Fakülteler / Faculties

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Author: search.filters.author.Kirnap, MahirHas files: Yes

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    Analysis of Quality of Life, Depression, and Sexual Function in Patients on the Liver Transplant List
    (2021) Fidan, Cihan; Akdur, Aydincan; Kirnap, Mahir; Selcuk, Haldun; Yildirim, Sedat; Moray, Gokhan; Haberal, Mehmet; 0000-0002-3462-7632; 0000-0002-8726-3369; 34609310; AAJ-8097-2021; AAA-3068-2021
    Background: I he only treatment in patients developing liver failure is liver transplantation. According to the Ministry of Health, the number of patients waiting for a liver transplantation is 2141, the average waiting period for liver transplantation is approximately 5 years, and 15-18% of these patients lose their life while waiting for transplantation. In these patients, limitations in daily activities and depression-anxiety are commonly found. The aim of this study was to analyze life quality, depression symptoms, and existence of sexual functional disorders of patients waiting for liver transplantation. Methods: A total of 74 patients, who were registered in Baskent University Hospital between 2015 and 2018, were included into the study. Short Form-36, Beck Depression Inventory, and Arizona Sexual Experiences Scale were applied to 56 patients who approved study. Results: Most of the patients were male (64.3%), and the mean age was 46 (18-64). Short Form-36 scores were low in all patients. The mean Beck Depression Inventory score of patients was found as 18.4 +/- 11.3, and they were suffering from moderate depressive symptoms. According to Arizona Sexual Experiences Scale, total mean scores of males was found as 16.3 +/- 5.5, and for females, it was 19.5 +/- 5.3 with a statistically significant difference (P < .05). It was found that sexual dysfunction mostly had moderate to mild. Conclusion: Depression and sexual dysfunction are common in patients with chronic liver diseases, and their life qualities deteriorate significantly. It is anticipated that evaluation of these patients in terms of psychological issues and sexual dysfunction will increase their quality of life during the organ waiting period and affect their well-being post-transplant.
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    Evaluation of new Baskent university preservation solution for kidney graft during cold ischemia: Preliminary experimental animal study.
    (2019) Haberal, Mehmet; Kirnap, Mahir; Erdem, S.Remzi; Ozdemir, B.Handan; Lux, K.Michael; Bacanli, Didem
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    Secondary Vascular Access Procedures for Hemodialysis After Primary Snuff-Box Arteriovenous Fistula
    (2017) Kirnap, Mahir; Tezcaner, Tugan; Moray, Gokhan; 0000-0002-3641-8674; 0000-0003-2498-7287; AAD-9865-2021; AAE-1041-2021; AAH-9198-2019
    Aim: To investigate the secondary arteriovenous fistulas constructed after a snuff-box fistula. Material and Method: We reviewed data on 95 arteriovenous fistulas that were created as a secondary vascular access between January 2007 and December 2015. Of those 95 fistulas, 37 (39%) were ipsilateral elbow brachial-cephalic arteriovenous fistulas and 58 (61%) were ipsilateral wrist radial-cephalic arteriovenous fistulas; all were created after a primary snuff-box fistula. Results: All arteriovenous fistulas had matured. The primary patency rates for elbow brachial-cephalic arteriovenous fistulas and radial-cephalic arteriovenous fistulas were as follows: 1-year rate, 88% to 87% and 4-year rate, 70% to 61%. The secondary patency rates for were as follows: 1-year rate, 91% to 93%; 4-year rate, 72% to 63%. No early failure occurred. There were 15 late failures. The most common causes of failure were stenosis within the vein (n=8 patients), aneurysm (n=5 patients), and central vein stenosis (n=2 patients). Discussion: These data suggest that before a radial-cephalic or brachial-cephalic arteriovenous fistula is created, the construction of a snuff-box fistula enable the vascular structures to dilate, and may so fascilitate the success rate of seconder AVFs. For this reason a radial-cephalic arteriovenous fistula or an elbow brachial-cephalic arteriovenous fistula should be the second choice.
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    Role of preoperative C-reactive protein value and neutrophil ratio in the determination of conversion from laparoscopic appendectomy to open appendectomy
    (2018) Aydin, Huseyin Onur; Avi, Tevfik; Tezcaner, Tugan; Kirnap, Mahir; Yildirim, Sedat; Moray, Gokhan; 0000-0003-3795-5794; 0000-0003-3795-5794; 0000-0003-2498-7287; 30394496; AAH-9198-2019; S-8185-2018; AAF-4610-2019; M-1422-2019
    BACKGROUND: In this study, we aimed to investigate the factors causing conversion from laparoscopic appendectomy (LA) to open appendectomy (OA) in patients with acute appendicitis and to investigate the role of preoperative C reactive protein (CRP) and neutrophil ratio in this conversion and determine a cut-off point for these parameters. METHODS: Records of patients who underwent LA due to acute appendicitis at our general surgery department between January 2011 and January 2017 were retrospectively evaluated. The preoperative American Society of Anesthesiology (ASA) scores, Alvarado scores, white blood cell count, C-reactive protein level, and neutrophil ratio were evaluated. RESULTS: LA was performed in 394 patients with an initial diagnosis of acute appendicitis. A conversion to OA (cOA) was performed in 17 patients (4.31%). A CRP value of >= 108.5 mg/L and a neutrophil ratio of >= 81.5% were found to be statistically significant for the cOA (p<0.001). CONCLUSION: Our study results showed that male gender, age, elevated neutrophil ratio, and CRP value were the main risk factors for cOA in patients who were scheduled for LA due to acute appendicitis.
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    Perivascular epithelioid cell tumor outgrowth from the liver
    (2018) Haberal, Mehmet; Kirnap, Mahir; Ozgun, Gonca; Moray, Gokhan; 30453241
    INTRODUCTION: Perivascular epithelioid celltumor (PEComa) is a rare mesenchymal neoplasia and can be found in various body sites. On the other hand, hepatic PEComa is very rare, with only a few studies having reported hepatic malignant PEComa. There is no gold standard regarding the use of diagnostic imaging studies. The diagnosis of hepatic PEComa is made by a positive immunohistochemical staining for HMB45 and Melan A. Herein, we discussed the therapeutic and follow-up process of a symptomatic hepatic PEComa case. PRESENTATION OF CASE: A 22-year-old woman presented with a palpable mass in abdomen. A computerized tomographic examination showed a giant hepatic mass of left lobe origin, which was excised surgically. The pathology result was reported as a PEComa. DISCUSSION: The diagnostic approach, treatment modalities, and follow-up procedures are not standard. The main treatment modality for PEComa is surgical excision with adequate surgical margin. CONCLUSION: A longer follow-up is required for patients with hepatic PEComa because the nature of the disease is not entirely clear. (C) 2018 The Author(s). Published by Elsevier Ltd on behalf of IJS Publishing Group Ltd.