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Interview with Prof. Lee Eng Hin

1) What attracted you to a career in biology/medicine?
  I was fortunate to have very good biology teachers in my high school. They made the subject extremely interesting and we had many opportunities to have hands-on learning activities on plants and animals. My firm grounding in the biological sciences and my positive experiences with a very caring family doctor who looked after my family and I in my childhood inspired me to take up a career in medicine. I was not particularly healthy in those days, and my mother had to take me to see him quite regularly for repetitive episodes of coughs and allergies. In retrospect, I think I was asthmatic as a child, although I was labeled as suffering from bronchitis. Later in my childhood and early adulthood, I read and heard stories about Albert Schweitzer in Africa and Norman Bethune in China, and I was impressed by their selfless devotion to the care of the sick and less fortunate in under-developed and developing countries. I felt that as a doctor I would have the opportunity to help a lot of people in this way.


Who are your scientific heroes?
  I have been impressed with a number of medical and scientific heroes. I recall as a medical student in Canada learning about the discovery of insulin by a great Canadian team made up of Sir Frederick Banting, Charles Best, JJR McLeod and JB Collip for which they won the Nobel prize in 1923. Their story was most inspiring and suspense and showed the value of working as a multidisciplinary team. The unraveling of the double helix structure of DNA by James Watson and Francis Crick in 1953 was an intriguing and controversial story which had the makings of a Hollywood movie. I learned over the years that over and above ones own skills and knowledge, one often needs a little bit of luck to be successful e.g. the serendipitous discovery of penicillin by Fleming.

My real initiation into the world of research began when I started my residency training in Toronto. The first year of training in the Orthopaedic Training Program was a mandatory research year. I spent the year in a laboratory in the basement of Mount Sinai Hospital in Toronto learning about the immunology of bone transplantation under the guidance of Drs Allan Gross, Fred Langer and Phil Halloran. It was there that I learned the basics of good scientific research. I remember not seeing daylight for most of that year as I started work quite early and ended quite late, but there were many rewards. I was given the opportunity to attend and present papers at the Orthopaedic Research Society meetings in the US and our research resulted in many excellent publications in good scientific journals.



Which scientist/clinician has made the biggest impact in your field?
  Over the years apart from clinical research, my main areas of research have been in Gait Analysis and Tissue Engineering. In Gait Analysis one name stands out: the late Dr David Sutherland from San Diego, who is acknowledged as the pioneer of gait analysis in children. His whole life was devoted to the then very new field of Gait Analysis using a computer-based opto-electronic system. He was best known for his work on the development of normal gait in children as well as the characterization of abnormal gait patterns in neuromuscular disease. In the field of Tissue Engineering, the Vacanti brothers (Joseph, Martin Charles and Francis), and Dr Arnold Caplan are the names that come to mind. However, even prior to the establishment of the field of Tissue Engineering, we must not forget the work of Dr Marshall Urist, who discovered the Bone Morphogenetic Protein (BMP) back in 1965, one of the first growth factors found to have a profound impact on bone and cartilage. Arising from the influence of work done by these giants, my research team has been concentrating on the study of the biology and behavior of the bone marrow derived mesenchymal stem cells (MSCs) and the molecular mechanisms involved in repair and regeneration of musculoskeletal tissues, especially cartilage. This fascinating field will hopefully result in our ability to repair damaged or diseased articular and physeal cartilage in the near future.


What paper had the most influence on you?
  One paper that impressed me a lot when I was training to become an orthopaedic surgeon was the classic description of a new operation to treat dislocated hips in children by Dr Robert Salter from Toronto. He devised an operation known as the Innominate Osteotomy based on studies of animal and human pelvic bone and hip joints. I was awed by the fact that at the age of 36 years he was able to design a new operation that has stood the test of time and is still universally accepted as the gold standard for treatment of Developmental Dislocation of the Hip.


What's the best advice you ever had?
  I suppose the best advice I have had came from my parents and that is to believe in oneself and to always try to do the right thing and help others. It is important not to be swayed easily and to think rationally before acting or reacting. This is not always easy but it is crucial to try know your ones abilities and understand oneself before one can interact in a positive way with others. I have always tried to think of the welfare of others and have tried very hard to be supportive and fair to all my colleagues and friends.


What's the worst advice you ever had?
  I cant think of any particularly bad advice. I guess I must have been lucky to have good friends, mentors and advisors.


What was your biggest thrill in the laboratory/clinic?
  The biggest thrill in the laboratory is when the experiments are going well. This usually leads to a feeling of exhilaration and excitement in the research team. It is especially thrilling to obtain significant results from the hard work which we can then see in print in international referred journals. The biggest thrill in the clinic is when patients thank you for what you have done for them. There was one occasion when one of my patients with osteogenesis imperfecta (brittle bones) wrote about his life in a book and thanked me for giving him the opportunity to walk after performing surgery on his crooked lower limbs.


What are the main issues confronting stem cell researcher with respect to clinical applications of stem cell?
  To put this in perspective, we must appreciate that there are different types of stem cells. The Haemopoeitic Stem Cells (HSCs) derived from bone marrow or cord blood are now used routinely to treat blood diseases such as leukaemia, thalassaemia and multiple myeloma. Adult stem cells such as Mesenchymal Stem Cells (MSCs) derived from bone marrow, fat and other sources are now undergoing clinical trials for repair of certain tissues such as damaged cardiac muscles and cartilage. On the other hand, it will be a while before Embryonic Stem Cells (ESCs) can be taken to the clinic. The main issues have to do with scientific considerations such as immunogenicity of the cells and the ability to control the cells so that they do not divide uncontrollably and become cancerous. The other consideration for ESCs is the ethical issue which may vary from country to country. It is important that all ESCs that are going to be used in a clinical situation must be derived and grown under conditions that will allow them to be used in humans.


What is the biggest threat to stem cell research??
  I would not call this a threat as much as trying to win the support of people through education and dialogue. It is important that everyone understands the challenges involved in stem cell research as outlined above but also realize that the potential benefits are tremendous. Of course the scientists involved with stem cell research must conduct their research with integrity and win the support of the public. Scientific issues can be overcome but a positive public perception and support is essential. At the end of the day, scientists and doctors will have to find a safe and effective way to use stem cells for treatment of various diseases that have hitherto been incurable by conventional means.

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