Cold weather injuries in an arctic environment.

The cases of eight Special Forces soldiers who sustained cold weather-related injuries while conducting winter training as part of Operation Arctic Saber in the Northwest Territories and Arctic Circle are reported. Environmentally related injuries can represent difficult diagnostic and treatment challenges in the field. Moreover, they may compromise the overall mission if they are not identified and treated early. Cold weather injuries can also result in long-term disfigurement and disability that may limit a soldier's future worldwide deployability. Mission requirements, equipment utilization, and environmental exposure place soldiers at particular risk for cold weather-related injuries in such austere settings. Nonetheless, with appropriate education and safety precautions, these potentially life-threatening risks can be greatly minimized.

Induction of peri-insulitis but not diabetes in islet transplants expressing a single foreign antigen. A multi-stage model of disease.

We have created a new transgenic model in which the human Epstein-Barr virus receptor, CR2 (CD21), has been expressed in pancreatic beta-cells. Mice derived from three transgenic founders bred into H-2b (C57BL/6) or H-2k (CBA) genetic backgrounds did not become spontaneously diabetic. After transplantation of CR2-expressing islets under the kidney capsule of genetically matched recipients, a histologic picture of peri-insulitis was found. However, animals did not manifest cellular invasion of the islets, destruction of the islets, or diabetes for at least 230 days. Significant numbers of both T and B lymphocytes were found in the cell population surrounding the islets. A pronounced serologic response to CR2 was also present and appeared to precede the onset of peri-insulitis. Thus, in this model, we have separated the process of diabetes induction into at least two phases. One is associated with peri-islet infiltration and an antibody response. However, at least one second signal is likely necessary for the process of islet destruction to follow.