In recent years, the buccal cancer in Taiwan has been ranked the fourth among the top ten leading causes of cancer death, and the first among people at the prime age ( 25 ~ 44 years old ). Since people at the prime age are usually the main bread winners in the family and the main contributors in the economic development of the society, how to prevent the occurrences of buccal cancers or how to provide proper medical service to buccal cancer patients has become an urgent topic of the present medical industry. It is pointed out that the incidence of buccal cancers is frequently related to men¡¦s smoking, diet habit and their chewing of betel nuts. Especially in Kaohsiung-Pingtung area in southern Taiwan, the population of chewing betel nuts is much higher than that in other metropolitan cities. Thus, the incidence of buccal cancers is in vogue in this area. The aim of the present study is to discuss the key factors affecting the quality of medical treatment on buccal cancer patients under the management system of E-Da Hospital. Based on this model, we wish to further apply it to other disease treatments as well and to make E-Da Hospital become a characteristic medical center in the near future. This thesis adopts the Analytic Hierarchy Process (AHP) to exploit the multi-estimate criteria models of the medical quality. The first layer is the key factor for medical quality to buccal cancer patients at E-Da Hospital. The second evaluation criterion is divided into three aspects: namely, ¡§the hospital image of medical service¡¨, ¡§the available administrative resources¡¨, and ¡§ the convenience for patients¡¦ taking medical treatment¡¨. The third layer is the twelve evaluation characteristics. From this point of view, we can easily understand why patients choose E-Da Hospital as their priority. The interviewed participants are composed of the surgeons, the nursing staff, the administration personnel at E-Da Hospital, and the buccal cancer patients and their family members. Fifteen effective questionnaires are collected. Based on the Analytic Hierarchy Process, each subject is interviewed throughout and the result is verified by ANOVA. Based on the present study, we have found that the key factors of the management system for medical quality to buccal cancer patients at E-Da hospital are listed below in sequence---¡§the hospital image of medical service¡¨, ¡§the convenience for patients¡¦ taking medical treatment¡¨, and then ¡§the available administrative resources¡¨. Among the twelve evaluation characteristics, the critical top five ones are ¡§medical team work¡¨, ¡§medical effects¡¨, ¡§equipment novelty¡¨, ¡§home visit after operation¡¨ and ¡§ the convenience of transportation¡¨ in order. Several recommendations have been made to hopefully improve the management system and medical quality at E-Da hospital by strengthening the in-job training to the physicians and nurses and renovating medical equipment continuously. Besides, it is expected to set up buccal cancer patient club in the near future in order to achieve ¡§the Five Whole Attendance of Cares¡¨ - the whole person, the whole family, the whole team, the whole journey, and the whole community. Meanwhile, some proposals have also been made to the related health departments of the government so as to promote education on cancer prevention, to create and develop economic & effective cancer sieve checks in order to reduce the possible waste on the consumption of the medical resources and make them benecifical to the health for all. In so doing, we hope that our government can stress its long-term planning and investment on improving its medical service and enhance its medical quality thereby.

Os filmes poliméricos a base de DNA (DNA-PFs) são um sistema de veiculação de fármacos extremamente promissor aplicado à medicina moderna além de convergir busca de alternativas mais seletivas para o tratamento de câncer de boca via Terapia Fotodinâmica. A Ftalocianina de alumínio-cloro (AlClPc) é um fotossensibilizador de segunda geração aplicado em terapia fotodinâmica (TFD) caracterizado por seu caráter anfifílico e tendência de autoagregação em meio aquoso, prejudicando diretamente seu potencial de aplicação. Objetivando a busca das melhores condições de incorporação da (AlClPc) ao (DNA) foram determinadas as melhores proporções dos componentes a serem estudadas em diferentes condições de solubilidade. Os (DNA-PFs) foram preparados via Casting e para esclarecer sua compatibilidade e aplicabilidade, foram avaliados os aspectos morfológicos, bioquímicos e adesão celular das células de carcinoma escamosas orais (OSCC) nos (DNA-PFs). Foi observada uma alteração inicial e temporária na morfologia das células, devido ao processo de ligação ao filme nos estágios iniciais, conforme esperado, que retorna então a um estado morfológico normal mais tarde na configuração. Os estudos de citometria de fluxo mostraram baixa citotoxicidade de (DNA-PFs) no sistema, apresentando viabilidade superior a 90% em todos os (DNA-PFs) testados. Corroboram com esses resultados as análises da cinética do ciclo celular, mostrando que a cinética das células OSCC é mantida na presença de (DNA-PFs). Esses resultados indicam uma alta biocompatibilidade dos (DNA-PFs) produzidos. Após a incorporação da (Al- ClPc) aos (DNA-PFs) efetuou-se o uso do novo do sistema de veiculação aplicado a (TFD). Ficando evidente o aumento da morte celular, nas respectivas doses aplicadas. Tento em vista a redução de viabilidade celular apresentada pelo tratamento dos (DNA-PFs-AlClPc) verificou- se ainda o tipo de morte celular induzida pelo tratamento indicando como via preferencial de morte celular ocasionado por apoptose Estes resultados servem como base e possibilitam a abertura de novas perspectiva do potencial uso dos (DNA-PFs) aplicados como sistema de veiculação de fármacos para o tratamento fotodinâmico. / DNA-based polymer films (DNA-PFs) are an active drug delivery system applied to modern medicine besides converging search for more selective alternatives for the treatment of oral cancer through Photodynamic Therapy (PDT). Aluminum chlorine phthalocyanine (AlClPc) is a second-generation photosensitizer applied in PDT characterized by amphiphilic and tendency for self-aggregation in the aqueous medium, directly damaging its application potential. Aiming the search for the best conditions of incorporation of AlClPc to DNA the best proportions of the components to be studied under different solubility conditions were determined. The DNA-PFs were prepared via Casting and to clarify their compatibility and applicability, the morphological, biochemical and cell adhesion aspects of oral squamous cell carcinoma (OSCC) were evaluated in DNA-PFs. An initial and temporary alteration in cell morphology was observed due to the process of binding to the film in the initial stages, as expected, which then returns to a normal morphological state later in the configuration. Flow cytometry studies showed low cytotoxicity of DNA-PFs in the system, presenting viability higher than 90% in all DNA-PFs tested. They corroborate with these results the analyzes of the cell cycle kinetics, showing that the kinetics of OSCC cells is maintained in the presence of DNA-PFs. These results demonstrate high biocompatibility of the DNA-PFs produced. After incorporation of AlClPc to the DNA-PFs, the new one of the delivery system applied to PDT was used. The increase in cell death was evident in the several doses applied. Given the reduction of cell viability presented by the treatment of DNA-PFs-AlClPc, the type of cell death induced by the treatment was also showing, as the preferential route of cell death caused by apoptosis. These results allow new opportunities for potential use DNA-PFs DNA applied as a drug delivery system for PDT.