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This paper reviews studies on biomechanical properties of the anterior lens capsule. Early experiments in this field were more fundamental. Later studies were aimed mainly at assessing the mechanical stability of the capsule edge after manual or femtosecond laser capsulorhexis (capsulotomy) - an important step in modern minimally invasive phaco surgery. For biomechanical tests, ex vivo samples of human and animal anterior capsules were used. The results of the studies presented here are quite heterogeneous, which suggests the necessity of gaining further insight into the issue.

Unlabelled: Hyponatremia is a relatively frequent and serious complication in patients with various neurosurgical pathologies., Objective: This study is aimed at assessing the incidence of hyponatremia in neurosurgical patients depending on the pathology., Material and Methods: This paper presents a retrospective analysis 39 479 cases of patients operated on at the Burdenko Neurosurgical Institute from 2008 to 2014., Results: A total of 785 hyponatremic patients with Na level lower than 130 mmol/l (2% of all operated patients) were identified. Mortality in patients with hyponatremia was 14.3%, which is tenfold higher compared to the rest of population of patients without hyponatremia who were operated on during the same period. In adults, hyponatremia most frequently occurred after resection of craniopharyngiomas (11%) and as a result of acute cerebrovascular accident (22%). In children, it occurred after resection of craniopharyngiomas (10%), astrocytomas (7%), ependymomas (24%), and germ cell tumors (10.5%)., Conclusion: This study, which was mainly statistical one, was not aimed at detailed investigation of hyponatremia in different groups of neurosurgical patients. We only tried to draw the attention of various experts to those categories of patients, where focused and in-depth developments are more than important. Obviously, already gained international experience should be taken into account for this, Purpose: Therefore, this article presents the literature data on the etiology and pathogenesis of hyponatremia. We describe the details of the various classifications of hyponatremia, its clinical symptoms, diagnosis, and treatments, primarily based on the recommendations of the last European consensus of various specialists (2014).

The paper provides current knowledge on cataract epidemiology worldwide and in the Russian Federation, including issues of cataractogenesis and prevention. An overview of medical equipment for preoperative and intraoperative diagnostics is provided. Key aspects of the conventional ultrasonic phacoemulsification method as well as the most marked trends in correction of aphakia with intraocular lenses and in design of the latter are presented. Major laser-assisted techniques, including those that imply the use of femtosecond laser systems, and results that they yielded to date are discussed in detail.

Statistical data on the incidence and spectrum of thrombotic complications presented in this paper are based on the materials collected by the Department of Expertise of Living Subjects, Rostov Regional Bureau of Forensic Medical Expertise, during 2004-2010. The cases of interest were analysed by age, sex, time of injury, character of traumatic impact, and time of surgical intervention. It is concluded that such cases require forensic medical expertise by standardized methods.

The comparative analysis by bronchial fistulae closure by hydatid lung cysts in children using two surgical techniques was conducted. All patients were divided in two groups: the first group (n = 98) included cases of fistula closure using the traditional solitary Z-suture; the second group (n = 54) had fistula closure with the use of the original method. The least was thoroughly described in the paper. The were no cases of postoperative complications among patients of the 2nd group, whereas 6 patients of the 1st group had bronchial fistula recurrence after the operation.

This paper describes the method and results of application of the pulsed low-frequency electrostatic field (PLFESF) to the lower extremities of the patients who underwent surgical treatment for the correction of valgus deformation of the first toe. The efficiency of the method used in the early period of rehabilitative treatment was estimated at 93.3% compared with 96.7% in the patients who were managed by the same therapy in combination with polyoxdonium.

This paper reports the results of the measurement of the linear blood flow velocity in the dorsal artery of the foot following surgical treatment. Rheovasographic characteristics of the lower extremity were obtained after the application of a pulsed low frequency electrostatic field (PLFESF) to correct valgus deformity of the first toe. It was shown that treatment with PLFESF significantly improved arterial and venous circulation in the operated leg.

The surgical treatment of postoperative ventral hernias (PVH) in patients with high operative-anesthesiologic risk (OAR) still remains a problem. The results of PVH treatment in 150 patients with different degrees of OAR are analyzed in the paper. Autoplastic operations and explantation of synthetic prostheses were performed. The second method demonstrated a range of advantages. The necessity of widening the indications for the planned surgery for PVH is proved, especially in patients with the increased OAR. This will permit avoiding complications of the hernia itself and decrease the frequency of urgent PVH surgery, very undesirable in such patients. The algorithm of the choice of reconstruction and anesthetic management is worked out.

The paper presents the results of clinical evaluation of combined prevention of leg deep vein thrombosis and pulmonary thromboembolism in 130 neurosurgical patients undergoing intracranial interventions for brain tumors. Combined prevention comprises mechanical (compression knitted wear + periodic pneumatic leg compression by a special device) and pharmacological (subcutaneous injection of low molecular-weight heparins on postoperative day 2, followed by the daily administration of acetylsalicylic acid from the moment of a patient's activation) treatments. The study has indicated that this preventive procedure is effective and at the same time safe against the development of intracranial hemorrhagic complications.

The paper describes a clinical case of the severe potentially fatal postoperative complication--massive pulmonary thromboembolism--in a patient after uncomplicated removal of meningioma of the wing of os basilare. It also describes the problems in the diagnosis, treatment, prevention of perioperative deep venous thrombosis of the shin and subsequent pulmonary thromboembolism in neurosurgery patients.

The paper describes the program of postoperative treatment of patients with orbital complications of frontal sinusitis (FS) basing on the phase theory of the wound process. The phase of the inflammation is to be treated with active osmotic drainage of the frontal sinus by currently available multicomponent ointments on the polyethylenoxide base. The efficacy of the program was compared to that of the conventional treatment in the study of 29 cases. It is shown that intrasinus administration of levomecol ointment promoted cure, shortening twice the inflammatory phase in patients with orbital complications of frontal sinusitis.

The paper deals with the relationship of homeostatic and motivational disorders in the postoperative clinical picture in basal-diencephalic tumors. The material included 354 clinical observations of: hypophysial adenoma (n = 135); craniopharyngioma (n = 71); tumors of the third ventricle (n = 88); basal meningiomas (n = 60). A comparative analysis of the findings allowed the authors to support that there are typical variants of changes in the patients' status, which reflect the nature of ion-osmotic disorders. The most significant mental disorders were transient hyperosmolar-hypernatriemic disturbances. The poor predictors were persistent hypernatriemia concurrent with evolving coma, systemic hemodynamic and respiratory disorders. Hyponatriemia is a better predictor of ionosmotic disorders, which requires a careful postoperative monitoring and a comparison of its findings with the specific features of intensive care performed.

Over 10 years (1990-1999), the Pediatric Department, Ukrainian Institute of Neurosurgery named after Academician A. P. Romodanov, operated on 376 children with posterior fossa tumors. Thirty two 8.7% children developed a posterior fossa syndrome and cerebellar mutism syndrome postoperatively. This paper gives a detailed analysis of the date available in the world literature on the incidence and causes of mutism, and mechanisms of its development. Many factors predisposing to mutism were identified, but no anatomic structures responsible for its formation were found. In the authors' opinion, mutism may not result from anatomic structures, but from the functioning of afferent or efferent connections to this brain region bilaterally.

The paper presents a clinical case of severe excess cerebrospinal spinal fluid drain syndrome with hematomas of the cerebral hemispheres being formed in a 18-year-old young man undergone ventriculoatriostomy with mean-pressure pump implantation. A complication occurred 6 months after surgery and ran progressively. Closed external drainage of hematomas greatly reduced their volumes, but deteriorated the patient's condition due to the development of excess drain syndrome. Replacement of the mean-pressure pump by a high-pressure one rapidly normalized the patient's status.

The paper describes a clinical case of the cerebral hyperperfusion syndrome, a rare complication of carotid endarterectomy. The syndrome appeared as the generalized convulsive syndrome in the patient in the early postoperative period. In the context of clinical observation, the results of analysis of the literature are presented and the pathogenesis, diagnosis, therapy, and prevention of the cerebral hyperperfusion syndrome considered.

High frequency of complications after pancreatoduodenal resections dictates the necessity to study causes of their origin. This paper provides the results of roentgenologic examinations in early and late postoperative periods in 24 patients who underwent classic pancreatoduodenal resection by Whipple and in 23 patients after pylorus saving pancreatoduodenal resection--operation by Traverzo-Longmire. Conventional method of roentgenologic examination of the operated stomach was used. In early postoperative period disturbances of motor-evacuatory function of upper parts of gastrointestinal tract were revealed in 50% of patients in any modification of pancreatoduodenal resection. In most cases slowering down of the evacuation up to complete gastrostasis was observed. But in long-term follow-up functional results after pancreatoduodenal resection according to x-ray examination data were much better after operation by Traverzo-Longmire (75% patients) than after classic version by Whipple (37% patients). Thus, the results of roentgenologic examination showed that pylorus saving version of pancreatoduodenal resection provides optimal conditions for normal activities of the saved organ.

The paper presents the follow-up data on 39 patients who underwent microsurgical removal of pineal tumors. Computerized and magnetic resonance tomographies were performed prior to and following the removal of pineal tumor. Otoneurological symptoms were analyzed in their dynamics in 32 patients in the early postoperative period (up to 20 days) and in 6 patients in the late period (1 to 5 years) after radiation therapy. Seven patients died from intracranial complications in the early postoperative period. Acoustic and vestibular functions were evaluated from otoneurological, electronystagmographic, pure-tone and verbal audiometric findings. The postoperative positive dynamics of acoustic and vestibular functions was observed in most patients. A steady-state positive effect also remained in 5 patients in the long-term period. The paper gives 2 cases with clear-cut positive cochlear dynamics after removing pineal tumors.

A summarized severity index has been defined on the basis of 11 preoperative findings from clinical and neurological studies, cerebral angiography, computerized tomography of the brain, and electroencephalography in 71 patients operated on for early aneurysmal rupture. The value of the summary severity index has a closely linear negative correlation with the likelihood of favourable postoperative outcomes: with a high summarized index, a risk for postoperative ischemic events and deaths increases. The paper shows it advisable to predict postoperative ischemic complications while defining indications for early aneurysmal surgical treatment.

The paper provides results of examinations and surgical treatment in 190 patients with laryngeal and tracheal stenosis of different origin. The most favourable results were obtained in patients with postresuscitation stenosis, middle paralysis, posttraumatic stenosis: up to 75%, 71% and 55% of the responders, respectively. The canule remains for life in 20% of the surgical patients, because they have severe laryngeal and tracheal deformities associated with other affections.

The paper summarizes the experience gained by the authors in 10-year treatment of esophageal cicatricial strictures. Work-up and treatment results available on 107 relevant patients provided evidence on the leading role of endoscopic diagnosis in cicatricial strictures, while endoscopic bouginage is effective treatment of the strictures. To prevent recurrences esophageal bouginage should be combined with drug and laser therapy. The immediate response was reached in 91 (85%) patients. Long-term response was good only in 34 (46.6%) patients. Six slight complications passed off without special treatment.

The paper analyzes one of the complication of spinal fluid bypass surgeries, i.e. epileptoid seizures. It is suggested that a significant role in the occurrence of seizures is played by irritation of the brain with an implantable drainage system, namely with the thickened drainage portion plunged into the brain at the junction of a pump and a ventricular catheter. The study provides evidence for the value of the presence of pathology risk for seizures which occurs after anastomosis implantation. This risk appears as EEG epileptoid activity even in the absence of clinical manifestations. Infectious complications and poor anastomosis drainage function are shown to be essential for the implantable anastomosis to provoke the seizures. The authors give recommendations to prevent epileptoid seizures following bypass surgeries and treat them if they occur, which allows this complication to be effectively combatted.

The paper specifies x-ray picture of surgically treated frontal and maxillary sinuses in uneventful healing without inflammation relapses (30 cases), in relapse of purulent (21 sinuses), purulent-polypous (15 sinuses), polypous (4 sinuses) sinusitis, in pain syndrome in the region of the operated on maxillary sinus projection (7 patients). X-ray symptoms of postoperative changes in the sinuses, varying in clinical course, are characterized.

This paper discusses the results of 649 rhinoseptoplastic and 139 rhinoconchoplastic operations performed according to modified methods of Killian and Cottle. The surgical intervention led to the following complications: 1) deformation of the nasal septum in the vestibule area (11 patients); 2) perforation of the nasal septum of atrophic origin (15 patients); 3) saddle-like deformation of external nose (7 patients); 4) vibration of the nasal septum which occurred in most patients after total resection of the cartilage and vomer. The author elaborated methods of plastic operations of: the vestibule of the nose in order to prevent its postoperative deformation, the vomerine zone in order to preserve intraosseous vessels in the foramen incisivum area, the ridge of the nose in order to avoid the saddle-like nose, and implantation of the zigzag cartilage graft in order to prevent vibration of the nasal septum. Analysis of the rhinoconchoplastic operations allowed the author to propose medial positioning of the nasal concha in the case of hypotrophic rhinitis and implantation of autocartilage into the nasal concha in order to enlarge it in the case of hypotrophy.

This paper presents the results of treatment of post-operative pharyngeal wounds in 54 tonsillectomized patients (residents of the Far North) using a helium-neon laser. The treatment had a significant analgetic and anti-inflammatory effect which was demonstrated by the so-called swallow test, bar-algisimetry, thermometry of the mucosa of the anterior palatine arches and mandibular area, and cytological examination of the exudate from the tonsillar niches. Application of a low energy helium-neon laser in tonsillectomized patients shortens the therapeutic period by 2 days.