Glial endothelin/nitric oxide system participates in hippocampus CA1 neuronal death of SHRSP following transient forebrain ischaemia

1. When delayed neuronal death occurred in the hippocampus CA1 pyramidal cell layer of stroke-prone spontaneously hypertensive rats (SHRSP) at 4 and 7 days after a 10 min bilateral carotid occlusion and reperfusion, intense endothelin-1 (ET-1)- and ET-3-like immunoreactivities became evident in astrocytes in the damaged hippocampus CA1 subfields. 2. We also observed that microglia equipped with an ETB receptor aggregated within the CA1 pyramidal cell layer with neuronal death. 3. There was a dramatic increase in nitric oxide synthase (NOS) activity in astrocytes and microglia in the damaged hippocampus CA1 subfields. 4. Thus, the possibility that microglia with the ETB receptor are activated to produce NO, a neurotoxic factor, by astrocytic ET-1 and ET-3 produced in response to transient forebrain ischaemia would have to be considered.

The promoter from the rice nuclear gene encoding chloroplast aldolase confers mesophyll-specific and light-regulated expression in transgenic tobacco

The rice genome contains at least four separate loci that encode aldolase isozymes. Among these, the aldolase P (AldP) gene, a nuclear gene coding for chloroplast aldolase, is expressed predominantly in the leaf blade mesophyll cells in rice. To dissect promoter elements that regulate such tissue- or cell type-specific expression, we constructed various AldP promoter-beta-glucuronidase (GUS) fusion genes and transferred them into Nicotiana tabacum (tobacco) plants. Analysis of GUS activities in the transgenic tobacco revealed the presence of at least two elements within 2.0 kb AldP promoter region. One is located within the segment from position -2.0 kb to -1.2 kb and acts as a negative element. The other is a positive element located between -1.2 kb and -0.31 kb that confers developmentally regulated, mesophyll cell-specific expression. In addition, the 1.2 kb rice promoter segment flanking the transcription start site contains an element(s) that serves as target for light induction in tobacco. The results suggest that the AldP gene promoter of rice, a monocot promoter, can function in an essentially physiological manner in the dicot tobacco plant.

Comparison of equations for predicting bound serum concentrations of carbamazepine and carbamazepine-10, 11-epoxide after polytherapy in patients with epilepsy

In a previous study, an equation with in vivo population binding parameters of carbamazepine and carbamazepine-10, 11-epoxide (CBZ-E) to serum proteins for the relation between unbound and bound serum concentrations was defined. A review by Pynnönen indicates that the average bound/unbound plasma fraction ratio is 3.0 for carbamazepine and 1.0 for CBZ-E. In this study, the ability of equations with in vivo population binding parameters of the previous study (method 1) or with the average bound/unbound plasma fraction ratio of 3.0 of Pynnönen (method 2) to predict the bound serum carbamazepine concentration was retrospectively evaluated using 85 serum samples from 46 patients with epilepsy taking carbamazepine polytherapy. In 21 serum samples from 16 patients, the ability of these equations to predict bound serum CBZ-E concentration was also determined with in vivo population binding parameters from the previous study (method A) or with the average bound/unbound plasma fraction ratio of 1.0 of Pynnönen (method B). Mean prediction error, mean absolute prediction error (MAE), and root mean squared error (RMSE) were calculated for each method, and these values served as a measure of prediction bias and precision. Method 1 showed a bias to overpredict bound serum carbamazepine. The MAE and RMSE were significantly smaller with method 2 (MAE = 2.4 mumol/L; RMSE = 3.2 mumol/L) than with method 1 (MAE = 4.1 mumol/L; RMSE = 4.8 mumol/L). Method 2 was superior to method 1 in terms of accuracy and precision. For bound CBZ-E prediction, method B had a bias to underprediction. The MAE and RMSE were smaller with method A (MAE = 0.581 mumol/L; RMSE = 0.796 mumol/L) than with method B (MAE = 0.724 mumol/L; RMSE = 0.905 mumol/L). Method A was superior to method B in terms of accuracy and precision.

[Surgical treatment of aneurysms at basilar artery and posterior cerebral artery associated with moyamoya disease: a case report]

This report describes a surgical case of basilar-superior cerebellar (BA-SCA) junction aneurysm and posterior cerebral artery (PCA) aneurysm associated with moyamoya disease. A-38-year-old man in an unconsciousness state and with mild left hemiparesis was referred to our hospital. CT scan demonstrated hemorrhage in the right basal ganglia. Carotid angiograms showed stenoses at the terminal portion of the bilateral internal carotid arteries and moyamoya vessels. Left vertebral angiograms showed two aneurysms at the junction of the right superior cerebellar artery and the basilar artery and at the P1 portion of the left posterior cerebral artery. Two aneurysms were successfully clipped using the pterional approach. Bilateral encephaloduroarteriosynangiosis (EDAS) was also performed for the treatment of Moyamoya disease. Postoperative angiograms revealed complete clipping of the aneurysms and the postoperative course was uneventful.

[The variability of blood velocity in the ophthalmic artery with color Doppler imaging]

Non-invasive measurements of blood velocities of the ophthalmic artery (BVA) in color Doppler imaging (CDI) are increasingly used to assess the influence of disease on the hemodynamics of the eye. Such measurements are only valid when compared to spontaneous variability. Therefore, the aim of this study was to examine the variability of BVA in healthy subjects. Within-a-day short-term variability was assessed from measurements obtained during one day from 5 healthy young male subjects as the coefficient of variation (CV) of 10 consecutive measurements. Between-days variability was assessed by comparing measurements made on three different days at one month intervals. The left and right BVA were measured five consecutive times to evaluate the difference in BVA between left and right eyes in 5 healthy young male subjects. In the within-a-day variability, mean CV in maximum systolic BVA (V max), minimum end diastolic BVA (V min), time-averaged BVA (V mean), resistive index (RI), and pulsatility index (PI) were found to be 6.6%, 14.0%, 14.9%, 3.2%, and 17.4%, respectively. The between-days variability was just as high as the within-a-day variability. There was significant difference in BVA between left and right eyes in two of the five subjects. We concluded that the within-a-day variability and the between-days variability of BVA measured using CDI are reproducible. The CDI can be used to assess the influence of disease and drugs on the hemodynamics of the eye.

Alterations in physical state and expression of human papillomavirus type 18 DNA following crisis and establishment of immortalized ectocervical cells

Integration of episomal human papillomavirus (HPV) DNA in infected cervical lesions during malignant progression is frequently observed, but the importance of integration is poorly understood. We have studied immortalization by HPV-18 of human cervical cells as an in vitro model system. Here, the status and expression of HPV-18 DNA in precrisis ectocervical keratinocytes was compared with that in the same cells after crisis and establishment of immortalization. Southern blots revealed, and two-dimensional gel analysis confirmed, that the precrisis culture contained more than 100 copies/cell of episomal HPV-18 DNA and no detectable integrated viral DNA. In contrast, the postcrisis cells contained a low copy number of only integrated viral genome. The Northern blot patterns of E6-E7 and E2/E4 RNA expression were also different. Analysis of RNA by RT-PCR indicated that neither culture expressed the unspliced HPV-18 E6 oncogene present in tumor cell lines and that the precrisis, but not postcrisis, culture expressed the full-length E2 repressor. The two cultures displayed a similar keratinocyte morphology in vitro and a similar low grade dysplasia in vivo and both were non-tumorigenic. These results suggest that, although insufficient for complete malignant conversion, viral DNA integration during crisis is associated with the establishment of an immortalized phenotype in which HPV-18 DNA is integrated and HPV-18 RNA expression is altered.

Endothelin receptor in microvessels isolated from human meningiomas: quantification with radioluminography

1. We characterized specific 125I-endothelin-1 (125I-ET-1) binding sites in microvessels isolated from human meningiomas, using an in vitro quantitative receptor autoradiographic technique coupled to a radioluminographic imaging plate system. 2. This newly developed and highly sensitive method revealed high-affinity ET receptors present in pellet sections of the microvessels from all the meningiomas studied, regardless of histological subtypes (dissociation constant, 1.2 +/- 0.3 nM; maximum binding capacity, 185 +/- 56 fmol/mg; means +/- SE for nine tumors). 3. In five cases of meningiomas, ET-3 competed for 125I-ET-1 binding to microvessels from those tumors with a low affinity [50% inhibiting concentration (IC50) of 1.6 +/- 0.4 x 10(-6) M], and a selective ETB receptor agonist, sarafotoxin S6c, up to 10(-6) M, did not displace ET binding from the sections. 4. In the sections of microvessels from four other tumors, biphasic competition curves were obtained in the case of incubation in the presence of increasing concentrations of ET-3, with an IC50 of 1.1 +/- 0.2 x 10(-9) M for the high-affinity component and 1.6 +/- 0.3 x 10(-6) M for the low-affinity component, respectively. In addition, S6c competed for ET binding to those sections (IC50 = 2.3 +/- 0.2 x 10(-10) M) and 10(-6) M S6c displaced 30% of the control, corresponding to the high-affinity component of competition curves obtained in the presence of ET-3. 5. Our results suggest that (a) capillaries in human meningiomas express a large number of high-affinity ETA (non-ETB) receptors with a small proportion of ETB receptors, and (b) ET may have a role in neovascularization, tumor blood flow, and/or function of the blood-tumor barrier in meningioma tissues by interacting with specific receptors present on the surface of the endothelium.

[Highlateral approach to the lesions around the upper cervical vertebrae and foramen magnum]

In the present paper, we describe the surgical techniques of high lateral cervical approach and its feasibility for the excision of tumors located in the ventral or lateral aspect of the upper cervical vertebrae and of the craniovertebral junction. The patient is positioned laterally on the operating table, but the operator's position and the skin incision are slightly altered depending on the location of the tumor. When the lesion is situated below C1, the ipsilateral shoulder is pulled down toward the back. The operator stands rostral to the head. The attachment of the sternocleidomastoid muscle to the mastoid is detached and reflected anteriorly through a retroauricular curved skin incision. The posterior cervical muscles such as the splenius capitis, longissimus capitis, semi-spinalis capitis are detached from the occipit and retracted posteriorly. At this point, the transverse process of C1 and the articular facet of the vertebrae of C2-C4 are identified by palpation. According to the tumor location, the muscles attached to the relevant transverse processes and facets are divided and reflected posteriorly. Through careful dissection, the cervical nerve roots and the vertebral artery are exposed. The root sleeves as well as thecal sac may be exposed by resecting the posterior two-thirds of the superior and inferior articular facets and the adjacent laminae of the vertebrae. In case the whole facet was removed, an iliac bone graft is placed between the remaining transverse processes and the laminae above and below for fixation.(ABSTRACT TRUNCATED AT 250 WORDS)

Correction of hypertriglyceridemia with low high-density lipoprotein cholesterol by the novel compound NO-1886, a lipoprotein lipase-promoting agent, in STZ-induced diabetic rats

We have previously reported that the novel compound NO-1886 increased lipoprotein lipase (LPL) activity, with resulting elevation of high-density lipoprotein (HDL) cholesterol in normal rats (J Clin Invest 92:411-417, 1993). The aim of this study was to ascertain whether the compound has the same action in diabetes, because hypertriglyceridemia with low HDL cholesterol is an extremely common concomitant condition in diabetes. Streptozotocin-induced diabetic rats showed marked elevation of plasma triglyceride and reduction of HDL cholesterol. Both single and repeated administration of NO-1886 increased postheparin plasma LPL activity, with resulting reduction of plasma triglyceride and elevation of HDL cholesterol. Repeated administration increased the amount of LPL mRNA in adipose tissue and myocardium. The compound had no effects on plasma glucose and insulin levels. Our study indicates that the compound is potentially beneficial for the treatment of hypertriglyceridemia with low HDL cholesterol in diabetes.

Expression of the small heat shock protein (hsp) 27 in human astrocytomas correlates with histologic grades and tumor growth fractions

1. Cellular expression and distribution of the stress response small heat shock protein 27 (hsp27) in 39 high-grade astrocytomas (27 glioblastoma multiformes, 12 anaplastic astrocytomas) and in 27 low-grade astrocytomas (grade I-II) were analyzed immunohistochemically. 2. The correlation between hsp27 expression and tumor growth fractions of the astrocytomas was examined following Ki-67 immunostaining. 3. The hsp27 staining was cell cytoplasmic. The hsp27 immunopositive rate was significantly higher in high-grade astrocytomas; the rates was 74% for glioblastomas, 58% for anaplastic astrocytomas, and 37% for low-grade astrocytomas. The small and large tumor cells, especially in glioblastomas, multinucleated tumor giant cells, tumor cells in the pseudopalisading and necrotic areas, cells of the microvascular endothelial proliferations, and tumor vascular smooth muscles were usually hsp27 positive. The mean percentage of hsp27-positive cells was significantly higher in the glioblastomas alone and in the combined high-grade astrocytomas, compared to the low-grade, and in recurrent rather than in primary high-grade astrocytomas. 4. The high-grade astrocytomas had a highly statistical significant Ki-67 labeling index. The Ki-67 labeling indices were significantly higher in the hsp27-positive than the hsp27-negative astrocytomas, irrespective of the histological grade. In the high-grade astrocytomas with a Ki-67 labeling index of five and above, 81% of those tumors were hsp27 positive. 5. Thus, a large number of human astrocytomas express hsp27, and hsp27 expression correlates with histological grades of astrocytoma and with tumor growth fractions. This being the case, hsp27 is likely to have a role in the growth of human astrocytomas.

An approach to cerebral vasodilatory capacity in unilateral and bilateral cerebrovascular diseases using radiolabeled human serum albumin

The acute cerebrovascular response to acetazolamide was assessed using a blood pool agent and planar dynamic imaging to evaluate cerebral vasodilatory capacity. Ten normal subjects and 12 patients with unilateral or bilateral cerebrovascular disease were studied. After the injection of radiolabeled human serum albumin, dynamic imaging of the anterior view of the head was started. Ten minutes later, 1000 mg of acetazolamide was infused. The dilatation index (the percent increase in activity at the peak response) was obtained for each cerebral hemisphere. The mean dilatation index in normal subjects was 17.1 +/- 3.2% (N = 20). The value was significantly lower in patients with multiple infarcts (7.7 +/- 1.1%, N = 8, P < 0.001), and below the normal range in two involved hemispheres of five patients with unilateral occlusive carotid artery disease and in three hemispheres of three patients with moyamoya disease. It was suggested that this simple method may be useful in assessing cerebral vasodilatory capacity in both unilateral and bilateral diseases.

[Anterior transcallosal approach for the mass lesions in and around the third ventricle: with particular reference to the method of enlarging the foramen of Monro]

Enlargement of the foramen of Monro is an essential maneuver to obtain an appropriate surgical view when large, solid lesions in and around the third ventricle are to be removed via the anterior transcallosal approach (ATA). For this purpose, three methods, i.e., the subchoroidal, transchororidal, and transfornicial approaches have so far been reported. However, since the locations and the pathological natures of space occupying lesions in this region are widely variable, the indication as well as the feasibility of each approach has remained rather unclear. The present paper deals with our surgical experience with six patients (2 gliomas, 1 angioma, 1 AVM, 1 plexus papilloma, 1 basilar top aneurysm) operated on using the ATA in which variable methods of enlarging the foramen of Monro were employed. Aiming at complete removal or clipping of the lesion, the seemingly best among the above three approaches was determined preoperatively, considering the size, location, and pathological nature of the lesion. The shape of the choroid plexus of the roof of the IIIrd ventricle as revealed by MRI was also taken into account. The subchoroidal, transchoroidal, and the transfornicial approaches were employed in 3, 2, and 1 cases, respectively. Except for one glioma which ended up being removed extensively, all the tumors and AVM were totally removed and the aneurysm successfully clipped. From the above experience, the merits and demerits of each approach for different types of lesions are discussed in view of their suitability for achieving total removal.(ABSTRACT TRUNCATED AT 250 WORDS)

Developmental alteration of the chromatin state at promoter/replication origin region of the aldolase B locus precedes transcriptional activation in the liver

Liver-specific expression of the rat aldolase B (AldB) gene is conferred by proximal promoter region (-200 bp to + 1 bp), which is centered on an origin region of DNA replication. Transcriptional activation of the gene in the liver occurs during the late one-third of fetal stage. To know the mechanism involved in such activation, we studied developmental changes in chromatin structure and in the extent of CpG methylation in the promoter/origin region of the gene. At an early fetal stage, when the AldB gene in the liver is not yet activated, the gene chromatin had two DNase 1-hypersensitive sites in the promoter region. One corresponded to that typical of AldB-expressing cells in the adult. The other, located approximately 200 bp upstream of the above site, disappeared as the activation of transcription started. A CpG dinucleotide in the promoter/origin region was heavily methylated at an early stage of gestation, but progressively demethylated as the liver develops. This CpG site is located at the center of an important binding site for a transcription factor. These changes occurred early in the fetal stage, prior to the gene activation, and were thus thought to be associated with differentiation of the liver cell or with cessation of cell proliferation.

Kidney angiotensin II receptors and converting enzyme in neonatal and adult Wistar-Kyoto and spontaneously hypertensive rats

The aim of the present study was to correlate the development of the renin angiotensin system (RAS) in the kidney of the rat with the development of genetic hypertension. Immature (1-week-old) and adult (12-week-old) normotensive Wistar-Kyoto (WKY) and spontaneously hypertensive kidney rats (SHR) were used for quantification of angiotensin II (ANG II) receptors and angiotensin converting enzyme (ACE) binding sites using quantitative autoradiography. In both neonatal and adult animals of either strain, ANG II receptors were of AT1 subtype. In all kidney areas of 1-week-old rats. ANG II receptor density was higher in SHR than WKY. Binding density increased with age in WKY rats; thus, in the glomeruli and the outer stripe of the outer medulla of 12-week-old WKY, binding was significantly higher than that present in age-matched SHR. [125I]351A binding to ACE was highest in the outer medulla and not detectable in glomeruli. In 1-week-old rats, binding to ACE was higher in WKY than in SHR strain. No differences in ACE binding were found between adult SHR and WKY rats, with the exception of the inner stripe of the outer medulla, where no binding was detected in SHR. Our results support the hypothesis that the RAS in kidney is developmentally regulated and is involved in the development and maintenance of genetic hypertension in SHR.

Angiotensin II receptor subtypes and phosphoinositide hydrolysis in rat adrenal medulla

Angiotensin II (ANG) receptor subtypes were characterized by quantitative autoradiography after incubation with the ANG agonist [124I]Sar1-ANG in rat adrenal medulla. ANG receptors are highly localized in adrenal medulla. Specific binding was displaced by 4% and by 95% with the AT, receptor blocker losartan and the AT2 receptor competitor CGP 42112A, respectively. Analysis of competition curves indicated relative binding potencies for the AT2 population of CGP 42112A>PD 123319> PD 123177. ANG stimulated +-nositol phosphate formation in a dose-dependent manner in rat adrenal medulla. Losartan at concentrations of 10(-9) to 10(-5) M antagonized the effect of ANG, whereas PD 123177 or PD 123319 had no antagonistic action. However, at a higher concentration (10(-5) M) PD 123177 or PD 123319 potentiated the effect of ANG on InsP1-accumulation. In the presence of PD 123319 (10(-5) M) ANG dose-response curve was shifted to the left with no change in the maximal effect. This affect was blocked by the addition of losartan (10(-5) M). On the contrary, the addition of CGP 42112A (10(-6) M) inhibited ANG-induced increase in InsP1-accumulation. On the other hand, ANG and CGP 42112A reduced basal cyclic GMP formation, this effect was partially reverted by sodium orthovanadate, a phosphotyrosine phosphatase inhibitor. Our results further demonstrate the presence of two ANG receptor subtypes in adrenal medulla: ANG binding to AT, receptor stimulates inositol phospholipid metabolism, whereas ANG binding to AT2 receptors decreases both inositol phosphate production and cGMP formation.

Initiation zone of DNA replication at the aldolase B locus encompasses transcription promoter region

Aldolase A (AldB) gene is one of the liver-specific genes, which is activated in the fetal stage. As a first step to investigate the functional relationship between transcription and DNA replication, we intended to determine the initiation zone of replication nearest to the AldB gene region. BrdU-labeled nascent DNA was obtained from G1/S arrested hepatoma cells at various times after entering S phase. Hybridization of the newly synthesized, BrdU-labeled DNA with probes corresponding to regions spanning about 26 Kb, revealed that replication zone locates within the AldB gene region. This result, together with the result of hybridization of nascent DNA obtained by alkaline sucrose density-gradient centrifugation, suggested that the initiation zone is located within a more defined region (about 1.0 Kb) containing AldB promoter. In the predicted initiation zone, a purine-rich element which shows high homology to known mammalian origin sequences and other replication components are found. Further, autonomously replicating activity of this initiation zone was examined by DNA transfection. The results showed that the predicted initiation zone confers replication initiation in Cos-1 cells.

Enhanced expression of an endothelin ETA receptor in capillaries from human glioblastoma: a quantitative receptor autoradiographic analysis using a radioluminographic imaging plate system

We identified and characterized 125I-endothelin-1 (125I-ET-1) binding sites in tumor capillaries isolated from human glioblastomas, using the quantitative receptor autoradiographic technique with pellet sections. Quantification was done using the computerized radioluminographic imaging plate system. High-affinity ET receptors were localized in capillaries from glioblastomas and the surrounding brain tissues (KD = 4.7 +/- 1.0 x 10(-10) and 1.6 +/- 0.3 x 10(-10) M, respectively; Bmax = 161 +/- 38 and 140 +/- 37 fmol/mg, respectively; mean +/- SEM, n = 5). BQ-123, a selective antagonist for the ETA receptor, potently competed for 125I-ET-1 binding to sections of the microvessels with IC50 values of 5.1 +/- 0.3 and 5.1 +/- 1.5 nM, and 10(-6) M BQ-123 displaced 84 and 58% of ET binding to capillaries from tumors and brains, respectively. In addition, competition curves obtained in the presence of increasing concentrations of ET-3 showed two components (IC50 = 5.7 +/- 2.5 x 10(-10) and 1.4 +/- 0.2 x 10(-6) M for tumor microvessels, 1.8 +/- 0.6 x 10(-10) and 1.1 +/- 0.3 x 10(-6) M for brain microvessels, respectively). Our results indicate that (a) the method we used is simple and highly sensitive for detecting and characterizing various receptors in tumor capillaries, especially in the case of a sparse specimen, and (b) capillaries in glioblastomas express specific high-affinity ET binding sites, candidates for biologically active ET receptors, which predominantly belong to the ETA subtype.

In vivo binding characteristics of carbamazepine and carbamazepine 10, 11-epoxide to serum proteins in monotherapy adult patients

The in vivo serum protein binding characteristics of carbamazepine and carbamazepine 10, 11-epoxide, which was the main metabolite of carbamazepine in plasma, were assessed in sera from 30 adult patients with epilepsy on carbamazepine monotherapy. The binding characteristics of each compound were analyzed according to the two-site binding model. Association constants to the high-affinity binding site on alpha 1-acid glycoprotein (AAG) were 0.053 l/mumol for carbamazepine and 0.013 l/mumol for carbamazepine 10, 11-epoxide. The maximum binding capacities for drug-AAG binding were 49.2 mumol/l for carbamazepine and 48.1 mumol/l for carbamazepine-10, 11-epoxide. The products of the association constant and binding capacity for the lower-affinity site (i.e., the linear component of albumin binding site) were 1.273 for carbamazepine and 0.525 for carbamazepine 10, 11-epoxide. Within the total concentration range of each compound investigated, the contribution of drug-AAG binding to the total serum binding was relatively larger than that of drug-albumin binding.

[Development of a perceived social support scale: for a Japanese population]

Social support is increasingly attracting interest in as a factor in epidemiological research of disease risks. However, at present, few methods for measuring social support that can be credited as having reliability and validity exist in Japan. Therefore a perceived social support scale was developed in relation to a population study of a town in Fukuoka prefecture. A method for measuring functional support from several external sources was designed consisting of a self-administered test provided with only two available response options--yes & no. Pretests were conducted twice in order to evaluate content validity and adjust the number of determinants and resulted in spouse, family members, and friends being selected to be primary sources of support. A factor analysis was applied to select 10 conditions with high internal consistency for each of the sources. Responses were scored 0 or 1, for 'no' or 'yes,' respectively. Subsequently each set of 10 variables was summed into an index ranking social support conditions for each of the three sources. The three highest ranking indicators from each of the respective sources were then integrated into a single comprehensive total social support score of the individuals. The inquiry method was applied on 277 adults, aged from 40 to 69 years, in the town. Intercorrelation between the indicators of support derived from the three sources was low and coefficients of reliability ranged from 0.892 to 0.978. The score of each set of the 10 variables were incorporated into a principal components analysis in order to determine factorial validity. All of the first factor loadings of the items measuring support from both spouse and family were greater than 0.7 and high eigenvalues were obtained. Therefore the methods applied to spouse and family were considered adequate to measure a given construct. The items measuring support from friends were divided into two factors, emotional support and tangible support.