Facelift in a patient with benign symmetric lipomatosis and HIV facial lipoatrophy: a case report.

Benign symmetric lipomatosis (BSL) is a rare condition characterized by deposition of unencapsulated adipose tissue at typical sites on the body. Although the pathogenesis is not clearly defined, the disease has been associated with male gender, alcoholism, Mediterranean descent, and highly active antiretroviral therapy. A case study is presented of a facelift performed on a human immunodeficiency virus-positive patient on a highly active antiretroviral therapy with facial lipoatrophy in the anterior cheek region in combination with BSL characterized by excess fat deposits in multiple areas including the posterior cheeks and neck. The resultant peculiar deformity was managed in this case with a modified facelift and fat excision without recurrence. There are few reports in the English literature describing surgical excision using the facelift pattern for treating BSL.

Hoxa-5 acts in segmented somites to regulate cervical vertebral morphology.

The vertebrate axial skeleton (vertebral column and ribs) is derived from embryonic structures called somites. Mechanisms of somite formation and patterning are largely conserved along the length of the body axis, but segments acquire different morphologies in part through the action of Hox transcription factors. Although Hox genes' roles in axial skeletal patterning have been extensively characterized, it is still not well understood how they interact with somite patterning pathways to regulate different vertebral morphologies. Here, we investigated the role of Hoxa-5 in after somite segmentation in chick. Hoxa-5 mRNA is expressed in posterior cervical somites, and within them is restricted mainly to a sub-domain of lateral sclerotome. RNAi-based knockdown leads to cartilage defects in lateral vertebral elements (rib homologous structures) whose morphologies vary within and outside of the Hoxa-5 expression domain. Both knockdown and misexpression suggest that Hoxa-5 acts via negative regulation of Sox-9. Further, Hoxa-5 misexpression suggests that spatial and/or temporal restriction of Hoxa-5 expression is necessary for proper vertebral morphology. Finally, the restriction of Hoxa-5 expression to lateral sclerotome, which we hypothesize is important for its patterning function, involves regulation by signaling pathways that pattern somites, Fgf-8 and Shh.