and randomized, 98 (31.7%) of whom had optic nerve
The material consists of
involvement during the first attack. 241 (78%) patients
received study treatment for two years; 278 (90%) re-
mained in the study until termination. 57 (85%) of 67 who
stopped therapy did so after conversion to clinically
definite MS. Fewer patients developed clinically definite
MS in the interferon group than in the placebo group
(52/154 [34%] vs. 69/154 [45%]; p 0.047). The time at
which 30% of patients had converted to clinically definite
MS was 569 days in the interferon group and 252 in the
placebo group (p 0.034). The annual relapse rates were
0.33 and 0.43 (p 0.045). The number of new T2-
weighted MRI lesions and the increase in lesion burden
were significantly lower with active treatment. This study
confirms that interferon beta-1a treatment at an early stage
of MS has significant positive effects on clinical and MRI
outcomes.Nancy J. Newman
*Department of Neuroscience, IRCCS Ospedale S Raffaele, via Olgettina
60, 20132 Milano, Italy. E-mail: g.comi@hsr.it
Control of a mucosal challenge and prevention of
AIDS by a multiprotein DNA/MVA vaccine. Amara RR,
Villinger F, Altman JD, Lydy SL, ONeil SP, Staprans SI,
Montefiori DC, Xu Y, Herndon JG, Wyatt LS, Candido
MA, Kozyr NL, Earl PL, Smith JM, Ma HL, Grimm BD,
Hulsey ML, Miller J, McClure HM, McNicholl JM, Boss B,
Robinson HL.* Science 2001;292:69 74.
H ETEROLOGOUS PRIME/BOOST REGIMENS HAVE THE PO-
tential for raising high levels of immune responses.
The authors report that DNA priming followed by a
recombinant modified vaccinia Ankara (rMVA) booster
controlled a highly pathogenic immunodeficiency virus
challenge in a rhesus macaque model. Both the DNA and
rMVA components of the vaccine expressed multiple
immunodeficiency virus proteins. Two DNA inoculations
at 0 and eight weeks and a single rMVA booster at 24
weeks effectively controlled an intrarectal challenge ad-
ministered seven months after the booster. These findings
provide hope that a relatively simple multiprotein DNA/
MVA vaccine can help to control the acquired immune
deficiency syndrome epidemic.Hans E. Grossniklaus
*Vaccine Research Center and Yerkes Regional Primate Research
Center, Emory University, Atlanta, GA 30329. E-mail: hrobins@
rmy.emory.edu
Experimental verification of a negative index of refrac-
tion. Shelby R,* Smith DR, Schultz S. Science 2001;292:
7779.
T HE AUTHORS PRESENT EXPERIMENTAL SCATTERING
data at microwave frequencies on a structured meta-
material that exhibits a frequency band where the effective
VOL. 132, NO. 4
index of refraction (n) is negative.
a two-dimensional array of strips of standard circuit board
material. By measuring the scattering angle of the trans-
mitted beam through a prism fabricated from this material,
the authors determined the effective n, appropriate to
Snells law. These experiments directly confirmed the
predictions of Maxwells equations that n is given by the
negative square root of for the frequencies where
both the permittivity () and the permeability () are
negative. Configurations of geometrical optical designs are
now possible that could not be realized by positive index
materials. The materials used do obey the laws of physics
while opening up new possibilities for manipulating
radiation.Hans E. Grossniklaus
*Department of Physics, University of California, San Diego, La Jolla,
CA 92093-0350.
Diffuse lamellar keratitis: isolation of endotoxin and
demonstration of the inflammatory potential in a rabbit
laser in situ keratomileusis model. Peters NT,* Iskander
NG, Anderson Penno EE, Woods DE, Moore RA, Gimbel
HV. J Cat Refract Surg 2001;27:917923.
T HE AUTHORS SYSTEMATICALLY EXAMINED SOURCES OF
endotoxin contamination in eye centers as a potential
cause of diffuse lamellar keratitis (DLK) and demonstrated
the inflammatory potential of endotoxin in a rabbit model
of laser in situ keratomileusis (LASIK) surgery. In this
prospective study, all water sources that routinely come in
contact with LASIK instruments, including sterilizer res-
ervoirs, eye drops, microkeratome blades, and cleaning
solutions, were examined for endotoxins at five eye cen-
ters. Bacterial cultures were performed on water samples
from five sterilizer reservoirs. A LASIK flap was created in
eight rabbit eyes using an Automated Corneal Shaper
microkeratome. The flaps were reflected, and a dose of
endotoxin at various concentrations was placed on the
interface. After one minute, the flap was irrigated and
repositioned. The rabbit eyes were examined daily with a
slit lamp biomicroscope for three days for the development
of DLK, which was classified on a scale from grade one to
four (mild to severe). The rabbits were killed at the
conclusion of the study, and the interfaces were stained to
rule out infectious etiologies. Endotoxin was detected in
significant concentrations in tap water, filtered and dis-
tilled water, instrument washbasins, and sterilizer reser-
voirs at all five centers. The cultures of the water samples
taken from the sterilizer reservoirs ranged from no growth
to the presence of 100 colony-forming units of Flavobac-
terium and Pseudomonas aeruginosa. Endotoxins caused
DLK-like interface inflammation in all eyes tested. Exam-
ination of stained scrapings showed no microorganisms in
the interface of the rabbit eyes. The authors conclude that
endotoxin contamination was detected in water sources
ABSTRACTS 607