The Since gallium is a bone-seeking element (1-3), radionuclides of this element have been of clinical interest as diagnostic screening agents of bone tumors. In 1969 Edwards and Hayes (4) noted that carrier-free gallium-67 citrate was localized in addition in nonosseous tumors in patients with Hodgkin's disease and other lyinphomas. Deposition of this radioactive salt was also observed in patients with other "soft-tissue", slow-growing tumors (4-8), such as poorly differentiated thyroid adenocarcinoma, reticulum cell sarcoma, lymphosarcoma, and carcinomas of the lung, breast, colon, and kidney. These unexpected observations prompted studies on the concentration of this gallium radionuclide in various experimental animal tumors. Seven nonosseous rat and mouse carcinomas and sarcomas showed variable but distinct localization of 67Ga, in contrast to deposition in normal tissues (9). In addition, the Cancer Chemotherapy National Service Center has found that gallium nitrate possessed antitumor activity against Walker 256 carcinosarcoma in rats. These observations prompted us to examine the antitumor activity of gallium and metal salts chemically related to gallium. In increasing order of atomic numbers and atomic weight, the elements of Group lila of the periodic table are boron (B), aluminum (Al), gallium (Ga), indium (In), and thallium (Tl). The +3 oxidation state of these elements as cations is the most stable form in aqueous solution, except for thallium +3 which is slowly converted to the +1 form. The +3 forms of these elements were used in our experiments. We were unable to obtain a stable cationic

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Abstract. Introduction: Proliferation of Food and Drug Administration-approved drugs makes it impossible for emergency medicine (EM) faculty to stay current on potential interactions between drugs, and with diseases, laboratory tests, and ethanol. A computer database may augment physician knowledge. Objectives: To compare the performance of EM faculty and an ''expert'' emergency physician (EP) with that of a criterion standard computer database in identifying potential drug interactions, and to report the incidence of drug-ethanol and drug-laboratory test interactions. Methods: This was a retrospective review of 276 emergency department charts for drug, ethanol, lab, and medical history. Evaluation by both EM faculty and an ''expert'' EP of patient history was done to identify potential interactions, and comparison with the Micromedex Drug-Reax database for potential interactions (graded minor, moderate, or major) was made. Clinical significance of potential interactions was judged by a second EM faculty member. Results: Seventeen percent of the patients had potential drug-drug interactions, and 25% of these were judged to be clinically significant. Up to 52% of the patients had potential drug-ethanol interactions, while 38% of the patients could have potential druglab interactions. Sensitivity, specificity, and positive and negative predictive values of the EM faculty for potential drug-drug interactions compared with the computer were poor, at 14%, 58%, 6%, and 23%, respectively. The corresponding values for the ''expert'' EP were 25%, 86%, 26%, and 85%. The ''expert'' EP was statistically better than the EM faculty, but still less sensitive and predictive than the computer. Conclusions: A computer can aid the physician in avoiding potential drug interactions. Prospective validation of these findings should be done.