Hsin-Ming Chen

National Taiwan University, T’ai-pei, Taipei, Taiwan

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Publications (96)183.49 Total impact

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    ABSTRACT: Background/purpose: Pleomorphic adenoma (PA) is the most common salivary gland tumor and the palate is the most common intraoral site for PA. This study aimed to present the clinicopathological features of a series of 74 palatal PAs. Methods: Seventy-four palatal PAs were collected from 1993 to 2009. The clinical and histopathological features of these 74 PAs were reviewed and analyzed. Results: The 74 palatal PA patients showed a marked female predilection (49:25, ∼2:1) and were nearly evenly distributed from the 3(rd) to 8(th) decades of life with a mean age of 47 years. All palatal PAs were treated by wide surgical excision and recurrence was noted in one PA. Histopathologically, there were 47 classic and 27 cellular PAs. Of the 74 PAs, 12 were completely encapsulated, 40 partially encapsulated, and 22 nonencapsulated. The duct-like structures and myxoid stroma were more or less found in every palatal PA. Plasmacytoid myoepithelial cell, clear cell, squamous epithelial nest, keratin pearl, hyalinized stroma, osteoid area, and chondroid area were found in 50, 19, 29, 19, 49, eight, and six PAs, respectively. Conclusion: We conclude that the palatal PA patients show a prominent female predilection (2:1) and are nearly evenly distributed from 20 years to 79 years of age. Plasmacytoid myoepithelial cell is the most characteristic type of tumor cell in PAs. Wide surgical excision is treatment of choice for PAs. Although ∼84% of palatal PAs are partially or nonencapsulated, recurrence of the lesion is rarely encountered after total surgical removal of the tumors.
    No preview · Article · Jan 2016 · Journal of the Formosan Medical Association
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    ABSTRACT: Background/purpose: The Taiwan National Health Insurance program has allocated a specific fund for dental services to patients with specific disabilities (PSDs); however, the trends and the quality are unknown. In this study, we conducted quantity analyses and quality assessments of dental service use among PSDs using a nationwide population-based database. Methods: PSDs were identified according to the codes of diagnosis fee. Quantity analyses included the number of patients receiving dental services, the number of visits, and the percentages of categories of dental service use. Quality assessments included refilling rates for operative dental treatments and unfinished rates for endodontic therapies. Results: For quantity analyses, dental services were accessible to 3-4% of patients with disabilities and were mostly provided to younger PSDs. The general population received more operative and endodontic therapies, and PSDs received more periodontal therapies. For quality assessments, the teeth of PSDs had a 9.74-15.07% refilling rate, which was higher than that of the general population (1.39-6.37%). Furthermore, the teeth of PSDs had a 32.03% unfinished endodontic rate, which was higher than that of the general population (21.42%). Conclusion: During 2010-2012, only 3-4% of patients with disabilities had access to dental services, mostly provided to younger PSDs. Teeth of PSDs had higher refilling rates and unfinished endodontic sessions than the general population. We suggest that a more comprehensive dental care system is necessary to improve the quantity and quality of dental services, especially in middle-aged and older PSDs.
    No preview · Article · Oct 2015 · Journal of the Formosan Medical Association
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    ABSTRACT: Background/purpose: In Taiwan, the combination of betel quid chewing, alcohol consumption, and smoking habits increases oral cancer risk by 123-fold compared to persons without these habits. Lymphocyte populations in patients may potentially affect the malignant transformation of oral precancer. Methods: A total of 28 patients with oral precancer from our previous cohort were enrolled in this study, and their personal information and oral habits were documented. Their lymphocyte populations (CD4+, CD8+, CD19+, and CD56+) and activation markers (CD25 and CD69) were determined by flow cytometry from 1999 to 2004. After follow up till December 2014, data of patients with/without malignant transformation were recorded, and the relation between oral habits and percentage of initial lymphocyte markers was evaluated using the Student t test and Fisher's exact test. Results: Ten precancer patients developed oral squamous cell carcinoma with a mean period of malignant transformation of 6.8 ± 2.1 years. Patients with malignant transformation had a mean age of 48.4 ± 5.0 years (n = 10), relatively more than that of patients without malignant transformation (41.6 ± 6.3 years, n = 18) (p < 0.05). An increase was noted in the population of peripheral blood mononuclear cells expressing CD4+CD69+, CD19+CD69+, and CD56+CD69+ (p < 0.05) in precancer patients with malignant transformation. Alcohol consumption showed an association with the malignant transformation of patients with precancer (p = 0.030), whereas betel quid and smoking showed little effect. Conclusion: These results suggest that age, alcohol consumption, and early activation of T cells, B cells, and natural killer cells are crucial in the malignant transformation of oral precancer. Analysis of patient's lymphocyte populations may help predict the malignant transformation of oral precancer.
    No preview · Article · Sep 2015 · Journal of the Formosan Medical Association
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    ABSTRACT: Folic acid deficiency (FAD) may result in macrocytic anemia. This study assessed the hematinic deficiencies and anemia statuses in oral mucosal disease patients with FAD (defined as folic acid ≤ 6 ng/mL). The blood hemoglobin (Hb), iron, vitamin B12, and folic acid concentrations, serum gastric parietal cell antibody level, and mean corpuscular volume (MCV) in 198 oral mucosal disease patients with FAD were measured. Based on World Health Organization (WHO) criteria, anemia or Hb deficiency was defined as having an Hb concentration of <13 g/dL for men and <12 g/dL for women. In this study, macrocytic anemia due to FAD was defined as having an MCV ≥100 fL and folic acid ≤6 ng/mL; pernicious anemia as having MCV ≥100 fL, vitamin B12 < 200 pg/mL, and serum gastric parietal cell antibody positivity; iron deficiency anemia as having MCV <80 fL and iron <60 μg/dL; and thalassemia trait as having MCV <74 fL, red blood cell (RBC) count > 5.0 × 10(12)/L, and Mentzer index (MCV/RBC) < 13. We found that by WHO definitions, 73 (36.9%), 41 (20.7%), and 10 (5.1%) of our 198 FAD patients had concomitant Hb, iron, and vitamin B12 deficiencies, respectively. Of 73 anemic FAD patients, three had macrocytic anemia due to FAD, one had pernicious anemia, 14 had iron deficiency anemia, eight had thalassemia trait, and the resting 47 had normocytic anemia. In addition to macrocytic anemia (2.0%), FAD patients may have concomitant normocytic (23.7%) or microcytic (11.1%) anemia. Copyright © 2015. Published by Elsevier B.V.
    No preview · Article · Jul 2015 · Journal of the Formosan Medical Association

  • No preview · Article · Jul 2015 · Journal of dental sciences
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    ABSTRACT: Oral submucous fibrosis (OSF) is a chronic progressive scaring oral disease associated with areca quid chewing. This study evaluated whether OSF patients had anemia, hematinic deficiencies, and serum gastric parietal cell antibody (GPCA) positivity. The blood hemoglobin (Hb), iron, vitamin B12, and folic acid concentrations, mean corpuscular volume, and serum GPCA in 68 male OSF patients were measured and compared with the corresponding data in 136 age-matched male healthy control individuals. We found that five (7.4%), 14 (20.6%), 34 (50.0%), 28 (41.2%), and nine (13.2%) of the 68 male OSF patients had Hb (< 13 g/dL), iron (≤ 70 μg/dL), vitamin B12 (≤ 450 pg/mL), and folic acid (≤ 6 ng/mL) deficiencies, and serum GPCA positivity, respectively. Furthermore, OSF patients had a significantly higher frequency of Hb (p = 0.006), vitamin B12 (p < 0.001), or folic acid (p < 0.001) deficiency and of serum GPCA positivity (p = 0.011) than healthy control participants. Of the five OSF patients with anemia, two had thalassemia trait, one had iron deficiency anemia, and two had macrocytic anemia (mean corpuscular volume ≥ 100 fL). In addition, of the nine OSF patients with serum GPCA positivity, six had vitamin B12 deficiency, five had folic acid deficiency, and two had iron deficiency. However, none of the nine GPCA-positive OSF patients had pernicious anemia based on the strict World Health Organization definition. We conclude that there are high frequencies of vitamin B12 and folic acid deficiencies and of serum GPCA positivity in our male OSF patients. Copyright © 2015. Published by Elsevier B.V.
    No preview · Article · Jun 2015 · Journal of the Formosan Medical Association
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    ABSTRACT: Vascular endothelial growth factor (VEGF) is a potent angiogenic factor. This study evaluated whether the VEGF mRNA level in oral squamous cell carcinoma (OSCC) tissue could be a biomarker to predict the progression and prognosis of OSCCs in Taiwan. This study used quantitative real-time reverse transcription-polymerase chain reaction (quantitative RT-PCR) to detect the VEGF mRNA levels in 60 OSCC specimens. Threshold cycle (CT) was defined as the PCR cycle number needed to generate a predetermined amount of DNA (threshold). The relative amount of tissue VEGF mRNA, standardized against the amount of glyceraldehyde 3-phosphate dehydrogenase (GAPDH) mRNA, was expressed as ΔCT = (VEGF CT - GAPDH CT). For a chosen threshold, a smaller starting copy number of mRNA results in a higher CT value. Thus, the lower the ΔCT, the greater the copy number of VEGF mRNA in tissues. The lower mean VEGF mRNA ΔCT value was significantly associated with OSCCs with larger tumor size (p = 0.040), positive lymph node metastasis (p = 0.023), and more advanced clinical stages (p = 0.008). VEGF mRNA ΔCT value < 4.2 (p = 0.026) was identified as an independent unfavorable prognosis factor using multivariate regression analyses. Moreover, Kaplan-Meier curve showed that OSCC patients with a VEGF mRNA ΔCT value < 4.2 had a significantly poorer overall survival than those with a VEGF mRNA ΔCT value ≥4.2 (log-rank test, p = 0.0427). The OSCC tissue VEGF mRNA level can be used to predict the progression and prognosis of OSCCs in Taiwan. Copyright © 2015. Published by Elsevier B.V.
    No preview · Article · Jun 2015 · Journal of the Formosan Medical Association
  • Yu Hsueh Wu · Julia Yu Fong Chang · Hsin-Ming Chen · Yi-Ping Wang

    No preview · Article · Jun 2015 · Journal of the Formosan Medical Association
  • Shih-Jung Cheng · Hsin-Ming Chen · Chun-Pin Chiang

    No preview · Article · May 2015 · Journal of dental sciences
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    ABSTRACT: Macrocytosis is defined as having the mean corpuscular volume (MCV) ≥ 100 fL. This study assessed hematinic deficiencies and pernicious anemia (PA) in oral mucosal disease patients with macrocytosis. The blood hemoglobin (Hb), iron, vitamin B12, folic acid, and homocysteine concentrations and MCV in 60 oral mucosal disease patients with macrocytosis were measured and compared with the corresponding data in 120 age- and sex-matched healthy control participants. PA was defined by the World Health Organization (WHO) as having an Hb concentration < 13 g/dL for men and < 12 g/dL for women, an MCV ≥ 100 fL, a serum vitamin B12 level < 200 pg/mL, and serum gastric parietal cell antibody (GPCA) positivity. We found that 30 (50.0%), 7 (11.7%), 24 (40.0%), and three (5.0%) oral mucosal disease patients with macrocytosis had deficiencies of Hb (men < 13 g/dL, women < 12 g/dL), iron (< 60 μg/dL), vitamin B12 (< 200 pg/mL), and folic acid (< 4 mg/mL), respectively. Moreover, 38 (63.3%) and 16 (26.7%) macrocytosis patients had abnormally high blood homocysteine level (> 12.3 μM) and serum GPCA positivity, respectively. Macrocytosis patients had a significantly higher frequency of Hb, iron, or vitamin B12 deficiency, of abnormally elevated blood homocysteine level, and of GPCA positivity than healthy control participants (p < 0.001). However, only 16.7% of 60 macrocytosis patients were diagnosed as having PA by the WHO definition. Only 16.7% of oral mucosal disease patients with macrocytosis are discovered to have PA by the WHO definition. Copyright © 2015. Published by Elsevier B.V.
    No preview · Article · Apr 2015 · Journal of the Formosan Medical Association
  • Hsin-Ming Chen · Shih-Jung Cheng · Chun-Pin Chiang

    No preview · Article · Apr 2015 · Journal of the Formosan Medical Association
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    ABSTRACT: Vitamin B12 and iron deficiencies lead to macrocytosis [mean corpuscular volume (MCV) ≧ 100 fL] and microcytosis (MCV < 80 fL), respectively. This study evaluated anemic status, MCV, serum homocysteine level, and serum gastric parietal cell antibody (GPCA) level in oral mucosal disease patients with both vitamin B12 and iron deficiencies. The blood hemoglobin (Hb), iron, vitamin B12, folic acid and homocysteine concentrations, MCV, and serum GPCA in 149 patients with both vitamin B12 and iron deficiencies were measured and compared with the corresponding data in 149 age- and sex-matched healthy control subjects. We found that 54 (36.2%), 16 (10.7%), 44 (29.5%), and 36 (24.2%) patients with both vitamin B12 and iron deficiencies had Hb deficiency (men <13 g/dL, women <12 g/dL), folic acid deficiency (≦ 6 mg/mL), abnormally high blood homocysteine level (>12.6 μM), and serum GPCA positivity, respectively. Patients with both vitamin B12 and iron deficiencies had a significantly higher frequency of Hb deficiency, abnormally elevated blood homocysteine level, and serum GPCA positivity than healthy control subjects (all p values < 0.001). Of 149 patients with both vitamin B12 and iron deficiencies, 10 (6.7%) had high MCV (≧ 100 fL), 108 (72.5%) had normal MCV (between 80 fL and 99 fL), and 31 (20.8%) had low MCV (<80 fL). Approximately 73%, 30%, and 24% of patients with both vitamin B12 and iron deficiencies are found to have normal MCV, abnormally high blood homocysteine level, and serum GPCA positivity, respectively. Copyright © 2015. Published by Elsevier B.V.
    No preview · Article · Apr 2015 · Journal of the Formosan Medical Association
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    ABSTRACT: Betel quid (BQ) chewing is popular in Taiwan and many other countries. There are about 200-600 million BQ chewers in the world. BQ chewing is one major risk factor of oral cancer and oral submucous fibrosis (OSF). While areca nut (AN), a main component of BQ, exhibits genotoxicity, its transformation capacity and its role in the initiation and promotion stages of carcinogenesis are not fully clear. Mouse C3H10T1/2 cells were exposed to AN extract (ANE) for 24 hours. Cytotoxicity was evaluated by colony forming efficiency. For the transformation assay, C3H10T1/2 cells were exposed to ANE for 24 hours and then incubated in medium with/without 12-O-tetradecanolylphorbol-13-acetate (TPA; a tumor promoter) for 42 days. Cells were stained with Giemsa and type II and type III transformed foci were counted for analysis of the transformation capacity of ANE. ANE exhibited cytotoxicity to C3H10T/12 cells at concentrations higher than 320 μg/mL as shown by a decrease in colony numbers. ANE (80-640 μg/mL) alone mildly stimulated the transformed foci formation (p > 0.05). In the presence of TPA, ANE (80-640 μg/mL) markedly stimulated the transformed foci formation. The percentage of dishes with foci increased from 0% in controls to 20% in ANE (80 μg/mL and 320 μg/mL)-treated groups and further increased to 65-94% in ANE plus TPA groups. These results indicate that ANE is a weak complete carcinogen. ANE is an effective tumor initiator and can induce malignant transformation of C3H10T1/2 cells in the presence of a tumor promoter. ANE may be involved in multistep chemical carcinogenesis by its malignant transformation capacity. Copyright © 2015. Published by Elsevier B.V.
    No preview · Article · Feb 2015 · Journal of the Formosan Medical Association
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    ABSTRACT: A portion of patients with oral lichen planus (OLP) may have nutritional deficiency. This study evaluated whether there was an intimate association of the deficiencies of hemoglobin (Hb), iron, vitamin B12, and folic acid and high blood homocysteine level with OLP. The blood Hb, iron, vitamin B12, folic acid, and homocysteine concentrations in 352 OLP patients were measured and compared with the corresponding levels in 352 age- and sex-matched healthy control participants. We found that 77 (21.9%) OLP patients, 48 (13.6%) OLP patients, 25 (7.1%) OLP patients, and one (0.3%) OLP patient had deficiencies of Hb (men < 13 g/dL, women < 12 g/dL), iron (< 60 μg/dL), vitamin B12 (< 200 pg/mL), and folic acid (< 4 ng/mL), respectively. Moreover, 52 (14.8%) OLP patients had abnormally high blood homocysteine level. OLP patients had a significantly higher frequency of Hb, iron, or vitamin B12 deficiency and of abnormally elevated blood homocysteine level than healthy control participants (all p < 0.001). Upon further dividing OLP patients into those with major erosive OLP (MjEOLP; n = 67), minor erosive OLP (n = 202), and nonerosive OLP (NEOLP; n = 83), we found that MjEOLP patients had a significantly higher mean homocysteine level than NEOLP patients (p = 0.035). We conclude that there is a significant association of deficiencies of Hb, iron, folic acid, and vitamin B12 and abnormally high blood homocysteine level with OLP. There may be a close relation of high blood homocysteine level to severity of OLP. Copyright © 2014. Published by Elsevier B.V.
    No preview · Article · Dec 2014 · Journal of the Formosan Medical Association
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    ABSTRACT: BackgroundA portion of patients with recurrent aphthous stomatitis (RAS) may have nutritional deficiency. This study evaluated whether there was an intimate association of the deficiencies of hemoglobin, iron, vitamin B12, and folic acid and high blood homocysteine level with RAS.Methods The blood hemoglobin, iron, vitamin B12, folic acid, and homocysteine concentrations in 273 RAS patients were measured and compared with the corresponding levels in 273 age- and sex-matched healthy control subjects.ResultsWe found that 57 (20.9%), 55 (20.1%), 13 (4.8%), and 7 (2.6%) RAS patients had deficiencies of hemoglobin (Men < 13 g/dl, Women < 12 g/dl), iron (<60 μg/dl), vitamin B12 (<200 pg/ml), and folic acid (<4 ng/ml), respectively. Moreover, 21 (7.7%) RAS patients had abnormally high blood homocysteine level. RAS patients had a significantly higher frequency of hemoglobin, iron, vitamin B12, or folic acid deficiency and of abnormally elevated blood homocysteine level than healthy control subjects (all P-values = 0.000 except for folic acid P = 0.022). If 273 RAS patients were further divided into 32 patients with major-typed RAS (MjRAS) and 241 patients with minor-typed RAS (MiRAS), we found that male MjRAS patients had a significantly lower mean hemoglobin concentration than MiRAS patients (P = 0.021), but MjRAS patients had a significantly higher mean homocysteine level than MiRAS patients (P = 0.000).Conclusion We conclude that there is a significant association of deficiencies of hemoglobin, iron, vitamin B12, and folic acid and abnormally high blood homocysteine level with RAS.
    No preview · Article · Jul 2014 · Journal of Oral Pathology and Medicine
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    ABSTRACT: Background/purpose Dental patients with mental, psychiatric, or neurological disorders may need general anesthesia during dental treatments. This study analyzed the dental treatments and postoperative complications of 200 dental patients in a special needs dental clinic in northern Taiwan. Materials and methods The dental treatments and postoperative complications of 200 dental patients who needed general anesthesia for performing the dental treatments in a special needs dental clinic were analyzed statistically. Results The mean age of 200 dental patients (97 pediatric and 103 adult patients; 130 males and 70 females) was 20.2 ± 15.2 years. Of the 200 patients, 145 had tooth extractions, 118 tooth fillings, 46 root canal treatments, 56 either pulpotomy or pulpectomy, 45 stainless steel crown placement, and seven panoramic radiographic examinations. In pediatric patients, psychiatric problems were the most commonly encountered disorders (61.9%), followed by mental retardation (44.3%). In adult patients, mental retardation was the most common disorder (81.6%), followed by psychiatric disorders (34.0%). Of the 200 patients, 66 needed intubation general anesthesia (IGA) and 134 nonintubation general anesthesia (NIGA). IGA patients needed a significantly longer operation duration than NIGA patients (P < 0.001). Regarding postoperative complications, IGA patients had significantly higher epistaxis episodes than NIGA patients (P < 0.001). However, NIGA patients had significantly higher desaturation rate than IGA patients (P = 0.028). Conclusion Both IGA and NIGA are effective and relatively safe methods for dental patients who need dental treatment in a special needs dental clinic, but anesthesia itself still carries certain risks.
    No preview · Article · Jul 2014 · Journal of dental sciences
  • Hsin-Ming Chen · Yang-Che Wu · Ling-Ying Wei · Chun-Pin Chiang

    No preview · Article · Jun 2014 · Journal of dental sciences
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    Deng-Fu Yang · Jeng-Woei Lee · Hsin-Ming Chen · Yih-Chih Hsu
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    ABSTRACT: Topical 5-aminolevulinic acid-mediated photodynamic therapy (ALA-PDT) is effective for treatment of human oral precancerous lesions. This animal study aimed to assess whether topical methotrexate (MTX) pretreatment could enhance the therapeutic effect of topical ALA-PDT on hamster buccal pouch precancerous lesions. Twenty hamster buccal pouch precancerous lesions were treated with either topical ALA-PDT with topical MTX pretreatment (topical MTX-ALA-PDT group, n = 10) or topical ALA-PDT alone (topical ALA-PDT group, n = 10). The intracellular protoporphyrin IX (PpIX) level in another 12 precancerous lesions (n = 6 for either the topical MTX-ALA or topical ALA group) was monitored by fluorescence spectroscopy. The intracellular PpIX reached its peak level in precancerous lesions 6.5 hours and 2.5 hours after topical ALA application for the topical MTX-ALA group (5.63-fold higher in the lesion than in the normal mucosa) and topical ALA group (2.42-fold higher in the lesion than in the normal mucosa), respectively. The complete response rate of precancerous lesions was 80% for the topical MTX-ALA-PDT group and 70% for the topical ALA-PDT group. In addition, the topical MTX-ALA-PDT group required a significantly lower mean treatment number (2.1 ± 0.6) to achieve complete response than the topical ALA-PDT group (4.4 ± 1.3, p < 0.001)). Moreover, the topical MTX-ALA-PDT group had a lower recurrence rate (12.5%) than the topical ALA-PDT group (28.6%). We conclude that topical MTX-pretreatment can increase intracellular PpIX production in hamster buccal pouch precancerous lesions and significantly improves the outcomes of the precancerous lesions treated with topical ALA-PDT.
    Full-text · Article · May 2014 · Journal of the Formosan Medical Association
  • Chuan-Hang Yu · Hung-Pin Lin · Shih-Jung Cheng · Andy Sun · Hsin-Ming Chen
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    ABSTRACT: Previous studies have used cryotherapy for the treatment of oral precancers including oral leukoplakia (OL) and oral verrucous hyperplasia (OVH) as well as oral cancers including oral verrucous carcinoma (OVC) and oral squamous cell carcinoma (OSCC). Cryotherapy is a method that locally destroys lesional tissues by freezing in situ. It can be carried out by either an “open” or a “closed” system. Lesional tissues are destroyed mainly through disruption of cell membrane, cellular dehydration, enzyme and protein damage, cell swelling and rupture, thermal shock injury to cells, damage to vasculature, and immune-mediated cytotoxicity. Cryotherapy is used frequently for the treatment of OL lesions with promising results. It can also be used to treat OVH and OVC lesions. Because OVH and OVC lesions are usually fungating and bulky, a combination therapy of shave excision and cryotherapy is needed to achieve a complete regression of the lesion. OSCCs have also been treated by cryotherapy. However, cryotherapy is not the main-stream treatment modality for OSCCs. Cryotherapy seems suitable for treatment of thin or relatively thick plaque-typed lesions such as OL lesions. By careful selection of patients, cryotherapy is a simple, safe, easy, conservative, and acceptable treatment modality for certain benign oral lesions and oral precancers.
    No preview · Article · May 2014 · Journal of the Formosan Medical Association
  • Jang-Jaer Lee · Fang-Yu Yang · Yang-Che Wu · Hsin-Ming Chen

    No preview · Article · Apr 2014 · Journal of the Formosan Medical Association

Publication Stats

988 Citations
183.49 Total Impact Points

Institutions

  • 2003-2016
    • National Taiwan University
      • • Department of Dentistry
      • • Graduate Institute of Clinical Dentistry
      T’ai-pei, Taipei, Taiwan
    • Taipei Medical University
      • Graduate Institute of Biomedical Materials
      T’ai-pei, Taipei, Taiwan
    • I-Shou University
      Kao-hsiung-shih, Kaohsiung, Taiwan
  • 2005-2015
    • National Taiwan University Hospital
      • School of Dentistry
      T’ai-pei, Taipei, Taiwan
  • 2004
    • Koo Foundation Sun Yat-Sen Cancer Center
      T’ai-pei, Taipei, Taiwan