The role of an open artificial intelligence platform in modern neurosurgical education: a preliminary study.

The use of artificial intelligence in neurosurgical education has been growing in recent times. ChatGPT, a free and easily accessible language model, has been gaining popularity as an alternative education method. It is necessary to explore the potential of this program in neurosurgery education and to evaluate its reliability. This study aimed to show the reliability of ChatGPT by asking various questions to the chat engine, how it can contribute to neurosurgery education by preparing case reports or questions, and its contributions when writing academic articles. The results of the study showed that while ChatGPT provided intriguing and interesting responses, it should not be considered a dependable source of information. The absence of citations for scientific queries raises doubts about the credibility of the answers provided. Therefore, it is not advisable to solely rely on ChatGPT as an educational resource. With further updates and more specific prompts, it may be possible to improve its accuracy. In conclusion, while ChatGPT has potential as an educational tool, its reliability needs to be further evaluated and improved before it can be widely adopted in neurosurgical education.

Impressions of the chronic 900-MHz electromagnetic field in the prenatal period on Purkinje cells in male rat pup cerebella: is it worth mentioning?

OBJECTIVE: The aim of this study was to examine the changes on the Purkinje cells in the cerebella of male rat pups born to pregnant dams that were exposed to an electromagnetic field in the prenatal period. METHODS: The first stage of the study involved 12 Sprague-Dawley rats, 6 male and 6 female, weighing between 180 and 250 g. The female rats in the experimental group were exposed to a 900-MHz electromagnetic field for 1 h at the same time every day, and no procedure was performed on the control group. Following pregnancy, six male pups from each group were divided into experimental and control groups without any procedure on the pups. After 2 months, they were sacrificed and their cerebella were removed. Histopathologically, following routine processing and fixation procedures, the cerebella were embedded in the tissue blocks. The sections taken from these blocks were stained with cresyl violet. The Purkinje cells in the cerebella were then counted on sections using the optical dissector method on an image analysis system. RESULTS: The estimation of number of the Purkinje cells in the groups revealed more cells in rats in the control group than in the experimental group. Histopathologically, Purkinje cells exhibited a normal morphological structure in the control group, while the cells in the experimental group showed damage. CONCLUSIONS: It might be asserted that the exposure of mothers to an electromagnetic field in the prenatal period may affect the development of Purkinje cells in the pup cerebella.

Impressions of the chronic 900-MHz electromagnetic field in the prenatal period on Purkinje cells in male rat pup cerebella: is it worth mentioning?

SUMMARY OBJECTIVE: The aim of this study was to examine the changes on the Purkinje cells in the cerebella of male rat pups born to pregnant dams that were exposed to an electromagnetic field in the prenatal period. METHODS: The first stage of the study involved 12 Sprague-Dawley rats, 6 male and 6 female, weighing between 180 and 250 g. The female rats in the experimental group were exposed to a 900-MHz electromagnetic field for 1 h at the same time every day, and no procedure was performed on the control group. Following pregnancy, six male pups from each group were divided into experimental and control groups without any procedure on the pups. After 2 months, they were sacrificed and their cerebella were removed. Histopathologically, following routine processing and fixation procedures, the cerebella were embedded in the tissue blocks. The sections taken from these blocks were stained with cresyl violet. The Purkinje cells in the cerebella were then counted on sections using the optical dissector method on an image analysis system. RESULTS: The estimation of number of the Purkinje cells in the groups revealed more cells in rats in the control group than in the experimental group. Histopathologically, Purkinje cells exhibited a normal morphological structure in the control group, while the cells in the experimental group showed damage. CONCLUSIONS: It might be asserted that the exposure of mothers to an electromagnetic field in the prenatal period may affect the development of Purkinje cells in the pup cerebella.

The effects of a continuous 1-h a day 900-MHz electromagnetic field applied throughout early and mid-adolescence on hippocampus morphology and learning behavior in late adolescent male rats.

The purpose of this study was to investigate hippocampus morphology and changes in learning behavior in male rats in late adolescence exposed to the effect of a continuous 1-h a day 900-megahertz (MHz) electromagnetic field (EMF). Twenty-four male Sprague Dawley rats aged 3-weeks were divided equally into control, sham and EMF groups. EMF group rats were exposed to a 900-MHz EMF inside an EMF cage, while the sham group rats were placed in the same cage but were not exposed to such an effect. No procedure was performed on the control group. Following 25-day application of EMF, passive avoidance, 8-arm radial maze and Y-maze tests were applied to determine rats' learning and memory performances. Open field and rotarod tests were applied to assess locomotor activity. At the end of the tests, the animals' brains were removed. Sections were taken and stained with toluidine blue. The regions of the hippocampus were subjected to histopathological evaluation. At histopathological examination, impairments of pyramidal and granular cell structures were observed in the EMF group hippocampus. No significant change was observed in learning, memory or locomotor behavior in any group. In conclusion, 900-MHz EMF applied in early and mid-adolescence causes no changes in learning, memory or locomotor behavior.

Pernicious effects of long-term, continuous 900-MHz electromagnetic field throughout adolescence on hippocampus morphology, biochemistry and pyramidal neuron numbers in 60-day-old Sprague Dawley male rats.

The central nervous system (CNS) begins developing in the intrauterine period, a process that continues until adulthood. Contact with chemical substances, drugs or environmental agents such as electromagnetic field (EMF) during adolescence therefore has the potential to disturb the development of the morphological architecture of components of the CNS (such as the hippocampus). The hippocampus is essential to such diverse functions as memory acquisition and integration and spatial maneuvering. EMF can result in severe damage to both the morphology of the hippocampus and its principal functions during adolescence. Although children and adolescents undergo greater exposure to EMF than adults, the information currently available regarding the effects of exposure to EMF during this period is as yet insufficient. This study investigated the 60-day-old male rat hippocampus following exposure to 900 megahertz (MHz) EMF throughout the adolescent period using stereological, histopathological and biochemical analysis techniques. Eighteen male Sprague Dawley rats aged 21days were assigned into control, sham and EMF groups on a random basis. No procedure was performed on the control group rats. The EMF group (EMFGr) was exposed to a 900-MHz EMF for 1h daily from beginning to end of adolescence. The sham group rats were held in the EMF cage but were not exposed to EMF. All rats were sacrificed at 60days of age. Their brains were extracted and halved. The left hemispheres were set aside for biochemical analyses and the right hemispheres were subjected to stereological and histopathological evaluation. Histopathological examination revealed increased numbers of pyknotic neurons with black or dark blue cytoplasm on EMFGr slides stained with cresyl violet. Stereological analyses revealed fewer pyramidal neurons in EMFGr than in the other two groups. Biochemical analyses showed an increase in malondialdehyde and glutathione levels, but a decrease in catalase levels in EMFGr. Our results indicate that oxidative stress-related morphological damage and pyramidal neuron loss may be observed in the rat hippocampus following exposure to 900-MHz EMF throughout the adolescent period.

Maternal exposure to a continuous 900-MHz electromagnetic field provokes neuronal loss and pathological changes in cerebellum of 32-day-old female rat offspring.

Large numbers of people are unknowingly exposed to electromagnetic fields (EMF) from wireless devices. Evidence exists for altered cerebellar development in association with prenatal exposure to EMF. However, insufficient information is still available regarding the effects of exposure to 900 megahertz (MHz) EMF during the prenatal period on subsequent postnatal cerebellar development. This study was planned to investigate the 32-day-old female rat pup cerebellum following exposure to 900MHz EMF during the prenatal period using stereological and histopathological evaluation methods. Pregnant rats were divided into control, sham and EMF groups. Pregnant EMF group (PEMFG) rats were exposed to 900MHz EMF for 1h inside an EMF cage during days 13-21 of pregnancy. Pregnant sham group (PSG) rats were also placed inside the EMF cage during days 13-21 of pregnancy for 1h, but were not exposed to any EMF. No procedure was performed on the pregnant control group (PCG) rats. Newborn control group (CG) rats were obtained from the PCG mothers, newborn sham group (SG) rats from the PSG and newborn EMF group (EMFG) rats from the PEMFG rats. The cerebellums of the newborn female rats were extracted on postnatal day 32. The number of Purkinje cells was estimated stereologically, and histopathological evaluations were also performed on cerebellar sections. Total Purkinje cell numbers calculated using stereological analysis were significantly lower in EMFG compared to CG (p<0.05) and SG (p<0.05). Additionally, some pathological changes such as pyknotic neurons with dark cytoplasm were observed in EMFG sections under light microscopy. In conclusion, our study results show that prenatal exposure to EMF affects the development of Purkinje cells in the female rat cerebellum and that the consequences of this pathological effect persist after the postnatal period.

Morphological and antioxidant impairments in the spinal cord of male offspring rats following exposure to a continuous 900MHz electromagnetic field during early and mid-adolescence.

The effects of devices emitting electromagnetic field (EMF) on human health have become the subject of intense research among scientists due to the rapid increase in their use. Children and adolescents are particularly attracted to the use of devices emitting EMF, such as mobile phones. The aim of this study was therefore to investigate changes in the spinal cords of male rat pups exposed to the effect of 900MHz EMF. The study began with 24 Sprague-Dawley male rats aged 3 weeks. Three groups containing equal numbers of rats were established-control group (CG), sham group (SG) and EMF group (EMFG). EMFG rats were placed inside an EMF cage every day between postnatal days (PD) 21 and 46 and exposed to the effect of 900MHz EMF for 1h. SG rats were kept in the EMF cage for 1h without being exposed to the effect of EMF. At the end of the study, the spinal cords in the upper thoracic region of all rats were removed. Tissues were collected for biochemistry, light microscopy (LM) and transmission electron microscopic (TEM) examination. Biochemistry results revealed significantly increased malondialdehyde and glutathione levels in EMFG compared to CG and SG, while SG and EMFG catalase and superoxide dismutase levels were significantly higher than those in CG. In EMFG, LM revealed atrophy in the spinal cord, vacuolization, myelin thickening and irregularities in the perikarya. TEM revealed marked loss of myelin sheath integrity and invagination into the axon and broad vacuoles in axoplasm. The study results show that biochemical alterations and pathological changes may occur in the spinal cords of male rats following exposure to 900MHz EMF for 1h a day on PD 21-46.

Effect of Ginkgo biloba on brain volume after carotid artery occlusion in rats: a stereological and histopathological study.

BACKGROUND/AIM: This study investigated the effect of Ginkgo biloba (GB) on brain volume in cerebral ischemia induced by stopping carotid artery blood flow. MATERIALS AND METHODS: Twenty-four adult male rats were divided into 4 groups of 6 rats each. No procedure was performed on the control group. Ischemia was applied to the rats in the ischemia and ischemia + GB groups by clamping the arteria carotis communis for 30 min. The rats in the ischemia + GB group were given 100 mg/kg drops (Tebokan Fort Drop, Abdi Ibrahim Ilaç Sanayi A.$., Turkey) containing dry GB leaf extract orally, every day for 14 days from the day of ischemia. In the sham group, surgical stress alone was applied by performing a skin incision. On the 14th day, brain tissues were extracted and evaluated stereologically and histopathologically. RESULTS: The only statistically significant difference was observed between the sham and control groups. CONCLUSION: This result may be interpreted as surgical stress, established by cutaneous incision, having an adverse effect on brain volume. Additionally, the absence of any difference in terms of brain volume following 30 min of ischemia between the ischemia and control groups suggests that a probable postischemic rise in brain volume disappears within 14 days.

A new evaluation method for the intracranial volume changes and subdural effusion of patients following endoscopic third ventriculostomy.

OBJECTIVE: Endoscopic third ventriculostomy (ETV) is a procedure commonly applied in the treatment of non-communicating (obstructive) hydrocephalus. One of the rare complications that can occur following ETV is a subdural effusion, even though this procedure is considered to be a more controlled and natural method of cerebrospinal fluid drainage compared to external drainage. In this study, we evaluated the intracranial volume changes and subdural effusion of patients following ETV using Cavalieri method. METHOD: Volumes analysis of the cranial cavity, brain, ventricles and subdural effusions of two patients after ETV were performed on computed tomography images using the Cavalieri principle, one of the stereological methods. RESULTS: The preoperative total intracranial volumes and the preoperative brain volumes decreased for both patients during the postoperative 3rd, 10th and 30th days. Following ETV, the volumes of the lateral ventricles of both patients initially decreased during the postoperative 3rd and 10th days, however, the volumes returned almost to their preoperative size by the end of the 30th day. The effusions were seen on the postoperative 3rd and 10th days resolved by the end of the 30th day. CONCLUSION: Our results show that the Cavalieri method can be used to unbiased prediction of intracranial volume changes and to follow the subdural effusion after the ETV surgery.

Variations of the superficial peroneal nerve and its terminal branches in the Turkish newborn fetuses.

AIM: The topography of the superficial peroneal nerve (SPN) and its terminal branches were studied, with the aim of providing further anatomical details for leg and foot in the Turkish newborn fetuses. MATERIAL AND METHODS: Limbs from twenty newborn cadavers were dissected. The course of the SPN on the leg and its terminal branches on the foot were investigated. RESULTS: The SPN was lateral (75%), anterior (15%), or branched in both areas (10%) of the cases. The SPN in the dorsum of the feet branched further into medial dorsal cutaneous nerve (MDCn) and intermediate dorsal cutaneous nerve (IDCn). In 82.5% of the cases the MDCn and the IDCn split into three and two branches, respectively. In 10% of the cases, the MDCn gave off three, and the IDCn one terminal branches. In 7.5% of the cases, the MDCn had three while the IDCn had two branches that communicated with the lateral dorsal cutaneous nerve. CONCLUSION: The course of SPN on the anterolateral surface of the leg and its terminal branches on the dorsal surface of the foot were quite different. This unusual variant location will enable the surgeon to find and preserve the SPN and its terminal branches.

Introducing a new risk factor for lumbar disc herniation in females : vertical angle of the sacral curvature.

OBJECTIVE: To characterize the importance of the vertical angle of the sacral curvature (VASC) in lumbar disc herniations. METHODS: Morphological data derived from lumbar sagittal MRI imaging. The statistical significance of the findings are discussed. The angles of 60 female patients with lumbar disc herniations (LDH) were compared with the 34 female patients without LDH. RESULTS: 128 of the 185 patients met our inclusion criteria. The vertical angle of sacral curvature is statistically significantly bigger in females with lumbar disc herniations when compared to subjects in control group, 28.32 and 25.4, respectively. (p=0.034<0.05). Same difference was not seen in males. CONCLUSION: The vertical angle of sagittal sacral curvature may be another risk factor in females with lumbar disc herniations.

Purkinje cell number decreases in the adult female rat cerebellum following exposure to 900 MHz electromagnetic field.

The biological effects of electromagnetic field (EMF) exposure from mobile phones have growing concern among scientists since there are some reports showing increased risk for human health, especially in the use of mobile phones for a long duration. In the presented study, the effects on the number of Purkinje cells in the cerebellum of 16-week (16 weeks) old female rats were investigated following exposure to 900 MHz EMF. Three groups of rats, a control group (CG), sham exposed group (SG) and an electromagnetic field exposed group (EMFG) were used in this study. While EMFG group rats were exposed to 900 MHz EMF (1h/day for 28 days) in an exposure tube, SG was placed in the exposure tube but not exposed to EMF (1h/day for 28 days). The specific energy absorption rate (SAR) varied between 0.016 (whole body) and 2 W/kg (locally in the head). The CG was not placed into the exposure tube nor was it exposed to EMF during the study period. At the end of the experiment, all of the female rats were sacrificed and the number of Purkinje cells was estimated using a stereological counting technique. Histopathological evaluations were also done on sections of the cerebellum. Results showed that the total number of Purkinje cells in the cerebellum of the EMFG was significantly lower than those of CG (p<0.004) and SG (p<0.002). In addition, there was no significant difference at the 0.05 level between the rats' body and brain weights in the EMFG and CG or SG. Therefore, it is suggested that long duration exposure to 900 MHz EMF leads to decreases of Purkinje cell numbers in the female rat cerebellum.

A stereological study of MRI and the Cavalieri principle combined for diagnosis and monitoring of brain tumor volume.

In this study, we aimed to describe the application of the Cavalieri principle for the assessment of tumor volume using MRI without an over-projection/estimation effect. For this purpose, the volume of a patient's brain and the brain tumor volume, or the volume of the former tumor region, were estimated preoperatively and postoperatively using a combination of the Cavalieri principle and MRI. The previously described formula was modified for MRI measurements to eliminate the over-estimation effects of imaging. The total brain and tumor volumes estimated using the MRI of a representative patient with glioblastoma multiforme were: preoperative, 1562.46 cm³ and 81.59 cm³, respectively; and postoperative, 1571.72 cm³ and 86.92 cm³, respectively. The mean time to count points for an estimation of brain and tumor volume (or the volume of the former tumor region) were 14 minutes and 3 minutes, respectively. The coefficients of the errors of the estimates for brain and tumor volume (former tumor volume, postoperative) measurements were: preoperative 0.01 and 0.02; and postoperative 0.01 and 0.03, respectively. Our results show that the combination of MRI and the Cavalieri principle can provide an unbiased, direct and assumption-free estimate of the regions of interest. Therefore, the presented method could be applied efficiently without any need for special software, additional equipment or personnel other than that required for routine MRI in daily use.

A new approach for the estimation of intervertebral disc volume using the Cavalieri principle and computed tomography images.

This study was carried out to describe a simple, accurate and practical technique for estimating the volume of intervertebral disc (ID) by the combination of the Cavalieri principle and computed tomography (CT) images. Total eight lumbar IDs from two cadavers were CT scanned in axial, sagittal and coronal sections. The consecutive sections with 5 and 3mm thickness were used to estimate the volume of the IDs by the Cavalieri principle. Three investigators estimated the volume of IDs independently to evaluate inter-observer differences. When the results were compared to the real volumes of IDs measured by the fluid displacement technique, there was no significant difference between the real volume measurements and the Cavalieri estimation results of ID volumes (P > 0.05). Moreover, findings of three investigators did not show significant variations (P > 0.05). Our results indicate that the section thickness and the section planes did not affect the accuracy of the disc volume estimation. Thus the combination of CT scanning with the Cavalieri principle may be used as a direct and reliable technique to estimate the volume of IDs with a mean of 4 min workload per ID.

Rapid estimation of the vertebral body volume: a combination of the Cavalieri principle and computed tomography images.

OBJECTIVE: The exact volume of the vertebral body is necessary for the evaluation, treatment and surgical application of related vertebral body. Thereby, the volume changes of the vertebral body are monitored, such as infectious diseases of vertebra and traumatic or non-traumatic fractures and deformities of the spine. Several studies have been conducted for the assessment of the vertebral body size based on the evaluation of the different criteria of the spine using different techniques. However, we have not found any detailed study in the literature describing the combination of the Cavalieri principle and vertebral body volume estimation. MATERIALS AND METHODS: In the present study we describe a rapid, simple, accurate and practical technique for estimating the volume of vertebral body. Two specimens were taken from the cadavers including ten lumbar vertebras and were scanned in axial, sagittal and coronal section planes by a computed tomography (CT) machine. The consecutive sections in 5 and 3 mm thicknesses were used to estimate the total volume of the vertebral bodies by means of the Cavalieri principle. Furthermore, to evaluate inter-observer differences the volume estimations were carried out by three performers. RESULTS: There were no significant differences between the performers' estimates and real volumes of the vertebral bodies (P>0.05) and also between the performers' volume estimates (P>0.05). The section thickness and the section plains did not affect the accuracy of the estimates (P>0.05). A high correlation was seen between the estimates of performers and the real volumes of the vertebral bodies (r=0.881). CONCLUSION: We concluded that the combination of CT scanning with the Cavalieri principle is a direct and accurate technique that can be safely applied to estimate the volume of the vertebral body with the mean of 5 min and 11 s workload per vertebra.