• Korean Journal of Radiology
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• 제23권4호
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• pp.466-478
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• 2022

Objective: ¹⁸F-fluorodeoxyglucose (FDG) PET/CT is often used for detecting malignancy in patients with newly diagnosed hemophagocytic lymphohistiocytosis (HLH), with acceptable sensitivity but relatively low specificity. The aim of this study was to improve the diagnostic ability of ¹⁸F-FDG PET/CT in identifying malignancy in patients with HLH by combining ¹⁸F-FDG PET/CT and clinical parameters. Materials and Methods: Ninety-seven patients (age ≥ 14 years) with secondary HLH were retrospectively reviewed and divided into the derivation (n = 71) and validation (n = 26) cohorts according to admission time. In the derivation cohort, 22 patients had malignancy-associated HLH (M-HLH) and 49 patients had non-malignancy-associated HLH (NM-HLH). Data on pretreatment ¹⁸F-FDG PET/CT and laboratory results were collected. The variables were analyzed using the Mann-Whitney U test or Pearson's chi-square test, and a nomogram for predicting M-HLH was constructed using multivariable binary logistic regression. The predictors were also ranked using decision-tree analysis. The nomogram and decision tree were validated in the validation cohort (10 patients with M-HLH and 16 patients with NM-HLH). Results: The ratio of the maximal standardized uptake value (SUVmax) of the lymph nodes to that of the mediastinum, the ratio of the SUVmax of bone lesions or bone marrow to that of the mediastinum, and age were selected for constructing the model. The nomogram showed good performance in predicting M-HLH in the validation cohort, with an area under the receiver operating characteristic curve of 0.875 (95% confidence interval, 0.686-0.971). At an appropriate cutoff value, the sensitivity and specificity for identifying M-HLH were 90% (9/10) and 68.8% (11/16), respectively. The decision tree integrating the same variables showed 70% (7/10) sensitivity and 93.8% (15/16) specificity for identifying M-HLH. In comparison, visual analysis of ¹⁸F-FDG PET/CT images demonstrated 100% (10/10) sensitivity and 12.5% (2/16) specificity. Conclusion: ¹⁸F-FDG PET/CT may be a practical technique for identifying M-HLH. The model constructed using ¹⁸F-FDG PET/CT features and age was able to detect malignancy with better accuracy than visual analysis of ¹⁸F-FDG PET/CT images.

• Journal of Korean Neurosurgical Society
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• 제67권3호
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• pp.345-353
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• 2024

Objective : Blood-blister aneurysms (BBAs) of the internal carotid artery (ICA) are challenging lesions with high morbidity and mortality rates. Although research on BBAs is well documented in different populations, the study of BBAs in the Tibetan population is extremely rare. This study aimed to evaluate the characteristics of BBAs and analyze the treatment modalities and long-term outcomes in the Tibetan population in comparison with the Han population. Methods : The characteristics of patients with BBAs of the ICA from January 2009 to January 2021 at our institution were reviewed. The features of aneurysms, treatment modalities, complications, and follow-up outcomes were retrospectively analyzed. Results : A total of 130 patients (41 Tibetan and 89 Han patients) with BBAs of the ICA who underwent treatment were enrolled. Compared with the Han group, the Tibetan group significantly demonstrated a high ratio of BBAs among ICAs (8.6%, 41/477 vs. 1.6%, 89/5563; p<0.05), a high ratio of vasospasm (34.1%, 14/41 vs. 6.7%, 6/89; p=0.001), a high risk of ischemic events (43.9%, 18/41 vs. 22.5%, 20/89; p<0.05), and a low ratio of good outcomes (modified Rankin scale, 0-2) at the 1-year follow-up (51.2%, 21/41 vs. 74.2%, 66/89; p<0.05). The multivariate regression model showed that ischemic events significantly contributed to the prediction of outcomes at 1 year. Further analysis revealed that microsurgery and vasospasm were associated with ischemic events. Conclusion : In comparison with Han patients, the Tibetan population had a high ratio of BBA occurrence, a high incidence of ischemic events, and a high ratio of poor outcomes. The endovascular approach showed more benefits in BBA patients.

• Animal Bioscience
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• 제37권3호
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• pp.437-450
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• 2024

Objective: Vanin-1 (VNN1) is a pantetheinase that catalyses the hydrolysis of pantetheine to produce pantothenic acid and cysteamine. Our previous studies have shown that the VNN1 is specifically expressed in chicken liver which negatively regulated by microRNA-122. However, the functions of the VNN1 in lipid metabolism in chicken liver haven't been elucidated. Methods: First, we detected the VNN1 mRNA expression in 4-week chickens which were fasted 24 hours. Next, knocked out VNN1 via CRISPR/Cas9 system in the chicken Leghorn Male Hepatoma cell line. Detected the lipid deposition via oil red staining and analysis the content of triglycerides (TG), low-density lipoprotein-C (LDL-C), and high-density lipoprotein-C (HDL-C) after VNN1 knockout in Leghorn Male Hepatoma cell line. Then we captured various differentially expressed genes (DEGs) between VNN1-modified LMH cells and original LMH cells by RNA-seq. Results: Firstly, fasting-induced expression of VNN1. Meanwhile, we successfully used the CRISPR/Cas9 system to achieve targeted mutations of the VNN1 in the chicken LMH cell line. Moreover, the expression level of VNN1 mRNA in LMH-KO-VNN1 cells decreased compared with that in the wild-type LMH cells (p<0.0001). Compared with control, lipid deposition was decreased after knockout VNN1 via oil red staining, meanwhile, the contents of TG and LDL-C were significantly reduced, and the content of HDL-C was increased in LMH-KO-VNN1 cells. Transcriptome sequencing showed that there were 1,335 DEGs between LMH-KO-VNN1 cells and original LMH cells. Of these DEGs, 431 were upregulated, and 904 were downregulated. Gene ontology analyses of all DEGs showed that the lipid metabolism-related pathways, such as fatty acid biosynthesis and long-chain fatty acid biosynthesis, were enriched. KEGG pathway analyses showed that "lipid metabolism pathway", "energy metabolism", and "carbohydrate metabolism" were enriched. A total of 76 DEGs were involved in these pathways, of which 29 genes were upregulated (such as cytochrome P450 family 7 subfamily A member 1, ELOVL fatty acid elongase 2, and apolipoprotein A4) and 47 genes were downregulated (such as phosphoenolpyruvate carboxykinase 1) by VNN1 knockout in the LMH cells. Conclusion: These results suggest that VNN1 plays an important role in coordinating lipid metabolism in the chicken liver.

• Korean Journal of Radiology
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• 제22권11호
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• pp.1841-1849
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• 2021

Objective: To prospectively investigate the feasibility of shear wave elastography (SWE) as a new quantitative and objective method for evaluating the stiffness of the gastrocnemius medialis (GM) muscle during passive stretching in patients with Parkinson's disease (PD). Materials and Methods: SWE of the GM muscle was performed in 28 patients with PD [13 female and 15 male; mean age ± standard deviation (SD): 63.0 ± 8.5 years] and 12 healthy controls (5 female and 7 male; mean age ± SD: 59.3 ± 6.4 years) during passive ankle rotation. A Young's modulus-ankle angle curve was constructed. The GM slack angle and baseline Young's modulus (E₀) were compared between the markedly symptomatic and mildly symptomatic sides of patients with PD, and healthy controls. Additionally, the correlation between the GM slack angle and the severity of rigidity, and the observer reproducibility of SWE in determining the GM slack angle were evaluated. Results: The GM slack angle was smaller on both the markedly and mildly symptomatic sides in patients with PD than in healthy controls (mean ± SD of -29.13° ± 3.79° and -25.65° ± 3.39°, respectively, vs. -21.22° ± 3.52°; p < 0.001 and p = 0.006, respectively). Additionally, in patients with PD, the GM slack angle on the markedly symptomatic side was smaller than that on the mildly symptomatic side (p = 0.003). The E0 value was lower on both the markedly and mildly symptomatic sides in patients with PD than in healthy controls (mean ± SD of 10.11 ± 2.85 kPa and 10.08 ± 1.88 kPa, respectively, vs. 12.23 ± 1.02 kPa; p = 0.012 and p < 0.001, respectively). However, no significant difference was found between the markedly and mildly symptomatic sides in patients with PD (p = 0.634). A negative linear relationship was observed between the GM slack angle and lower limb rigidity score on the markedly symptomatic side in patients with PD (r = -0.719; p < 0.001). The intraclass correlation coefficients for observer reproducibility of SWE ranged from 0.880 to 0.951. Conclusion: The slack angle determined by SWE may be a useful quantitative and reproducible method for evaluating muscle stiffness in patients with PD.

• Korean Journal of Radiology
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• 제22권2호
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• pp.168-178
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• 2021

Objective: To provide an automatic method for segmentation and diameter measurement of type B aortic dissection (TBAD). Materials and Methods: Aortic computed tomography angiographic images from 139 patients with TBAD were consecutively collected. We implemented a deep learning method based on a three-dimensional (3D) deep convolutional neural (CNN) network, which realizes automatic segmentation and measurement of the entire aorta (EA), true lumen (TL), and false lumen (FL). The accuracy, stability, and measurement time were compared between deep learning and manual methods. The intra- and inter-observer reproducibility of the manual method was also evaluated. Results: The mean dice coefficient scores were 0.958, 0.961, and 0.932 for EA, TL, and FL, respectively. There was a linear relationship between the reference standard and measurement by the manual and deep learning method (r = 0.964 and 0.991, respectively). The average measurement error of the deep learning method was less than that of the manual method (EA, 1.64% vs. 4.13%; TL, 2.46% vs. 11.67%; FL, 2.50% vs. 8.02%). Bland-Altman plots revealed that the deviations of the diameters between the deep learning method and the reference standard were -0.042 mm (-3.412 to 3.330 mm), -0.376 mm (-3.328 to 2.577 mm), and 0.026 mm (-3.040 to 3.092 mm) for EA, TL, and FL, respectively. For the manual method, the corresponding deviations were -0.166 mm (-1.419 to 1.086 mm), -0.050 mm (-0.970 to 1.070 mm), and -0.085 mm (-1.010 to 0.084 mm). Intra- and inter-observer differences were found in measurements with the manual method, but not with the deep learning method. The measurement time with the deep learning method was markedly shorter than with the manual method (21.7 ± 1.1 vs. 82.5 ± 16.1 minutes, p < 0.001). Conclusion: The performance of efficient segmentation and diameter measurement of TBADs based on the 3D deep CNN was both accurate and stable. This method is promising for evaluating aortic morphology automatically and alleviating the workload of radiologists in the near future.

• Pediatric Infection and Vaccine
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• 제4권1호
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• pp.116-125
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• 1997

목 적 : 국내에서 사용되고 일본뇌염 바이러스 백신에 대한 야외 실험을 실시하여 국내 백신 제조에 사용되는 Nakayama-NIH주의 국내 접종자에 대한 항체 생성율 및 중화 항체의 지속율을 조사하고, 일본뇌염 접종 스케줄의 재조정 및 국내 면역 집단의 민감도 조사 등을 통하여 방역 대책의 기초 자료로 활용하고자 하였다. 방 법 : 일본뇌염 백신의 면역효과 및 항체지속 기간을 알아보고자 1994년부터 계속 사업으로 강화군에 소재하고 있는 K 초등학교 학생들을 대상으로 조사를 실시하였다. 대상자들의 혈액을 시기에 따라 채혈하여 hemagglutination inhibition test (HI) 및 plaque reduction neutralization test (PRNT)를 실시하여 항체가를 조사하였다. 결 과 : 총 조사 대상자 213명은 이미 기초 접종이 끝난 자들로서 HI 항체가는 '95년 4월 백신 면역전에 이미 63.4%가 1:10 이상의 항체가를 가지고 있었으며 중화항체가는 전원이 1:20 이상의 항체가를 가지고 있었다. '95년 백신 접종 후 12개월이 지난 1996년 4월까지 HI 항체가 1:20 이상이 55.7%이며, 중화항체가는 전원이 1:20 이상을 보유하고 있었다. 이들에게 1996년 4월에 재접종 후 6개월째에는 HI 항체가가 1:10 이상이 69.7%로 증가하였고 G.M.T값은 1:11.6에서 1:13.23, 중화 항체의 G.M.T는 1:275.7에서 1:348.1로 증가하였다. 결 론 :위의 실험 결과에 따르면 현재 국내에서 사용중인 불활화 일본뇌염 백신은 자연계 에서 일본뇌염 바이러스가 공격하는 $10^5$ $LD_{50}$를 막을 수 있는 중화항체가 1:20을 기본면역 1회로 1년 이상 유지하고 있었으며, 충분한 boosting 효과를 보이고 있었다. 따라서 일본뇌염 백신의 추가면역은 기본접종후 개인의 상태에 따라 2~3년 간격의 추가접종이 적절하다 고 생각된다.

• Korean Journal of Radiology
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• 제25권5호
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• pp.426-437
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• 2024

Objective: Cardiac magnetic resonance (CMR) is a diagnostic tool that provides precise and reproducible information about cardiac structure, function, and tissue characterization, aiding in the monitoring of chemotherapy response in patients with light-chain cardiac amyloidosis (AL-CA). This study aimed to evaluate the feasibility of CMR in monitoring responses to chemotherapy in patients with AL-CA. Materials and Methods: In this prospective study, we enrolled 111 patients with AL-CA (50.5% male; median age, 54 [interquartile range, 49-63] years). Patients underwent longitudinal monitoring using biomarkers and CMR imaging. At follow-up after chemotherapy, patients were categorized into superior and inferior response groups based on their hematological and cardiac laboratory responses to chemotherapy. Changes in CMR findings across therapies and differences between response groups were analyzed. Results: Following chemotherapy (before vs. after), there were significant increases in myocardial T2 (43.6 ± 3.5 ms vs. 44.6 ± 4.1 ms; P = 0.008), recovery in right ventricular (RV) longitudinal strain (median of -9.6% vs. -11.7%; P = 0.031), and decrease in RV extracellular volume fraction (ECV) (median of 53.9% vs. 51.6%; P = 0.048). These changes were more pronounced in the superior-response group. Patients with superior cardiac laboratory response showed significantly greater reductions in RV ECV (-2.9% [interquartile range, -8.7%-1.1%] vs. 1.7% [-5.5%-7.1%]; P = 0.017) and left ventricular ECV (-2.0% [-6.0%-1.3%] vs. 2.0% [-3.0%-5.0%]; P = 0.01) compared with those with inferior response. Conclusion: Cardiac amyloid deposition can regress following chemotherapy in patients with AL-CA, particularly showing more prominent regression, possibly earlier, in the RV. CMR emerges as an effective tool for monitoring associated tissue characteristics and ventricular functional recovery in patients with AL-CA undergoing chemotherapy, thereby supporting its utility in treatment response assessment.

• Pediatric Infection and Vaccine
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• 제9권1호
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• pp.67-73
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• 2002

목 적 : 최근 2~3년 주기로 홍역이 유행하고 있으며, 특히 2000년 말부터 2001년 초까지는 홍역의 집단발생으로 방역당국과 의료계가 비상이었다. 이에 저자들은 홍역에 이환된 환아의 혈청 항홍역 항체를 측정하고 홍역 예방 접종 유무에 따른 차이를 조사하여, 홍역 예방 접종의 효과를 보고, 추가접종의 필요성 및 시기를 살펴보고자 본 연구를 시행하였다. 방 법 : 2000년 6월부터 2001년 6월까지 임상적으로 홍역이 의심되어 원주기독병원에 입원 또는 외래 방문한 298명의 환아 중, criteria for disease control을 만족하는 201명의 환아를 대상으로 홍역 발생의 성별, 월별분포, 예방접종 유무에 따른 연령별 분포 및 항홍역 항체의 양상을 조사하였다. 항홍역 항체의 측정은 발진시기에 채혈한 혈액을 Immunofluorescent Assay로 시행하였으며 IgG 항체는 역가가 1 : 10 이상인 경우를 양성으로 판정하였고, IgM 항체는 양성인 경우를 양성으로 하였다. 결 과 : 1) 대상군은 남아 117명, 여아 84명으로 남녀비는 1.4 : 1이었다. 2) 월병 발생 빈도는 5월에 38례(18.9%)로 가장 많이 발생하였으며, 2000년 11월부터 2001년 1월까지 증가 추세에 있다가 2월과 3월에 감소한 후 4월부터 다시 증가하였다. 3) 대상군 중 예방 접종을 시행한 경우는 93례(46.3%), 시행하지 않은 경우는 108례(53.7%)로 비접종군이 더 많았으나, 통계학적으로 유의한 차이는 없었다. 4) 접종군에서의 연령별 분포는 10세 이상에서 54례(58.1%), 7~10세가 15례(16.0%), 15개월~3세가 12례(12.9%), 4~6세 및 6~14개월이 각각 6례(6.5%)였다. 5) 비접종군에서의 연령별 분포는 6~14개월이 88례(81.5%), 15개월~3세가 9례(8.3%), 6개월 미만이 7례(6.5%), 10세 이상 3례(2.8%), 7~10세가 1례(0.9%)였다. 6) 예방접종 유무에 따른 항홍역 항체 IgG, IgM의 분포는 접종군에서 IgG, IgM 모두 양성인 경우가 78례(87.6%), IgG(+) IgM(-)인 경우가 11례(12.4%)였으며, 비접종군에서는 IgG, IgM 모두 양성인 경우가 69례(63.9%), IgG(-), IgM(+)인 경우는 39례(36.1%)로 나타났다. 결 론 : 홍역에 이환된 환아 중 비접종군에서는 6~14개월에 이환율이 가장 높았으며 이는 6~14개월에 모체로부터 받은 항체가 가장 많이 소실되기 때문으로 사료된다. 접종군에서는 10세 이상에서 이환율이 가장 높았고, IgG, IgM 모두 양성이면서 홍역에 이환된 경우가 대부분인 점으로 보아, 홍역 특이 IgG 항체 역가가 10세 이후에 가장 많이 감소하는 것으로 추측할 수 있다. 따라서 홍역의 퇴치를 위해서 홍역의 초기 예방접종 뿐만 아니라 재접종이 중요하며, 특히 재접종의 시기가 매우 중요할 것으로 사료된다.

• Nuclear Medicine and Molecular Imaging
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• 제42권6호
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• pp.469-477
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• 2008

목적: 소동물용 PET은 우수한 공간분해 능과, 민감도가 요구된다. 본 연구에서는 256개의 개별적 채널을 4개로 줄여 검출위치를 추정할 수 있는 회로를 설계하고 제작하였으며, 256($16{\times}16$)개의 양극 출력 채널을 가지는 고집적도의 광전자증배관 및 $L_{0.9}GSO$ 섬광결정과 결합하여 그 성능을 검증하였다. 대상 및 방법: 설계한 회로를 제작하기에 맞서 전자회로 시뮬레이션을 통해 성능을 예상하였다. 회로의 검증과 성능분석을 위하여 위치결정회로, H9500(Hamamatsu Photorucs K.K., 일본) 광전자증배관, $1.5{\times}1.5{\times}7.0\;mm^3$ $L_{0.9}GSO$ 섬광결정으로 두 개의 검출단을 제작하고 $3.7{\times}10^5$ Bq의 $^{22}Na$ 방사선원을 사용하여 동시이벤트를 검출하였다. 첫 번째 검출단은 $L_{0.9}GSO\;29{\times}29$ 섬광결정블록을 단층으로 구성하였고, 두 번째 검출단은 $L_{0.9}GSO\;29{\times}29$와 $28{\times}28$ 섬광결정블록을 x와 y방향으로 각각 섬광결정 단면 길이의 반만큼 오프셋을 두어 접합하였다. 또한 측정된 데이터를 실제 섬광결정 영역으로 보정하기 위하여 섬광결정지도를 구했다. 결과: 평면영상을 통해 각 섬광결정들이 잘 구분되는 것을 확인할 수 있었고, 회로 개선 후 주변부의 섬광결정들이 마지막 줄까지 명백히 구분되었다. 각 섬광결정들의 에너지 분해능은 11.6%(표준편차 1.6)이었다. 결론: 본 연구에서 제안한 위치결정회로는 실험을 통해 소동물용 PET개발에 있어 만족할만한 성능을 보여주었다. 향후 더욱 정밀한 시스템을 제작하기 위해서는 다중양극 광전자증배관의 이득 불균일을 보정하기 위한 연구가 진행되어야 할 것이다.

• 자원환경지질
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• 제30권5호
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• pp.417-431
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• 1997

Characteristics of sedimentary rocks and enrichment of toxic elements in shale and coal from the Chungnam coal field were investigated based upon geochemistry of major, trace and rare earth elements. Shale and coal of the area are interbedded along the Traissic to the Jurassic Daedong Supergroup, which can be subdivided into grey shale, black shale and coal. The coal had been mined, however all the mines are abandonded due to the economic problems. The shale and coal are characterized by relatively low contents of $SiO_2$, and $Al_2O_3$ and high levels of loss-on-ignition (LOI), CaO and $Na_2O$ in comparison with the North American Shale Composite (NASC). Light rare earth elements (La, Ce, Yb and Lu) are highly enriched with the coal. Ratios of $Al_2O_3/Na_2O$ and $K_2O/Na_2O$ in shale and coal range from 30.0 to 351.8 and from 4.2 to 106.8, which have partly negative correlations against $SiO_2/Al_2O_3$ (1.24 to 6.06), respectively. Those are suggested that controls of mineral compositions in shale and coal can be due to substitution and migration of those elements by diagenesis and metamorphism. Shale and coal of the area may be deposited in terrestrial basin deduced from high C/S (39 to 895) and variable composition of organic carbon (0.39 to 18.40 wt.%) and low contents of reduced sulfur (0.01 to 0.05 wt.%). These shale and coal were originated from the high grade metamorphic and/or igneous rocks, and the rare earth elements of those rocks are slightly influenced with diagenesis and metamorphism on the basis of $Al_2O_3$ versus La, La against Ce, Zr versus Yb, the ratios of La/Ce (0.38 to 0.85) and Th/U (3.6 to 14.6). Characteristics of trace and rare earth elements as Co/Th (0.07 to 0.86), La/Sc (0.31 to 11.05), Se/Th (0.28 to 1.06), V/Ni (1.14 to 3.97), Cr/V (1.4 to 28.3), Ni/Co (2.12 to 8.00) and Zr/Hf (22.6~45.1) in the shale and coal argue for inefficient mixing of the simple source lithologies during sedimentation. These rocks also show much variation in $La_N/Yb_N$ (1.36 to 21.68), Th/Yb (3.5 to 20.0) and La/Th (0.31 to 7.89), and their origin is explained by derivation from a mixture of mainly acidic igneous and metamorphic rocks. Average concentrations in the shale and coal are As=7.2 and 7.5, Ba=913 and 974, Cr=500 and 145, Cu=20 and 26, Ni=38 and 35, Pb=30 and 36, and Zn=77 and 92 ppm, respectively, which are similar to those in the NASC. Average enrichment indices for major elements in the shale (0.79) and coal (0.77) are lower than those in the NASC. In addition, average enrichment index for rare earth elements in coal (2.39) is enriched rather than the shale (1.55). On the basis of the NASC, concentrations of minor and/or environmental toxic elements in the shale and coal were depleted of all the elements examined, excepting Cr, Pb, Rb and Th. Average enrichment indices of trace and/or potentially toxic elements (As, Cr, Cu, Ni, Pb, U and Zn) are 1.23 to 1.24 for shale and 1.06 to 1.22 for coal, respectively.