likely to keep treating patients with antibiotics, instead of removing the testicle. Dr. Prout said the general rule should be: ''Epididymitis has three weeks to clear up on proper antibiotic therapy, or the testicle should be removed because it is cancerous.'' The push for men to examine their testicles routinely reflects the biological factors of testicular cancer. Some types of testicular cancer tend to grow more rapidly than any other tumor that has been studied. ''The loss of time, be it one, two or three months, may be critical,'' Dr. Prout said at a recent seminar of the American Cancer Society in San Diego

''Dr. [Barney B. Clark] was not a perfect candidate,'' Dr. [William C. DeVries] said, ''but, all factors considered, he was the best we would ever get, and I thought we could get by.'' In answer to a question, Dr. DeVries said, ''Knowing everything I know about him now, I'd pick him again as the first patient.'' ''When I put the heart in Barney, I said to [Rob], 'I really hope this doesn't break,' '' Dr. DeVries said. ''I had confidence in the Bjork-Shiley valves but I just had more confidence in the Hall-Kaster valve.'' ''Both the lay and scientific world have a limit to how much research they will tolerate,'' Dr. [Chase N. Peterson] said. ''It's as simple as that.'' Need 'a Real Success'

Getting Dr. [Barney B. Clark] to the operating room alive - Dr. DeVries's first crisis - was an exercise in medical management as delicate as any aerial acrobatic act. Under Federal guidelines ''there had to be no question there was no more life left in Barney,'' Dr. [William C. DeVries] said. ''But I couldn't step too far to let him die before he was in the operating room, and I couldn't go too fast or he might have bled to death'' from complications of his heart disease. ''But if Dr. Clark was dead or dying, I should let him die and not be intubating him,'' Dr. DeVries said. He went ahead, acting on instinct as well as training. ''But those few seconds before I put in the tube were really difficult,'' he said. ''When Barney started moving, I was really elated.'' Then Dr. [Willem J. Kolff] walked back toward the power system. ''Barney got nervous again and his eyes started popping,'' Dr. DeVries said. ''Then Dr. Clark said, 'Don't quit, don't quit.' He was scared for the first time that someone was going to do that to him, and it took me almost a whole night to explain that we were not stopping.''

The clinical findings were verified by an autopsy that was done immediately after Dr. Clark's death and that showed ''no surprises,'' Dr. William C. DeVries, head of the team that cared for him, said at a news conference. He added, ''There was nothing significant that we missed,'' meaning that the doctors had diagnosed and treated Dr. Clark properly. Dr. DeVries said that the artificial heart could pump blood into a dead body ''but at an ineffective level to sustain life,'' adding, ''It's a correlation of all organs together that make a living being. It is not merely one heart keeping everything alive. It was the whole organism's response that failed together.'' All the Clark children live in the Seattle area, where Dr. Clark practiced as a dentist for 27 years until retiring five years ago. Shortly after the implant operation, Dr. Clark's son, [Stephen Kent Clark], told reporters, ''I don't think he really felt it would succeed.'' ''His interest in going ahead, he told this to me,'' the son continued, ''was to make this contribution, whereas the only other way was to die of the disease. This was one of his strong motivations. Perhaps he could help on the research and help somebody else.''

''It is a sad time for all of us,'' Mr. [John Dwan] said. ''He was an incredible man, one of the strongest men I have ever known, one of the strongest families I have ever known. He did a service to mankind and the knowledge that we will gain from him will serve us all.'' ''He died in peace and with dignity,'' Mr. Dwan said. ''The mood in the unit was quiet, subdued and dignified. It was very professional.'' Mr. Dwan said Dr. [Barney B. Clark] was surrounded by his physicians, Dr. William C. DeVries, Dr. Lyle Joyce and Dr. Chase N. Peterson, at the time of his death at the Salt Lake City facility. Mr. Clark's wife, Una Loy, was in the intensive care unit at the time, but was not in the room. Mr. Dwan said Mrs. Clark was ''tremendously saddened'' at her husband's death

''[Barney B. Clark]'s not looking good right now,'' Dr. Chase N. Peterson, the University of Utah's vice president for health sciences, said in an interview. ''He has got a fever and we don't know it's cause.'' Mr. [John Dwan] said early last evening that Dr. Clark ''continues to deteriorate but we all continue to be hopeful,'' adding, ''His fever and kidney problem could ultimately be life-threatening.'' Mr. Dwan said that ''the doctors really do not know what's causing Dr. Clark's problems and they are very concerned about his lack of response to treatment.'' Mr. Dwan also said that the doctors might downgrade Dr. Clark's condition from ''fair'' to ''serious'' if he showed no improvement by today