Laryngotracheal injuries are relatively rare but their mortality rate is fairly high. Complete disruption of trachea is extremely rare and a systematic approach is needed for early diagnosis and favourable outcome. The patients symptoms and physical signs do not necessarily correlate with the severity of the injuries and this case report highlights it. This is a case report of 25-year-old man who arrived to the emergency department 8 h after a motor accident in which a rope was wrapped around his neck. Because of the good general and respiratory condition of the patient on admission, the pathognomonic signs of laryngeal injury were not noticed. A computed tomographic scan showed distortion of cricotracheal framework. Flexible bronchoscopy showed cricotracheal transaction. Immediately, the endotracheal tube was advanced distal to the transection site under bronchoscopic guide and then after neck exploration primary end-to-end cricotracheal anastomosis was performed.
Most of researches consider seismic analysis using amplification of ground acceleration due to geotechnical effects. Many efforts also have been done to consider topographical effects in seismic analysis of alluvial valleys. Presented here is a new practical approach in spectral response of non-curved valleys which may be used as a simple method for considering topographical effects. A hybrid numerical approach which uses both FEM and BEM is conducted to study spectral acceleration increment due to geotechnical aspects in various topographical conditions. At first, spectral acceleration of non-curved valleys due to presence of sediments is investigated for various geometrical dimensions. The results show that the maximum value of normalized spectral acceleration response increases when the depth ratio of valleys increases. Practical criterion based on shape of configurations is presented to estimate normalized spectral acceleration. Finally geotechnical effects are quantified and a practical formulation is presented which cover all the conditions in non-curved valleys.
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