21:I[432972,["/_next/static/chunks/bb923814e1f4d2e9.js","/_next/static/chunks/dd3ee9f5b7716ca6.js","/_next/static/chunks/4204a0ae82542ca8.js","/_next/static/chunks/1270dead247da766.js","/_next/static/chunks/6e1aa89a642f40be.js","/_next/static/chunks/2d7aa753e81324a8.js","/_next/static/chunks/8ffd0b71567920d8.js","/_next/static/chunks/67ea6dfd21f16c5f.js","/_next/static/chunks/24eb4379f68013fd.js","/_next/static/chunks/b8cd775ffdf935bd.js","/_next/static/chunks/983103cd9eb7b428.js","/_next/static/chunks/263f2cdcb9aa2341.js","/_next/static/chunks/294b9525248c8e5f.js"],"default"] 22:T489,We used recombinant-DNA technology and gel electrophoresis to find hepatitis B virus DNA (HBV-DNA) in liver and tumor tissue from patients with hepatocellular carcinoma and chronic liver disease, and to study the integration of HBV-DNA into the genome of these tissues' cells. In 12 patients with hepatocellular carcinoma who had hepatitis B surface antigen (HBsAg) in their serum, integrated HBV-DNA was identified in the tumors; it was also found in tumors from three of eight patients who were seronegative for HBsAg but positive for antibody to HBsAg. In some cases, integrated HBV-DNA was also present in nontumorous liver tissue that had the same hybridization pattern or one different from that of the tumor. In five carriers of HBsAg who had evidence of the carrier state and chronic liver disease for less than two years, HBV-DNA was present but not integrated in liver tissue. In the two patients who had carried HBsAg for more than eight years, HBV-DNA was integrated into the host genome. These data suggest that integration of HBV-DNA into hepatocytes occurs during the course of persistent HBV infection and precedes development of gross neoplasm.23:T469,FRICTION rubs heard over the liver result from inflammation or necrosis.^1,2Hepatic rubs may occur in metastatic cancer,³gonococcal perihepatitis,⁴alcoholic cirrhosis,¹pyogenic abscess,^1,5bile duct carcinoma, viral hepatitis, perihepatitis secondary to systemic lupus erythematosus, cholecystitis, and tuberculous peritonitis.¹ Hepatic arterial bruits have been reported to occur in malignant hepatoma, metastatic cancer of the liver, and alcoholic hepatitis.⁶ We postulated the presence of a hepatic rub and bruit in the same patient would be indicative of a malignant neoplasm in the liver.

Patients and Methods

Approximately 1,000 patients were examined the morning after their admission to general medical wards at the Veterans Administration Hospital and Grady Memorial Hospital during a two-month period. Auscultation was carried out in four quadrants of the abdomen to detect rubs and bruits. Organomegaly was determined by palpation.

Results

Bruits From Large Vessels.—

Four patients without hepatomegaly had systolic

#	Concept	H-Index	Publications	Citations
1	Health Sciences	1	1	16
2	Medicine	1	1	16
3	Gastroenterology	1	1	16
4	Hepatology	1	1	16
5	Pathology	1	1	16

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