Summary: Background: MIP is an unusual variant of distal hypospadias. It is characterized by a deep meatal groove and intact prepuce. Methods: This case report describes a 10‐year‐old boy referred for circumcision for religious reasons. Results: According to the boy’s pediatrician the child has never had any urologic complaints. The boy’s parents, however, maintained that his miction stream was turbulent and suggested that this might be attributed to the uncircumcised prepuce. Physical examination revealed MIP associated with a distal meatal web. After retraction of the prepuce, we inspected the stream and found that it was the distal meatal web that caused the turbulent miction pattern. Conclusions: Several operative techniques aim at a cosmetical remodelling of MIP. Yet, as miction caliber and esthetic appearance of the glans were acceptable in our patient, we only performed web excision and circumcision on him. The postoperative period was uneventful and the stream pattern was normal.

The effectiveness of fibrinolytic treatment has been shown in cases of thoracic empyema in adults. In pediatric patients experience is, however, very limited. The aim of this study was to determine the success and complication rates of fibrinolytic treatment in thoracic empyema in children. A series of 25 consecutive children who had loculated pleural empyemas that did not respond to tube thoracostomy and antibiotics is presented. Their ages ranged from 1 to 12 years (mean 4.2). There were 19 boys and 6 girls, and all epyemas were postpneumonic. The fibrinolytic agent used was urokinase in 17 and streptokinase in 8. The mean duration of fibrinolytic treatment was 4.3 days (range 2 to 8) and the mean duration of chest-tube drainage was 8.9 days (range 7 to 13). In 20 patients the fluid output from the chest tube increased significantly after instillation of the fibrinolytic agent, and these patients showed almost complete resolution of the effusion on chest radiograph and ultrasound examinations (80%). Only 5 patients developed complications: bronchopleural fistula and pleural thickening in 3, and recurrent effusion, multiloculation, and pleural thickening in other 2 which were managed by surgical intervention (20%). Our study suggests that intrapleural fibrinolytic treatment is an effective and safe adjunctive therapy in children with thoracic empyema and can obviate a thoracotomy in most cases.

Operations to treat complicated gastroesophageal reflux disease (GERD) have become the third most commonly performed general surgical procedure in large pediatric centers, and many surgical techniques have come into use to prevent gastroesophageal reflux. This paper presents our experience with gastric tube cardioplasty, a new procedure described by Oktay Mutaf (Mutaf procedure). Eleven children with GERD were successfully operated on. The postoperative period was uneventful, and all patients were symptom-free.

Earlier studies have shown successful transplantation of fetal grafts into the greater omenturn of rats.This report evaluates the effects of fetal adrenal glands in adult rats, who underwent bilateral staged adrenalectomy.At first "-e carried out a preliminary study to im'estigate the outcome of bilateral adrenalectomy:There were three graups each consisting of 10 rats. In Group I we performed bilateral adrenalectomy, and all rats died postoperatively within 8 hours. In Group 2 the rats undenvent sham procedure, and only one rat died. Group 3 was for control and all rats survived.

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