The recent use of checklists in surgery has shown improvements in patient outcomes post-operatively. A review was conducted to establish the impact of the checklist on different surgical specialities.

The purpose of this study is to assess the role of tumour necrosis factor (TNF) polymorphisms in the risk of developing bladder cancer and effect on tumour stage, grade and progression. In all, seven single-nucleotide polymorphisms in TNF were studied in 196 bladder cancer patients and 208 controls using a PCR-SSP genotyping technique. It was seen that there was a significant association of two polymorphisms in TNF with bladder cancer: the TNF þ 488A allele was found in 28.1% of patients compared with 14.9% of controls (P ¼ 0.0012). In addition, TNFÀ859T was found in 26.0% of patients compared with 14.4% of the controls (P ¼ 0.0036). The two loci were in tight linkage disequilibrium, that is, almost all the individuals having TNF þ 488A also had TNFÀ859T. Patients with the TNF þ 488A or TNFÀ859T were more likely to present with a moderately differentiated tumour than those patients without the uncommon allele. In all, 16.7% of patients with TNF þ 488A and 29.9% of patients without TNF þ 488A presented with a G1 tumour (P ¼ 0.015). A total of 14% of patients with TNFÀ859T and 30.5% of patients without TNFÀ859T presented with a G1 tumour (P ¼ 0.0043). There was no significant effect on time to first recurrence, stage progression or grade progression. In conclusion, a significant association between TNF polymorphisms TNF þ 488A and TNFÀ859T and risk of bladder cancer was detected in this study. Both these polymorphisms were associated with grade of tumour at presentation although there was no significant effect on subsequent tumour behaviour.

The action of psoas major muscle as a primary flexor of the hip joint is undisputed. However it is also variably reported as being a medial and a lateral rotator of the femur at the hip joint. The psoas and iliacus muscles, along with their common insertion, were isolated by dissection in six adult cadaveric specimens. The action of psoas muscle was assessed by pulling the muscle along its long axis and then observing the effects on rotation of the femur, with a visual estimation of the rotation in degrees. The experiment was repeated with the hip joint capsule removed. In the anatomical position, applied traction along the long axis of the muscle produced hip flexion with no rotational component. With the hip in the abducted position, traction produced flexion, adduction, and lateral rotation of the femur at the hip joint. In adduction of the hip, traction on psoas produced only flexion at the hip joint, with no rotation. In maximal flexion, traction also produced adduction. The results were unaffected by the removal of the joint capsule. Clin. Anat. 12:264–265, 1999. © 1999 Wiley‐Liss, Inc.

Obstructive uropathy secondary to uretero-inguinal hernia is a rare phenomenon. Two types have been described-the rarer extraperitoneal type is frequently associated with other renal anomalies. Pre-operative diagnosis is essential in order to reduce the risk of ureteric injury intra-operatively. We describe one such case.