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Penile and scrotal entrapment from a metal ring placed at the base of the penis is a rare, but important clinical dilemma encountered in urology. Emergent presentation to the urologist, after ring placement far longer than safely practiced, risks ischemic and permanent injury to penile, scrotal, and intrascrotal structures. Treating urologists should be aware of the prevalence of metal ring use, their potential complications, and the surgical approach to their safe removal. We present two patients who were identified at our institution with strangulating injuries of retained penile rings. The first patient was a healthy, 43-year-old male with a metal ring retained for 24 hours that was safely removed with industrial bolt cutters. The second patient, a 74-year-old male, died as a result of sepsis from injuries secondary to penoscrotal ischemia after >48 hour ring retention despite prompt removal at emergent presentation. Although rare, sexual practices may include the use of penoscrotal rings. When retained, ischemic injury and edema may lead to strangulation. Emergent removal may require industrial equipment that is not within the confines of normal operating room tools. Tissue injury may be severe and sepsis life-threatening, even after ring removal.

Hyper IgE Syndrome (HIES) is an immunodeficiency disorder characterized by increased serum levels of IgE, eczema, and recurrent cutaneous and pulmonary infections. In this report, we present, to our knowledge, the first documented case of renal cell carcinoma (RCC) found in a patient with HIES. The patient received infectious disease clearance prior to obtaining a partial nephrectomy which revealed clear cell histology. Both HIES and RCC have an immunological basis for their pathophysiology and may involve common pathways. Further studies may provide insight into any possible link and clinicians should be mindful of immunocompromised patients who present with risk factors for genitourinary malignancy.

A lightwell is a daylighting design that brings daylight (including sunlight and skylight) to the lower floors in a multi-storey building. A lightwell has a similar function to a lightpipe or an atrium, but its size is medium. This paper presents construction, measurement and RADIANCE simulation of a model lightwell. The model lightwell has a scale factor of 1:20 to simulate a real lightwell design for a multi-storey hotel. The model lightwell has the dimension of 100mm (width) x 150 mm (length) x 800 mm (height) contained in a six-storey model building section with a dimension of 400 mm x 500 mm x 800 mm. Comparison of the measured daylighting performance is made for two different inner surfaces (matt white paint and mirror-finish) of the model lightwell under overcast and sunny sky conditions, respectively. Computational analysis on the daylight factor (DF) or illuminance ratio provides essential information to determine key design parameters and applicability of a lightwell.