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August 26, 1950


JAMA. 1950;143(17):1489. doi:10.1001/jama.1950.02910520031014

Hofbauer1 suggests a new approach to the problem of the etiology of vascular hypertension in toxemia of pregnancy, namely, the study of the disturbed balance in certain hormonal regulatory mechanisms and homeostatic adjustments of normal gestation. The various factors involved in the imbalance are to be seen in the hyperactivity of the pituitary, the adrenal cortex and the accessory medulla-like formation occurring in the cervical ganglions during gestation. Attention is called particularly to the pronounced secretory activation of the chromaffin elements and their numerical increase in certain sympathetic ganglions located lateral to the upper wall of the vagina and the cervix. These structures were described by Frankenhäuser, who observed their enlargement during gestation in human beings. The cells of these ganglions, rich in chromaffin elements, display a close resemblance to the pheochromocytes of the adrenal medulla. The structure appears to act during the gestation as an accessory adrenal-medullary tissue

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