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In recent years, many expert panels have warned that budget cuts were causing the public health system in the United States to crumble. On top of traditional services for mothers and children, health departments have had to apply more sophisticated laboratory techniques and newer methods to counter the resurgence of tuberculosis and to keep other infectious diseases in check. The latest demands involve a vaccine that few practicing doctors have ever given because the United States abandoned it as a routine in 1972, eight years before smallpox was eradicated from the world. Now health departments must train workers in how to use two-pronged needles to administer the vaccine and recognize its many complications, some of which are rare but potentially lethal. The vaccine, which is made from a live virus that is a cousin to smallpox, is the most dangerous human immunization. Experts have predicted that some recipients will have sore arms and suffer flulike symptoms that will keep them home from work and that a few will have much more serious reactions. Some people are advised to forgo vaccination unless there is a terrorist attack. Among them are those with weakened immune systems or a history of eczema or atopic dermatitis, two common skin conditions. Dr. Elizabeth McNeill, the chief medical officer of the Pima County Health Department in Tucson, Arizona, said she had a hard time justifying putting so many resources into smallpox vaccinations. I don't see a tangible benefit, she said. In other words, there is no case of smallpox out there

Many local health departments across the nation say they will have to curtail an array of services, including cancer and tuberculosis screenings and children's dental check-ups, to meet the needs of President Bush's federal smallpox vaccination program

WASHINGTON - Many local health departments across the nation say they will have to curtail an array of services, including cancer and tuberculosis screening and children's dental examinations, to meet the needs of President Bush's federal smallpox vaccination program. The Bush administration has requested that health departments administer smallpox vaccine to health care workers on a voluntary basis. Local health departments are responsible for giving smallpox vaccinations in two stages. In the first, which is expected to begin this month and last about 60 days, up to 500,000 civilian health care and emergency workers will be vaccinated. In the second, up to 10 million health care workers, police officers, firefighters and emergency medical technicians will be offered the vaccine. The latest demands involve a vaccine that few practicing doctors have ever given because the United States abandoned it as a routine in 1972, eight years before smallpox was eradicated from the world. Now health departments must train workers how to use two-pronged needles to administer the vaccine and recognize its many complications, some rare but potentially lethal

WASHINGTON _ Many local health departments across the nation say they will have to curtail an array of services, including cancer and tuberculosis screening and children's dental examinations, to meet the needs of President [Bush]'s federal smallpox vaccination program. The Bush administration has requested that health departments administer smallpox vaccine to health care workers on a voluntary basis. Local health departments are responsible for giving smallpox vaccinations in two stages. In the first, which is expected to begin this month and last about 60 days, up to 500,000 civilian health care and emergency workers will be vaccinated. In the second, up to 10 million health care workers, police officers, firefighters and emergency medical technicians will be offered the vaccine. The latest demands involve a vaccine that few practicing doctors have ever given because the United States abandoned it as a routine in 1972, eight years before smallpox was eradicated from the world. Now health departments must train workers how to use two-pronged needles to administer the vaccine and recognize its many complications, some rare but potentially lethal

The [Bush] administration has requested that health departments administer smallpox vaccine to health care workers on a voluntary basis. Local health departments are responsible for giving smallpox vaccinations in two stages. In the first, which is expected to begin this month and last about 60 days, up to 500,000 civilian health care and emergency workers will be vaccinated. In the second, up to 10 million health care workers, police officers, firefighters and emergency medical technicians will be offered the vaccine. Dr. Thomas R. Frieden, the New York City health commissioner, said he expected the impact to be severe. ''While we appreciate the federal government's support for bioterrorism preparedness, the vaccination drive will be extraordinarily disruptive to our day-to-day work of protecting the public's health,'' Dr. Frieden said. ''This is the unfortunate price we are paying for the level of preparedness it appears we need.'' The latest demands involve a vaccine that few practicing doctors have ever given because the United States abandoned it as a routine in 1972, eight years before smallpox was eradicated from the world. Now health departments must train workers how to use two-pronged needles to administer the vaccine and recognize its many complications, some rare but potentially lethal

Local health departments are responsible for giving smallpox vaccinations in two stages. In the first, which is expected to begin this month and last about 60 days, up to 500,000 civilian health- care and emergency workers will be vaccinated. In the second, up to 10 million health-care workers, police officers, firefighters and emergency medical technicians will be offered the vaccine

Many local health departments across the nation say they will have to curtail an array of services, including cancer and tuberculosis screening and children's dental examinations, to meet the needs of President Bush's federal smallpox vaccination program. The Bush administration requested that health departments administer smallpox vaccine to health care workers on a voluntary basis. Local health departments are responsible for giving the vaccinations in two stages. In the first, expected to begin this month and last about 60 days, up to 500,000 civilian health care and emergency workers will be vaccinated. In the second, up to 10 million health care workers, police, firefighters and emergency medical technicians will be offered the vaccine. Dr. Thomas R. Frieden, the New York City health commissioner, said he expected the impact to be severe. 'While we appreciate the federal government's support for bioterrorism preparedness, the vaccination drive will be extraordinarily disruptive to our day-to- day work of protecting the public's health,' Frieden said

Many health departments across the nation say they will have to curtail an array of services, including cancer and tuberculosis screening and children's dental examinations, to meet the needs of President Bush's federal smallpox vaccination program. The Bush administration has requested that health departments administer smallpox vaccine to health-care workers on a voluntary basis. Local health departments are responsible for giving smallpox vaccinations in two stages. In the first, which is expected to begin this month and last about 60 days, up to 500,000 civilian health-care and emergency workers will be vaccinated. In the second, up to 10 million health-care workers, police officers, firefighters and emergency medical technicians will be offered the vaccine

Dr. James Crucetti, Albany County public health commissioner, said he is concerned to hear other health departments are considering cutting programs to cover smallpox vaccination costs. The [Bush] administration has requested that health departments administer smallpox vaccine to health care workers on a voluntary basis. Local health departments are responsible for giving smallpox vaccinations in two stages. In the first, which is expected to begin this month and last about 60 days, up to 500,000 civilian health care and emergency workers will be vaccinated. In the second, up to 10 million health care workers, police officers, firefighters and emergency medical technicians will be offered the vaccine. The latest demands involve a vaccine that few practicing doctors have given because the United States abandoned it as a routine in 1972, eight years before smallpox was eradicated from the world. Now health departments must train workers how to use two-pronged needles to administer the vaccine and recognize its many complications, some rare but potentially lethal

5-Fluorouracil (5-FU) is the most routinely administered drug in the treatment of colon cancer. The main mechanism of the drug is not completely understood and its method of administration has been strongly disputed. A 24-hour infusion of 5-FU has clinically yielded better response rates and lower toxicities in comparison to bolus administration, but an exploration into possible mechanisms needs to be performed. Experiments were conducted with two 5-FU resistant cell lines where cytotoxicity, thymidylate synthase (T.S.) activity, thymidine kinase (T.K.) activity, DNA and RNA incorporation, and T.S. expression were contrasted between a 10 microM/24 hour administration of 5-FU (simulating continuous exposure) and a 100 microM/1 hour schedule (simulating bolus administration). After 6 days from the initial exposure, the 10 microM/24 hour schedule (schedule A) inhibited more cell growth than the 100 microM/1 hour regimen (schedule B) by more than 38% and 17% in the two cell lines. After the 6-day observation, schedule A inhibited twice as much T.S. activity as schedule B. Incorporation of [14C]-5-FU into DNA and total RNA was higher in cells exposed to schedule A in comparison to schedule B over the 6 days. T.S. expression and T.K. activity patterns were variable over time. Thus, the exposure of 10 microM/24 hour 5-FU results in superior cytotoxicity when compared to a 100 microM/1 hour regimen and its effectiveness may be explained mechanistically by T.S. activity and DNA and RNA incorporation