Results: PPC significantly reduced hepatocyte damage, hepatitis, and hepatic fibrosis, but did not affect steatosis. Phosphorylation of apoptosis signal-regulating kinase 1, p38 mitogen-activated protein kinase, and protein kinase C, as well as activation of nuclear factor-kappa B, were markedly suppressed by PPC. These effects were likely a consequence of decreased oxidative stress through down-regulation of reactive oxygen species (ROS)-generating enzymes, including cytochrome P450 2E1, acyl-CoA oxidase, and NADPH oxidases, in addition to restoration of ethanol-induced increases in Toll-like receptor 4 and CD14. PPC also decreased the pro-apoptotic proteins Bax and truncated Bid, thus inactivating mitochondrial permeability transition. Furthermore, PPC suppressed overexpression of transforming growth factor-1 and hepatic stellate cell activation, which retarded hepatic fibrogenesis. Conclusion: PPC exhibited anti-inflammatory, anti-apoptotic, and anti-fibrotic effects on ALD as a result of inhibition of alcohol-induced ROS production. Background: Dysctamnus dasycarpus has used for the promotion of health in South Korea. But, there were rare a report concerning the hepatotoxicity. We report cilinical features of liver injury by Dysctamnus dasycarpus. Method: Eighteen patients diagnosed as acute toxic hepatitis by Dysctamnus dasycarpus in Chungnam national university hospital between January 2005 and Arpil 2008 was enrolled. Toxic hepatitis was diagnosed by RUCAM score ( 4). The medical records were reviewed, retrospectively. Result: Eleven patients (61%) were female and the mean age was 53.5. Most common symptom was jaundice. Initial laboratory findings were as follows(mean value): WBC 6126/uL, Hemoglobin 13.4 g/dL, Platelet 212×10 3 /L,ALT 1375IU/L, total bilirubin 11.3 mg/dL, alkaline phosphatase 159 U/L, GGT 244U/L, prothrombin time(INR) 1.1. The mean hospitalization was 21.5days. Peak laboratory findings were as follows: ALT 1382IU/L, total bilirubin 15mg/dL. Recovery time of each biochemical finding was as follows: ALT 37days, total bilirubin 39.4 days. Recovery rates of ALT and total bilirubin were 27.8% and 38.9%, 89.9% and 89.9% at 4 weeks, 8 weeks, respectively. The main biochemical pattern of hepatotoxicity was hepatocellar (72.2%) type. Prednisolone was prescribed in six patients. Progressive anemia and thrombocytopenia were detected in one patient diagnosed as pure red cell aplasia. Other one patient had prolonged jaundice (117 days). But, all patients had recovered without sequelae. Conclusion: In South Korea, Liver injury by Dysctamnus dasycarpus was more frequent in women. The main pattern of hepatotoxicity was hepatocelluar type. Most patients had prolonged icteric phase and hospitalization. Patients were recovered by supportive management after drug cessation or prednisolone therapy. In Korea, traditional medicine that is based on the use of herbal medicine developed from a long time ago. However, clinical study of the herbal medicine is not conducted in a structured manner. We report three cases of toxic hepatitis caused by the intake of Dictamnus Albus. The first patient, a 44 year old woman was admitted due to nausea after ingestion of liquor containing Dictamnus albus for 2 months. Total bilirubin was 2.55 mg/dL AST/ALT 774/1,424 IU/L on admission. Liver biopsy observed hepatocyte necrosis and cholestasis. The elevated bilirubin and transaminase returned to normal 2 weeks later after cessation of Dictamnus albus. The second patient, a 64 year old man was admitted due to jaundice after ingestion of boiling Dictamnus albus for 3 months. Total bilirubin was 11.37 mg/dL AST/ALT 2,010/2,522 IU/L on admission. Liver biopsy observed pericellular fibrosis and necrosis. The bilirubin decreased slowly compared to the transaminase and normalized 3 months later after cessation of Dictamnus albus. The third patient, a 48 year old man was admitted due to jaundice after ingestion of liquor containing Dictamnus ablus for 1 month. Total bilirubin was 12.8 mg/dL AST/ALT 1,097/1,869 IU/L The hepatocyte necrosis was observed by liver biopsy. The elevated bilirubin and transaminase levels normalized 1 month later after cessation of Dictamnus albus. All patients had negative viral markers and non-specific ultrasonographic findings. The above mentioned three cases demonstrate that liver may have been damaged by Dictamnus albus, which indicated clinical characteristics. Background/Aims: CMILI poses a diagnostic challenge as no tests are available to confirm the causality. The aims of this study were 1) to evaluate clinical features and patterns of CMILI and 2) to assess the likelihood of causality among patients with liver impairment and exposure to Chinese Medicine (CM) by a multidisciplinary approach. Method: Between 5/2005 and 8/2007, patients who had liver derangement and CM or proprietary CM exposure within six months managed in the United Christian Hospital were studied. Clinical features and the CM were reviewed by a multidisciplinary team involving a hepatologist, a toxicologist and CM experts. Literature search of relevant herbs in Chinese and western journals were performed. CM samples or residue were sent to toxicology laboratory for analysis to look for any toxic constituents, adulterant or contaminant. The likelihood of causality was ranked by various experts independently and disagreements were settled by a consensus meeting. Results: There were forty-six cases of suspected CMILI, nineteen cases with alternative causes of liver diseases were excluded. Twenty-seven cases of CMILI proceeded to detailed analysis. Median age of patients was 51 (21-76) with female predominance. The median duration of CM exposure to presentation was 20 (1-150) days. Majority of them (82%) had hepatocellular liver injury pattern. One case of adulteration with NSAID and erroneous substitution of herb was identified respectively Causality were classified as unlikely, possible, probable and highly probable in 3, 12, 8 and 3 patients respectively. Conclusion: A multidisciplinary approach allows systemic evaluation of suspected CMILI.