gastro ./ gastrointestinal tract

Peptic Ulcer Disease
An ulcer is defined as a breach in the mucosa of the alimentary tract, which extends through the muscularis mucosae into the submucosa or deeper. Although ulcers may occur anywhere in the alimentary tract, none are as prevalent as the peptic ulcers that occur in the duodenum and stomach. Acute gastric ulcers may also appear under conditions of severe systemic stress.

Peptic ulcers

Peptic ulcers are chronic , most often solitary, lesions that occur in any portion of the gastrointestinal tract exposed to the aggressive action of acid peptic juices. Peptic ulcers are usually solitary lesions less than 4 cm in diameter, located in the following sites, in order of decreasing frequency:

Duodenum, first portion
Stomach, usually antrum
At the gastroesophageal junction, in the setting of gastroesophageal reflux
Within the margins of a gastrojejunostromy
In the duodenum,stomach, or jejunum of patients with Zollinger-Ellison syndrome.
Within or adjacent to a Meckel diverticulum that contains ectopic gastric mucosa

In the United States, approximately 4 million people have peptic ulcers (duodenal and gasteric), and 350,000 new cases are diagnosed each year. Around 100,000 patients are hospitalized yearly , and about 3000 people die each year as a result of peptic ulcer disease. The lifetime likelihood of developing a peptic ulcer is about 10% for American men and 4% for women. Visit for Medical help

Peptic ulcers are remitting , relapsing lesions that are most often diagnosed in middle aged to older aged, but

Extreme Liminal Spaces, Boynton Beach, Florida edition
Bunny and I found ourselves at the Boynton Beach Mall. While Bunny shopped at Jock Pennet, I decided to wander the mall to see what wonderful and delightful stores awaited me there.

Um ? not much.

I would say that, at best, 50% of the stores were occupied, with two of the five anchor stores open for business. It wasn't hard for me to get these pictures without people, as there weren't many there to begin with. Yes, there were some people wandering around, but I think at most I had to wait maybe a minute or so before the area was clear of anyone.

The only store I found worthwile to actually go into was ?Guides & Angels.? It's utterly woo-woo, but the crystal selection was wondeful (if not a bit overpriced for my tastes).

This was easily the best shop in the entire mall.

I was really curious about this store:

Such an entrance! I doubt Avis & Budget paid for this architectual detail for their store. I wonder what was here before? An arcade or some type? A Victorian time portal of some sort? So strange.

But not as strange as what happened as I passed by this:

I swear the first time I passed this I could hear children laughing. No, really! I thought I might have triggered a proximity recording or something, but nope, the subsequent times I passed this I heard silence. Or rather, I didn't hear anything, as how could one hear silence? It's silent, as in ?no sound.? As in, this mall is eerily silent. Except for this haunted kiddie ride with the laughter of ghost children taunting me as I walk by.

And even if Jock Pennet was open, it was by no means crowded.

Not to mention this oddly placed store display in one corner of the store:

Overall, it was a rather sad mall, sadder than if it had simply been closed down entirely.

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they may first become evident in young adult life. They often appear without obvious precipitating influences and may then after a periof of weeks to months of active disease, heal with or without therapy. Even with healing however, the propensity to develop peptic ulcers remains in part because of the propensity for recurrent infections with H.pylori. The male to female ration for duodenal ulcers is about 3:1 and for gasteric ulcers about 1.5 to 2:1. Women are most often affected at or after menopause. For unknown reasons, there has been a significant decrease in the prevalence of duodenal ulcers over the past decades but little change in the prevalence of gastric ulcers.

Peptic ulcers appear to be produced by an imbalance between the gastroduodenal mucosal defense mechanisms and the damaging forces. Gastric acid and pepsin are requisite for all peptic ulcerations. Hyperacidity is not a prerequisite because only a minority of patients with duodenal ulcers have hyperacidity, and it is even less common in those with gastric ulcers. Gasric ulceration can rapidily occur when mucosal defenses fall, however as when mucosal blood flow drops gastric emptying is delayed or epithelial restitution is impaired.

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