Characterization of the image plate multi-scan response to mono-energetic x-rays.

Image plates (IPs), or phosphor storage screens, are a technology employed frequently in inertial confinement fusion (ICF) and high energy density plasma (HEDP) diagnostics because of their sensitivity to many types of radiation, including, x rays, protons, alphas, beta particles, and neutrons. Prior studies characterizing IPs are predicated on the signal level remaining below the scanner saturation threshold. Since the scanning process removes some signal from the IP via photostimulated luminescence, repeatedly scanning an IP can bring the signal level below the scanner saturation threshold. This process, in turn, raises concerns about the signal response of IPs after an arbitrary number of scans and whether such a process yields, for example, a constant ratio of signal between the nth and n + 1st scan. Here, the sensitivity of IPs is investigated when scanned multiple times. It is demonstrated that the ratio of signal decay is not a constant with the number of scans and that the signal decay depends on the x-ray energy. As such, repeatedly scanning an IP with a mixture of signal types (e.g., x ray, neutron, and protons) enables ICF and HEDP diagnostics employing IPs to better isolate a particular signal type.

Image plate multi-scan response to fusion protons in the range of 1-14 MeV.

Image plates (IPs) are a quickly recoverable and reusable radiation detector often used to measure proton and x-ray fluence in laser-driven experiments. Recently, IPs have been used in a proton radiography detector stack on the OMEGA laser, a diagnostic historically implemented with CR-39, or radiochromic film. The IPs used in this and other diagnostics detect charged particles, neutrons, and x-rays indiscriminately. IPs detect radiation using a photo-stimulated luminescence (PSL) material, often phosphor, in which electrons are excited to metastable states by ionizing radiation. Protons at MeV energies deposit energy deeper into the IP compared with x rays below ∼20 keV due to the Bragg peak present for protons. This property is exploited to discriminate between radiation types. Doses of mono-energetic protons between 1.7 and 14 MeV are applied to IPs using the MIT linear electrostatic ion accelerator. This paper presents the results from consecutive scans of IPs irradiated with different proton energies. The PSL ratios between subsequent scans are shown to depend on proton energy, with higher energy protons having lower PSL ratios for each scan. This finding is separate from the known energy dependence in the absolute sensitivity of IPs. The results can be compared to complimentary work on x rays, showing a difference between protons and x rays, forging a path to discriminate between proton and x-ray fluence in mixed radiation environments.

Characterization of the response of radiochromic film to quasi-monoenergetic x rays through a cross-calibration with image plates.

Radiochromic film (RCF) and image plates (IPs) are both commonly used detectors in diagnostics fielded at inertial confinement fusion (ICF) and high-energy-density physics (HEDP) research facilities. Due to the intense x-ray background in all ICF/HEDP experiments, accurately calibrating the optical density of RCF as a function of x-ray dose, and the photostimulated luminescence per photon of IPs as a function of x-ray energy, is necessary for interpreting experimental results. Various measurements of the sensitivity curve of different IPs to x rays have been performed [Izumi et al., Proc. SPIE 8850, 885006 (2013) and Rosenberg et al., Rev. Sci. Instrum. 90(1), 013506 (2019)]; however, calibrating RCF is a tedious process that depends on factors such as the orientation in which the RCF is scanned in the film scanner and the batch of RCF used. These issues can be mitigated by cross-calibrating RCF with IPs to enable the use of IPs for the determination of dose on the RCF without scanning the RCF. Here, the first cross-calibration of RCF with IPs to quasi-monoenergetic titanium, copper, and molybdenum K-line x rays is presented. It is found that the IP-inferred dose rates on the RCF for the Ti and Mo x rays agree well with the measured dose rates, while the IP-inferred dose rate for the Cu x rays is larger than the measured dose rate by ∼2×. Explanations for this discrepancy and plans for future work are discussed.

Quantifying the effects of neutron fluence on proton signal retention in CR-39.

This paper reports on investigations on the impact of higher neutron fluences on the detection efficiency of protons with CR-39, a charged particle track detector. CR-39 is widely used as a diagnostic for inertial fusion applications and is an integral component of numerous particle diagnostics at the OMEGA laser facility and National Ignition Facility. As experiments continue to produce higher and higher yields, existing diagnostics are impacted by higher particle fluences than they were originally designed for. This paper presents data from experiments measuring proton signal on pieces of CR-39 with different levels of neutron fluence with two different etch times. The experiments show a decrease in signal recovery with increased neutron fluence, which is exacerbated at longer etch times. At 3 h etch time, data suggest a 17% ± 7% signal loss at 1.3 × 105 neutron-induced tracks per cm2 and a 67% ± 21% loss at 6 h etch time. Careful signal isolation techniques can recover most of the proton tracks even with moderate neutron fluence.

Errors in the field reconstruction using CR-39 proton radiographs with high fluence variation.

CR-39 proton radiography is an experimental charged-particle backlighter platform fielded and used at OMEGA and the NIF to image electric and magnetic fields in a subject plasma. Processing a piece of CR-39 involves etching it in hot NaOH, and the etch time can greatly impact the background-to-signal ratio (BSR) in low-fluence (≲4 × 104 cm-2) regions and detection efficiency in high-fluence regions (≳7 × 105 cm-2). For CR-39 data with high fluence variation, these effects mean that any single etch time will result in ≳15% error in the measured signal in either the high- or low-fluence regions. This study aims to quantify the impact of the etch time on the BSR and efficiency losses and how these affect the field reconstruction. Experiments at the MIT Linear Electrostatic Ion Accelerator provided empirical values of the BSR and efficiency losses as a function of the fluence and etch time for fluences ranging from 3 × 103 to 7 × 105 cm-2. Synthetic radiographs were generated with known fields and modulated based on empirical values of BSR and efficiency losses. The fields were reconstructed using a Monge-Ampère code with the modulated radiographs as input. The results indicate that combining short and long etches allows for more accurate analysis of radiographs with high fluence variation, with the mean squared error of the reconstructed fields decreasing by factors of 1.2-7 compared to the reconstructions using only one etch time.

Cyclin A potentiates maturation-promoting factor activation in the early Xenopus embryo via inhibition of the tyrosine kinase that phosphorylates cdc2.

We have produced human cyclin A in Escherichia coli and investigated how it generates H1 kistone kinase activity when added to cyclin-free extracts prepared from parthenogenetically activated Xenopus eggs. Cyclin A was found to form a major complex with cdc2, and to bind cdk2/Eg1 only poorly. No lag phase was detected between the time when cyclin A was added and the time when H1 histone kinase activity was produced in frog extracts, even in the presence of 2 mM vanadate, which blocks cdc25 activity. Essentially identical results were obtained using extracts prepared from starfish oocytes. We conclude that formation of an active cyclin A-cdc2 kinase during early development escapes an inhibitory mechanism that delays formation of an active cyclin B-cdc2 kinase. This inhibitory mechanism involves phosphorylation of cdc2 on tyrosine 15. Okadaic acid (OA) activated cyclin B-cdc2 kinase and strongly reduced tyrosine phosphorylation of cyclin B-associated cdc2, even in the presence of vanadate. 6-dimethylamino-purine, a reported inhibitor of serine-threonine kinases, suppressed OA-dependent activation of cyclin B-cdc2 complexes. This indicates that the kinase(s) which phosphorylate(s) cdc2 on inhibitory sites can be inactivated by a phosphorylation event, itself antagonized by an OA-sensitive, most likely type 2A phosphatase. We also found that cyclin B- or cyclin A-cdc2 kinases can induce or accelerate conversion of the cyclin B-cdc2 complex from an inactive into an active kinase. Cyclin B-associated cdc2 does not undergo detectable phosphorylation on tyrosine in egg extracts containing active cyclin A-cdc2 kinase, even in the presence of vanadate. We propose that the active cyclin A-cdc2 kinase generated without a lag phase from neo-synthesized cyclin A and cdc2 may cause a rapid switch in the equilibrium of cyclin B-cdc2 complexes to the tyrosine-dephosphorylated and active form of cdc2 during early development, owing to strong inhibition of the cdc2-specific tyrosine kinase(s). This may explain why early cell cycles are so rapid in many species.

Two members of the mouse mdr gene family confer multidrug resistance with overlapping but distinct drug specificities.

We report the cloning and functional analysis of a complete clone for the third member of the mouse mdr gene family, mdr3. Nucleotide and predicted amino acid sequence analyses showed that the three mouse mdr genes encode highly homologous membrane glycoproteins, which share the same length (1,276 residues), the same predicted functional domains, and overall structural arrangement. Regions of divergence among the three proteins are concentrated in discrete segments of the predicted polypeptides. Sequence comparison indicated that the three mouse mdr genes were created from a common ancestor by two independent gene duplication events, the most recent one producing mdr1 and mdr3. When transfected and overexpressed in otherwise drug-sensitive cells, the mdr3 gene, like mdr1 and unlike mdr2, conferred multidrug resistance to these cells. In independently derived transfected cell clones expressing similar amounts of either MDR1 or MDR3 protein, the drug resistance profile conferred by mdr3 was distinct from that conferred by mdr1. Cells transfected with and expressing MDR1 showed a marked 7- to 10-fold preferential resistance to colchicine and Adriamycin compared with cells expressing equivalent amounts of MDR3. Conversely, cells transfected with and expressing MDR3 showed a two- to threefold preferential resistance to actinomycin D over their cellular counterpart expressing MDR1. These results suggest that MDR1 and MDR3 are membrane-associated efflux pumps which, in multidrug-resistant cells and perhaps normal tissues, have overlapping but distinct substrate specificities.

Activation of the mouse mdr3 gene by insertion of retroviruses in multidrug-resistant P388 tumor cells.

In multidrug-resistant (MDR) derivatives of the mouse lymphoid tumor P388, the emergence of MDR is associated with overexpression and transcriptional activation of the mdr3 gene, either in the absence of (P388/VCR-10) or concomitant with (P388/ADM-2) gene amplification. In both instances, Northern (RNA) blotting analyses have suggested the presence of altered mdr3 transcripts in these cells, possibly originating from novel transcription initiation sites. The mechanisms underlying mdr3 overexpression in these cells have been investigated. In P388/VCR-10 cells, Southern blotting analyses together with genomic DNA cloning and nucleotide sequencing have demonstrated the presence of an intact mouse mammary tumor virus (MMTV) within the boundaries of intron 1 of mdr3. cDNA cloning and nucleotide sequencing indicated that this integration event results in the synthesis and overexpression of a hybrid MMTV-mdr3 mRNA which initiates within the U3 region of the 5' long terminal repeat (LTR) of the provirus. Consequently, this mRNA lacks the normal exon 1 of mdr3 but contains (i) MMTV LTR-derived sequences at its 5' end, (ii) a novel mdr3 exon, mapping within the boundaries of intron 1 downstream of the MMTV integration site and generated by alternative splicing, and (iii) an otherwise intact 3' portion of mdr3 starting at exon 2. A similar type of analysis of P388/ADM-2 cells revealed that mdr3 overexpression in these cells is associated with the integration of an intracisternal A particle (IAP) within an L1Md repetitive element, immediately upstream of mdr3. The IAP insertion results in the overexpression of hybrid IAP-mdr3 mRNA transcripts that initiate within the 3' LTR of the IAP and which contain IAP LTR-derived sequences at the 5' end spliced 14 nucleotides upstream of the normal exon 1 of mdr3. Taken together, these results indicate that independent retroviral insertions were the initial mutagenic event responsible for mdr3 overexpression and survival during drug selection of these cell lines. Amplification of the rearranged and activated mdr3 gene copy occurred during further selection for high-level drug resistance in P388/ADM-2 cells.

The three mouse multidrug resistance (mdr) genes are expressed in a tissue-specific manner in normal mouse tissues.

The gene responsible for multidrug resistance (mdr), which encodes the P-glycoprotein, is a member of a multigene family. We have identified distinct mdr gene transcripts encoded by three separate mdr genes in the mouse. Expression levels of each mdr gene are dramatically different in various mouse tissues. Specific mdr RNA transcripts of approximately 4.5, 5, and 6 kilobases have been detected. Each of the mdr genes has a specific RNA transcript pattern. These results should be considered in relation to understanding the normal physiological function of the mdr multigene family.

Is Cdk7/cyclin H/MAT1 the genuine cdk activating kinase in cycling Xenopus egg extracts?

Formation of active cdk (cyclin dependent kinase)/ cyclin kinases involves phosphorylation of a conserved threonine residue in the T loop of the cdk catalytic-subunit by CAK (Cdk Activating Kinase). CAK was first purified biochemically from higher eukaryotes and identified as a trimeric complex containing a cdk7 catalytic subunit, cyclin H and MAT1 (Ménage à trois), a member of the RING finger family. The same trimeric complex is also part of basal transcription factor TFIIH. In budding yeast, the closest homologs of cdk7 and cyclin H, KIN28 and CCL1, respectively, also associate with TFIIH. However, the KIN28/CCL1 complex does not display CAK activity and a distinct protein kinase able to phosphorylate monomeric CDC28 and GST-cdk2 was recently identified, challenging the identification of cdk7 as the physiological CAK in higher eukaryotes. Here we demonstrate that immunodepletion of cdk7 suppresses CAK activity from cycling Xenopus egg extracts, and arrest them before M-phase. We also show that specific translation of mRNAs encoding Xenopus cdk7 and its associated subunits restores CAK activity in cdk7-immunodepleted Xenopus egg extracts. Hence, the cdk7 complex is necessary and sufficient for activation of cdk-cyclin complexes in cycling Xenopus egg extracts.

Cloning, expression and subcellular localization of the human homolog of p40MO15 catalytic subunit of cdk-activating kinase.

Transitions of the cell cycle are controlled by cyclin-dependent protein kinases (cdks) whose phosphorylation on the Thr residue included in the conserved sequence YTHEVV dramatically increases the activity. A kinase responsible for this specific phosphorylation, called CAK for cdk-activating kinase, has been recently purified from starfish and Xenopus oocytes and shown to contain the MO15 gene product as a catalytic subunit. In the present paper, we have cloned the human homolog of Xenopus p40MO15 by probing a HeLa cell cDNA library with degenerate oligonucleotides deduced from Xenopus and starfish MO15 sequences. Human and Xenopus MO15 displayed a strong homology showing 86% identity with regard to amino acid sequences. Northern blot analysis of RNA extracts from a series of human tissues as well as from cultured rodent fibroblasts revealed a unique 1.4 kb MO15 mRNA. No variation in the amount of MO15 transcript or protein was found along the entire course of the fibroblast cell cycle. Fluorescence in situ hybridization on human lymphocyte metaphases showed two distinct chromosomal locations of human MO15 gene at 5q12-q13 and 2q22-q24. By using gene tagging and mammalian cell transfection, we demonstrate that the KRKR motif located at the carboxy terminal end of MO15 is required for nuclear targeting of the protein. Mutation of KRKR to NGER retains MO15 in the cytoplasmic compartment, whilst the wild-type protein is detected exclusively in the nucleus. Interestingly, we demonstrate that the nuclear targeting of MO15 is necessary to confer the protein its CAK activity. In contrast to the wild-type, the NLS-mutated MO15 expressed in Xenopus oocytes is unable to generate CAK as long as the nuclear envelope is not broken. The nuclear localization of both the MO15 gene product and CAK activity may imply that cdks activation primarily occurs in the cell nucleus.

Photoangioplasty for human peripheral atherosclerosis: results of a phase I trial of photodynamic therapy with motexafin lutetium (Antrin).

BACKGROUND: In photoangioplasty, light activation of a photosensitive drug offers the potential for treatment of long segments of vascular disease. This is a brief description of a study designed to evaluate the safety and tolerability of a new photosensitizer, Antrin (motexafin lutetium), in the endovascular treatment of atherosclerosis. METHODS AND RESULTS: An open-label, single-dose, escalating drug- and light-dose study was performed in patients with atherosclerotic peripheral arterial insufficiency. Clinical evaluation, serial quantitative angiography, and intravascular ultrasonography were performed. Therapy was well tolerated, and only minor side effects were observed. Treatment produced no deleterious vascular effects. Although this study was not designed to examine clinical efficacy, several secondary end points suggested a favorable therapeutic effect. CONCLUSIONS: This phase I study demonstrates that photoangioplasty with motexafin lutetium is well tolerated and safe. Preliminary efficacy data suggest a future role for the treatment of flow-limiting atherosclerosis.

Pharmacokinetics and pharmacodynamics of pravastatin alone and with cholestyramine in hypercholesterolemia.

The pharmacokinetics, pharmacodynamics, and safety of pravastatin, a new selective 3-hydroxy-3-methylglutaryl coenzyme A reductase inhibitor, were evaluated during monotherapy and with subsequent concomitant cholestyramine therapy in 33 patients with primary hypercholesterolemia in this randomized study. After 4 weeks, pravastatin monotherapy (5 mg, 10 mg, and 20 mg twice daily) significantly decreased total cholesterol by 17% to 24% (p less than 0.001 versus baseline) and low-density lipoprotein cholesterol by 23% to 35% (p less than 0.001). High-density lipoprotein cholesterol increased by 8% to 9%, and triglycerides decreased by 6% to 9%. The area under the serum concentration-time curve and maximum serum concentration of pravastatin showed dose-proportionality; time to maximum serum concentration and serum elimination half-life were independent of dose. When added to pravastatin therapy, cholestyramine enhanced the lipid-lowering effects of pravastatin. After 4 weeks of combination therapy, total cholesterol was reduced by 32% to 38% (p less than 0.001 versus baseline), and low-density lipoprotein cholesterol was reduced by 47% to 56% (p less than 0.001). High-density lipoprotein cholesterol increased by 11% to 18% (p less than 0.05). Pravastatin was well tolerated; no clinical adverse events directly attributable to the drug were reported.

Cyclin A-Cys41 does not undergo cell cycle-dependent degradation in Xenopus extracts.

Truncated cyclin A and cyclin B lacking the N-terminal domain comprising the 'destruction box' escape from proteolysis and arrest cells at metaphase. Mutation of a conserved arginine residue of the destruction domain makes cyclin B resistant to proteolysis. Here we show that mutation of the same residue also makes cyclin A resistant to proteolysis, in either of two situations in which the cyclin degradation pathway is turned on: (i) in Xenopus extracts of activated eggs where the degradation pathway has been permanently turned on by adding a recombinant undegradable cyclin B in which the arginine residue of the destruction box has been substituted by alanine; (ii) in extracts of metaphase II-arrested oocytes after Ca(2+)-dependent inactivation of the cytostatic factor (CSF).

Exploration of the catalytic site of endopeptidase 24.11 by site-directed mutagenesis. Histidine residues 583 and 587 are essential for catalysis.

Direct comparison of the primary structure of neutral endopeptidase (NEP, EC 3.4.24.11) with that of thermolysin, a bacterial metalloendopeptidase with a similar specificity, has revealed very few similarities between the two sequences, except for two conserved short segments. In thermolysin, these segments contain several of the residues involved in catalysis, including two zinc coordinating histidines (His-142 and His-146) and a third histidine (His-231) involved in stabilizing the transition state through hydrogen bonding. The role of the corresponding histidines in NEP (His-583, His-587 and His-637) was explored by site-directed mutagenesis of NEP cDNA and expression of the mutated cDNA in COS-1 cells. Substitution of either His-583 or His-587 of NEP for Phe completely abolished the activity and Zn-directed inhibitor recognition of the recombinant enzyme, suggesting that these residues play a role similar to His-142 and His-146 of thermolysin as zinc ligands. In contrast, substitution of His-637 for a phenylalanine residue was without effect on enzyme activity.

Pravastatin experience in elderly and non-elderly patients.

Epidemiologic evidence linking elevated cholesterol concentrations and coronary heart disease (CHD) through the eighth decade of life provides a rationale for lowering cholesterol concentrations to reduce morbidity and mortality from CHD. Pravastatin, a well tolerated HMG CoA reductase inhibitor with a convenient once-daily dosing regimen, has been shown to effectively lower total and low density lipoprotein (LDL) cholesterol. Individual data from more than 1800 hypercholesterolemic patients enrolled in six double-blind, randomized, multicenter studies were pooled and then analyzed to compare the safety and efficacy of pravastatin in the elderly (i.e., patients at least 65 years old) and the non-elderly. In short-term studies (8-16 weeks), response was dose-related and similar in elderly and non-elderly subjects. Pravastatin 20 or 40 mg daily lowered total cholesterol 19-25%, LDL-cholesterol 25-33%, and triglycerides 14-23%; high density lipoprotein (HDL) cholesterol increased 5-10%. During long-term studies, improvements were sustained for more than 24 months in both the non-elderly and elderly. The incidences of adverse drug events and laboratory abnormalities were similar in the elderly and non-elderly patients in all groups (active treatment control with resin, pravastatin alone, or combination therapy). In short-term studies, treatment was discontinued because of adverse events in < 1% of all patients treated with pravastatin (all doses) or placebo. The frequency and profile of adverse events were similar among patients treated with pravastatin or placebo. In long-term studies, treatment was discontinued in 0.4% of patients in the pravastatin group and in 0.3% of the patients in the bile-acid-binding resin group. If drug therapy is warranted, pravastatin appears to be safe and effective for long-term use in elderly patients with hypercholesterolemia.

Single-dose pharmacokinetics of pravastatin and metabolites in patients with renal impairment.

The disposition of a single 20-mg oral dose of pravastatin was assessed in subjects with various degrees of renal function. Sixteen subjects (13 males, 3 females) with creatinine clearance values ranging from 15 to 112 mL/min/1.73 m2 completed the study. Area under the serum concentration-time curve, maximum serum concentration, time to maximum serum concentration, terminal serum elimination half-life, apparent clearance, and apparent volume of distribution for pravastatin were not affected by renal impairment, whereas the renal clearance of pravastatin decreased as creatinine clearance decreased (r2 = 0.697, P less than .001). The area under the serum concentration-time curve and time to maximum serum concentration of SQ 31,945 (a hepatic metabolite) increased in patients with renal impairment, whereas the terminal elimination rate constant and renal clearance of SQ 31,945 significantly decreased as a function of creatinine clearance. The renal clearance of another metabolite (SQ 31,906) also significantly declined with decreasing renal function. This single-dose study demonstrates that pravastatin pharmacokinetics were not affected in patients with renal impairment, probably because of its dual route of elimination.

Comparative pharmacokinetics and pharmacodynamics of pravastatin and lovastatin.

The oral bioavailability of two HMG-CoA reductase inhibitors, pravastatin and lovastatin, was investigated in this randomized, two-way crossover study. Twenty healthy men were randomly assigned to treatment with a 40-mg dose of pravastatin or lovastatin once daily for 1 week; steady state kinetics were assessed after the last dose. After 1 week of washout, each subject received the alternate treatment. Serum specimens were assayed by gas chromatography/mass spectrometry (GC/MS) for intact pravastatin or lovastatin acid and by bioassay for active inhibitor concentration and, after hydrolysis of lactones, for total inhibitor concentration. The systemic bioavailabilities of total (active plus potentially active) inhibitors for the two drugs were different, with the mean AUC value for lovastatin being 50% higher than that of pravastatin (mean +/- SEM AUC0-24 values of 285 +/- 25 and 189 +/- 13 ng-equiv x hr/mL, respectively, P less than .0001). Pravastatin, which is administered as the monosodium salt, is present in the systemic circulation as the open acid; lovastatin, which is administered as the lactone, is present as both open-acid active metabolites (62%) and closed-ring lactone metabolites (38%), which are potentially active. Based on mean AUC values, pravastatin accounted for 75% of the active inhibitors from a pravastatin dose. Lovastatin acid accounted for just 25% of the active inhibitors from a lovastatin dose, with the remainder due to other active metabolites. Significant decreases from baseline in total and low-density lipoprotein (LDL) cholesterol were observed during the first treatment leg for both pravastatin and lovastatin.(ABSTRACT TRUNCATED AT 250 WORDS)

Comparative efficacy of once-daily versus twice-daily pravastatin in primary hypercholesterolemia.

The efficacy of once-daily versus twice-daily dosing of pravastatin was determined in men with primary hypercholesterolemia. The same group of patients was used in the two studies. In the once-daily study, 18 patients took 20 mg of pravastatin at bedtime for four weeks and then 40 mg of pravastatin for an additional four weeks. In the twice-daily study, 22 patients took 10 mg or 20 mg of pravastatin twice daily for four weeks. Total cholesterol was reduced 18% in the 20-mg once-daily group, 20% in the 10-mg twice-daily group, 23% in the 40-mg once-daily group, and 24% in the 20-mg twice-daily group; the respective reductions in low-density cholesterol were 27%, 28%, 32%, and 34%. All these reductions were statistically significant; no between-group differences were significant. Pravastatin was well tolerated and no patients dropped out because of side effects.

[The efficiency of mass media utilization in preventive health programs and mental health promotion]. / L'utilisation efficace des médias de masse dans des programmes de prévention et de promotion de la santé mentale.

This paper reviews articles pertaining to mental health prevention and promotion programs that have used mass media as a component of their program. The programs are analyzed according to four roles that media can play in health promotion programs: promotion, education, complementarity, and support. The relationship between the function assigned to the media and the effects of the programs in changing knowledge, attitudes, or behaviour is explored. When mass media are used alone, they seem to be powerful in recruiting people into groups or social services and in enhancing knowledge and changing attitudes. But when it comes to changing behaviour, mass media by themselves have limited impact. This type of change is more likely to occur when media are combined with face-to-face intervention. Finally, some issues involved in improving the use of mass media in mental health are discussed.