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Abstract Background Rectal metastasis from pulmonary adenocarcinoma is rare, and it has been regarded as an end-stage phenomenon. Recently, however, advances in lung cancer treatment have improved the chance of long-term survival of patients with unresectable distant metastases. We describe the occurrence and management of metastatic spread of a pulmonary carcinoma to the rectum. Case presentation The patient was a 79-year-old woman who had undergone thoracoscopic left lobectomy for pulmonary adenocarcinoma and then, over the next 11 years, various drugs (carboplatin + paclitaxel (as adjuvant therapy), gefitinib, gemcitabine + vinorelbine, S1 (an oral 5-fluorouracil-based drug), carboplatin + pemetrexed + bevacizumab, erlotinib, nivolumab, afatinib, and carboplatin+ S1) were administered, especially for hilar and mediastinal lymph node recurrences. During the eleventh postoperative year, left and right iliac bone metastases were detected, and radiation therapy was undertaken for local control of these lesions. When 18F-fluorodeoxyglucose positron emission tomography was performed for evaluation of the disease, tracer accumulation in the upper rectum was seen. Colonoscopic examination of the rectum revealed an intramural mass with central ulceration, and the mass was diagnosed histologically as an adenocarcinoma. The bone metastases appeared to be controlled, and the patient’s performance status was good, but she had suffered constipation for about a year and desired treatment. Thus, laparoscopic low anterior resection was performed. Histopathologic analysis revealed a moderately differentiated adenocarcinoma existing mainly between the submucosa and serosa, and immunohistochemical analysis showed the tumor to be positive for cytokeratin (CK) 7, negative for CK20, positive for thyroid transcription factor-1, and negative for special AT-rich sequence-binding protein 2 and caudal type homeobox 2, confirming the diagnosis of rectal metastasis from the primary pulmonary adenocarcinoma. The patient recovered well without any change in her functional status. Systemic chemotherapy was resumed, and she continues to do well, now 6 months after surgery. Conclusions Surgery may be a good option for the management of an isolated rectal metastasis from pulmonary cancer in patients whose functional status is good.

In this study, constituent elements affecting the shear strength of RCS joints were investigated through experiment and analysis study. A series of five interior RCS beam-column joint specimens, which were classified as JH-type and CP-type, was tested to investigate the contribution of each shear resisting element such as JH (Joint Hoop), CP (Cover Plate), FBP (Face Bearing Plate), E-FBP (Extended Face Bearing Plate), TB (Transverse Beam), and BP (Band Plate). Comparison between experiment and analysis results showed that the stiffness and strength of the RCS joint were reasonably assessed from the analysis. As a result of the analysis, it was found that TB, E-FBP, and CP increased the shear strength by about 15%, 14%, and 26%, respectively. For the JH-type specimen, 70% of the shear strength of the RCS joint is supported by the inner element and 30% of the shear strength is supported by the outer element. Shear strength contribution ratio of the outer element of CP-type specimen is larger than that of the JH-type specimen. For all specimens except for SNI-1, around 10% of total shear strength is supported by FBP. The shear strength equation of the RCS joint proposed by ASCE underestimates the contribution of the outer element, while that of M-Kanno tends to overestimate it.

In a precast concrete (PC) composite beam, the horizontal interface between the PC beam and the cast-in-place (CIP) slab is located either on the compression side or on the tensile side of the cross-section. If the CIP slab is on the compression side, it becomes C-type interface, and if it is on the tensile side, it becomes T-type interface. Tensile cracks in the CIP slab may cause the horizontal shear strength of composite beams to decrease because of the reduced anchorage performance of shear reinforcements as well as the sliding on the interface. Such a tendency can be found from previous test results of specimens having T-type interface. In this study, the results of the push-off test and the beam flexure test were collected and analyzed to evaluate effects on the horizontal shear strength depending on the interface conditions, such as the interface location, surface roughness, concrete compressive strength, and clamping stress by shear connectors. The horizontal shear strength equations of ACI, PCI, AASHTO LRFD, and MC 2010 were evaluated with a database composed of 84 push-off tests and 95 beam tests from previous studies. According to the evaluation, evaluation results show that the design codes predict the horizontal shear strength conservatively for conditions other than the interface location. The horizontal shear strength deviated largely depending on the interface locations. The design codes conservatively estimate the horizontal shear strength for C-type interface, but the horizontal shear strength of T-type interface is overestimated. Based on current studies, it is recommended to use a friction coefficient of 0.7 as MC 2010 when calculating the horizontal shear strength of a composite beam with roughened T-type interface.

Abstract Background Pancreatic neoplasms are usually characterized by ductal, acinar, or endocrine differentiation. Mixed exocrine and endocrine pancreatic tumours are extremely rare. Here, we report a case of pancreatic mixed acinar-endocrine carcinoma (MAEC) with multiple synchronous liver metastases that were treated with surgery and transcatheter arterial chemoembolization (TACE) that later recurred in the stomach. Case presentation A 45-year-old female with severe anaemia was referred to our hospital. Computed tomography (CT) demonstrated a hypervascular tumour, 17 cm in diameter, that was in the tail of the pancreas. In addition, there were multiple hypervascular tumours in the liver. She underwent a distal pancreatectomy with splenectomy after the liver metastases were treated with TACE. Pathology confirmed that the pancreatic tumour was MAEC. After 4.5 years, a follow-up CT showed a hypervascular tumour at the upper part of the stomach. Gastric endoscopy showed a big tumefactive lesion with surface irregularities, gastric erosion, and multiple dilated vessels in the fornix and greater curvature of the stomach. She underwent a proximal gastrectomy and survived 7 years and 2 months after the start of the treatment. Conclusions This is the first report of a metastatic stomach tumour from pancreatic MAEC, which was successfully treated with a multidisciplinary approach. Additionally, we review the literature and discuss the treatment of MAEC.