Shen-Han Lee

Shen-Han Lee

MA (Cantab), MBBS, PhD, MRCSEd | Otorhinolaryngology-Head & Neck Surgery Resident | PhD in Oncology

Publications

You can also find my articles on my Google Scholar profile.

Journal Articles

Theatre etiquette Delphi: the development of a guide on professional conduct and best practices in operating environments

Published in The Annals of The Royal College of Surgeons of England, 2025

An international Delphi consensus study among senior surgeons to develop standardized guidance on theatre etiquette to address professional conduct and team dynamics for those unfamiliar with the theatre environment, including resident surgical trainees and medical students. I was part of the TED Collaborative Group

Recommended citation: El Boghdady M, Hardie J, Brennan PA, TED Collaborative Group. (2025). "Theatre etiquette Delphi: the development of a guide on professional conduct and best practices in operating environments." The Annals of The Royal College of Surgeons on England. doi: 10.1308/rcsann.2025.0040. Epub ahead of print
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Metabolic regulation of the tumour and its microenvironment: The role of Epstein-Barr virus

Published in International Journal of Cancer, 2024

This is the first review paper that examines the links between Epstein-Barr virus, tumour metabolism and its microenvironment. Our review highlights how targeting this link may overcome resistance to immunotherapies.

Recommended citation: Lee SH, Khoo ASB, Griffiths JR, Mat Lazim N. (2024). "Metabolic regulation of the tumour and its microenvironment: The role of Epstein-Barr virus." International Journal of Cancer. 156(3):488-498.
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Massive immediate post-tracheostomy bleeding from the innominate artery

Published in Polish Annals of Medicine, 2023

This is a case report of a difficult tracheostomy complicated by massive immediate bleeding from the innominate artery that required a median sternotomy for vascular access and control.

Recommended citation: Mohd Zakir NN, Mohamad I, Lee SH, Yusof Z, Muhammod Riaz Z. (2023). "Massive immediate post-tracheostomy bleeding from the innominate artery." Polish Annals of Medicine. 30(2):157-160.
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Author response to: Comment on: Evolution of transoral endoscopic thyroidectomy vestibular approach according to the IDEAL framework

Published in British Journal of Surgery, 2022

Our response to a comment by by Alkaissy et al. on the transoral endoscopic thyroidectomy vestibular approach (TOETVA) IDEAL Framework for surgical innovation paper in the Britsh Journal of Surgery.

Recommended citation: Lee SH, Moorthy R, Nagala S. (2022). "Author response to: Comment on: Evolution of transoral endoscopic thyroidectomy vestibular approach according to the IDEAL framework." British Journal of Surgery. 109(11):e118.
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IgG4-Related Disease of the Pharynx with Spontaneous Regression

Published in American Journal of Medicine, 2022

The first case report of spontaneous regression of IgG4-related disease of the upper aerodigestive tract.

Recommended citation: Lee SH, Jaafar R, Misron NA, Yusof Z. (2022). "IgG4-Related Disease of the Pharynx with Spontaneous Regression." American Journal of Medicine. 135(11):e420-e422.
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Evolution of transoral endoscopic thyroidectomy vestibular approach according to the IDEAL framework

Published in British Journal of Surgery, 2022

This article reviews the evidence base, including landmark studies in the field of transoral endoscopic thyroid surgery vestibular approach (TOETVA), and assesses whether the evolution of TOETVA has aligned with the IDEAL framework, a scheme for safe implementation and assessment of surgical innovation.

Recommended citation: Lee SH, Moorthy R, Nagala S. (2015). "Evolution of transoral endoscopic thyroidectomy vestibular approach according to the IDEAL framework." British Journal of Surgery. 109(6):497-502.
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Negative Index Metamaterial-Based Frequency-Reconfigurable Textile CPW Antenna for Microwave Imaging of Breast Cancer

Published in Sensors, 2022

This study reports the design and development of a metamaterial-based reconfigurable textile antenna for microwave breast imaging. This microwave imaging system was capable of detecting a tumour as small as 10 mm in a breast phantom and we propose that it may be used clinically for detection of breast cancer.

Recommended citation: Hossain K, Sabapathy T, Jusoh M, Lee SH, Rahman KSA, Kamarudin MR. (2015). "Negative Index Metamaterial-Based Frequency-Reconfigurable Textile CPW Antenna for Microwave Imaging of Breast Cancer." Sensors. 22(4)1626.
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Self-reported symptom study of COVID-19 chemosensory dysfunction in Malaysia

Published in Scientific Reports, 2022

This is a nationwide, multi-centre, cross-sectional study of self-reported chemosensory dysfunction of 498 adult COVID-19 patients in Malaysia between June to November 2020 during the COVID-19 pandemic. By combining epidemiological and machine learning analyses, our study found that chemosensory dysfunction in COVID-19 was more widespread that previously reported among Asians and may be related to the infectivity of viral strains.

Recommended citation: Lee SH, Yeoh ZX, Sachlin IS, Gazali N, Soelar SA, Foo CY, Low LL, Alwi SB, Kamalden TM, Shanmuganathan J, Zaid M, Wong CY, Chua HH, Yusuf S, Muhamad D, Devesahayam PR, Ker HB, Salahuddin Z, Mustafa M, Sawali H, Lee HG, Din S, Misnan NA, Mohamed A, Ismail MN, Periasamy C, Chow TS, Krishan EK, Leong CL, Lim LPF, Zaidan NZ, Ibrahim Z, Abd Wahab S, Mohd Hashim SS, Malaysian COVID-19 Anosmia Research Group . (2022). "Self-reported symptom study of COVID-19 chemosensory dysfunction in Malaysia." Scientific Reports. 12(1):2111.
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HIF-1-Independent Mechanisms Regulating Metabolic Adaptation in Hypoxic Cancer Cells

Published in Cells, 2021

This is a review paper on metabolic adaptations involving carbohydrate and creatinine metabolism and other hypoxia-inducible factor-1 (HIF-1)-independent mechanisms that enable cancers to survive hypoxia despite anti-HIF-1 therapy.

Recommended citation: Lee SH, Golinska M, Griffiths JR. (2021). "HIF-1-Independent Mechanisms Regulating Metabolic Adaptation in Hypoxic Cancer Cells." Cells. 10(9)2371.
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Clinical characteristics and predictors of mortality in patients with melioidosis: the Kapit experience

Published in Tropical Medicine & International Health, 2021

This is a retrospective study of 73 patients with melioidosis at Kapit Hospital, Sarawak, Malaysia between 2016 to 2019. Patients commonly presented with septic shock, in the form of bacteraemia and pneumonia. Two routine clinical parameters, serum bicarbonate and albumin were found to have important prognostic implications in septicaemic melioidosis..

Recommended citation: Toh V, Tee SP, Lee SH. (2021). "Clinical characteristics and predictors of mortality in patients with melioidosis: the Kapit experience." Tropical Medicine & International Health. 26(6):664-671.
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How and Why Are Cancers Acidic? Carbonic Anhydrase IX and the Homeostatic Control of Tumour Extracellular pH

Published in Cancers, 2020

This is a review paper on the causes and consequences of the acidic tumour microenvironment, with a focus on carbonic anhydrase IX (CAIX) and prospects for clinical translation of CAIX-targeted therapies in oncology

Recommended citation: Lee SH, Griffiths JR. (2020). "How and Why Are Cancers Acidic? Carbonic Anhydrase IX and the Homeostatic Control of Tumour Extracellular pH." Cancers. 12(6)1616.
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Comparing the Utility and Surgical Outcomes of Harmonic Focus Ultrasonic Scalpel with Ligasure Small Jaw Bipolar Device in Thyroidectomies: A Prospective Randomized Controlled Trial

Published in Annals of Surgical Oncology, 2019

This is a randomized controlled trial comparing the use of Harmonic Focus ultrasonic scalpel and Ligasure Small Jaw bipolar device in thyroidectomy at a single tertiary center. There were significant differences in duration of surgery, postoperative drainage or adverse events. The Harmonic scalpel was associated with a higher postoperative pain but favoured by surgeons due to the ability to perform fine dissection with the device itself.

Recommended citation: Lee SH, Nguyen TK, Ong WS, Haaland B, Tay GC, Tan NC, Tan HK, Ng JCF, Iyer NG. (2019). "Comparing the Utility and Surgical Outcomes of Harmonic Focus Ultrasonic Scalpel with Ligasure Small Jaw Bipolar Device in Thyroidectomies: A Prospective Randomized Controlled Trial." Annals of Surgical Oncology. 26(13):4414-4422.
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Carbonic anhydrase IX is a pH-stat that sets an acidic tumour extracellular pH in vivo

Published in British Journal of Cancer, 2018

This pre-clinical study, which forms part of my PhD thesis, is the first to demonstrate that a hypoxia-associated tumour enzyme, carbonic anhydrase IX (CAIX) acidifies the tumor microenvironment in vivo. This study also uncovered a extracellular pH-stat mechanism for CAIX that maintains a more acidic environment within solid tumors.

Recommended citation: Lee SH, McIntyre D, Honess, D, Hulikova A, Pacheco-Torres J, Cerdán S,Swietach, P, Harris AL, Griffiths JR. (2018). "Carbonic anhydrase IX is a pH-stat that sets an acidic tumour extracellular pH in vivo." British Journal of Cancer. 119(5):622-630.
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Carbonic Anhydrase Activity Monitored In Vivo by Hyperpolarized 13C-Magnetic Resonance Spectroscopy Demonstrates Its Importance for pH Regulation in Tumors

Published in Cancer Research, 2015

This is a pre-clinical study measuring the in vivo functional activity of Carbonic Anhydrase IX (CAIX) in colorectal tumor models with hyperpolarized H13CO2 using 13C magnetic resonance spectroscopy magnetization transfer measurements. Paradoxically, tumors overexpressing CAIX showed lower enzyme activity using magnetization transfer measurements, which could be explained by the more acidic tumour extracellular pH in these tumors and the decreased activity of CAIX at low pH.

Recommended citation: Gallagher FA, Sladen H, Kettunen MI, Serrao EM, Rodrigues TB, Wright A, Gill AB, McGuire S, Booth TC, Boren J, McIntyre A, Miller JL, Lee SH, Honess D, Day SE, Hu DE, Howat WJ, Harris AL, Brindle KM (2015). "Carbonic Anhydrase Activity Monitored In Vivo by Hyperpolarized 13C Magnetic Resonance Spectroscopy Demonstrates Its Importance for pH Regulation in Tumors." Cancer Research. 75(10):4109-4118.
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Magnetic resonance spectroscopy of cancer metabolism and response to therapy

Published in Radiation Research, 2012

This is a review paper on magnetic resonance spectroscopy (MRS) methods and their applications to evaluate cancer metabolism and tumour responses to radiotherapy and chemotherapy

Recommended citation: McIntyre DJ, Madhu B, Lee SH, Griffiths JR. (2012). "Magnetic resonance spectroscopy of cancer metabolism and response to therapy." Radiation Research. 177(4):398-435.
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