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We report a case of an uneventful course after electroconvulsive therapy (ECT) of a patient who had undergone coil embolization for an intracranial aneurysm 37 days earlier. There have been no reports until now of ECT after coil embolization. According to histopathologic examinations, it takes approximately 2 weeks after coil embolization for the aneurysm to become fixed. The ECT can be a therapeutic option even in patients with a previous history of coil embolization, as long as it is performed under proper anesthetic management.

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SUMMARYWe evaluated total energy consumption and CO 2 emissions in the phases of a city gas utilization system from obtaining raw materials to consuming the product. Assuming monthly and hourly demand figures for electricity, heat for space heating, and hot water in a typical hospital, we explore the optimal size and operation of a city gas system that minimizes the life cycle CO 2 emissions or total cost. The cost-effectiveness of conventional cogeneration, a solar heating system, and hybrid cogeneration utilizing solar heat is compared. We formulate a problem of mixed integer programming that includes integral parameters that express the state of system devices such as the on/off condition of switches. As a result of optimization, the hybrid cogeneration can reduce annual CO 2 emissions by 43% compared with the system without cogeneration. The sensitivity of CO 2 reduction and cost to the scale of the CGS is also analyzed.