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One Year Research Fellowships - 2015-2016

For 2015-16 the RCS awarded 26 one-year surgical research fellowships, following an interview assessment. The Research Board selected the fellowships from an extremely high-quality field, reflecting the standard of surgical research being carried out throughout the UK today.

Donate to surgical research

We depend on voluntary donations from individuals and trusts as well as legacy bequests to fund these invaluable research projects.Find out more about supporting surgical research. Alternatively, please call us on 020 7869 6086 or email fundraising@rcseng.ac.uk.

Mr Muneer Ahmed Ms Ellie Edlmann Dr Ajay Sud
Dr Ali Al-Hussaini Miss Amel Ibrahim Dr Peter Szatmary
Mr James Barnes Ms Susanna Jolly Mr Tanujan Thangarajah
Mr Damiano Barone Ms Rachel O'Connell Mr Simon Timbrell
Miss Ruth Benson Mr Peter Rees Mr Navin Vig
Miss Vanessa Brown Dr Ramsay Refaie Mr Akira Wiberg
Mr Pankaj Chandak Mr Ali Salamat Mr Tom Wiggins
Mr Mohammed Chowdury Miss Anna Sharrock Mr Pouya Youssefi
Ms Helen Cui Mr Sean Strong  Mr Ankur Mukherjee

Bicuspid aortic valves and aortic aneurysms - the importance of wall shear stress and proteomic changes in the aortic wall

'Bicuspid aortic valves cause aortic aneurysms'

Bicuspid aortic valve (BAV) is the commonest congenital heart abnormality, affecting 1.2 million people in the UK. Complications related to BAV account for more than that of all other congenital heart diseases. BAV is linked with aneurysms (abnormal enlargement) of the aorta, the main artery leaving the heart. Aneurysms pose a major life-threatening risk to the patient. The cause of aneurysm formation in BAV patients is still controversial. We aim to investigate the link between aneurysm and BAV, identify patients at high risk of rupture, and clarify the appropriate and timely treatment of this condition.

Mr Muneer Ahmed

Muneer Ahmed

King's College London, Guy's Hospital Campus

 

Magnetic occult lesion localization (MOLL) in breast cancer

'Magnetic technique for breast cancer treatment'

In the UK 50,000 women are diagnosed with breast cancer each year. Due to breast screening more than one-third of these cannot be felt and require wire insertion to be marked prior to surgery.

The novel magnetic technique involves injection of an inert magnetic tracer into the tumour avoiding the need for a wire. This novel technique may be able to reduce the need for patients to have a second operation due to incomplete removal of the breast cancer, which currently stands at 20% in the UK.

Dr Ali Al-Hussaini

Ali Al-Hussaini

Tissue Engineering and Reparative Dentistry Unit, School of Dentistry, Cardiff University

 

Investigating the role of novel cytokine-IL-35 in the regulation of anti-tumour immunity against head and neck cancer

'How cancer escapes the immune system'

Head and neck cancer is among the 10 most common malignancies in the UK, and its incidence is increasing. The overall 5-year survival rate is 60%. Cancer survival is dependent on the ability of cancer cells to escape from the body's defence system (immune system). The immune system can destroy cancer cells, but proteins (such as IL-35) produced by cancer can allow cancer cells to grow and spread to other parts of the body. We will study how the protein IL-35 promotes cancer growth and look at ways to eliminate this.

Mr James Barnes

James Barnes

Oxford Transplant Centre, Nuffield Department of Surgery

 

Donor-derived skin grafts to detect rejection in pancreas transplantation

'Sentinel donor skin graft monitoring.'

The cardiovascular, neurological, and retinal complications of diabetes are devastating for many patients with diabetes (up to 30% of patients develop impaired vision). There is increasing evidence that pancreatic transplantation is a highly effective treatment option for patients with advanced diabetic complications.

The benefits of pancreas transplantation require the graft to function for many years. Nevertheless, medium-term graft loss is common because there is no effective way to monitor the graft until the damage is irreversible. Direct access to donor skin tissue would enable daily inspection and, where necessary, early biopsy and treatment.

Mr Damiano Barone

Damiano Barone

Addenbrookes Hospital

 

Targeting the molecular basis of foreign body reaction to neural interfaces and investigation of prevention strategies

'Foreign body reaction in neural interfaces'

Neurological disability can be secondary to many conditions, including trauma, degenerative disease and cancer, imposing a significant health, economic and social burden. Nowadays rehabilitation medicine is the only therapy available to patients with existing deficits, although its main focus is optimising residual function rather than reversing neurological disability.

Neural interface implants represent a very promising tool in restoring neurological functions, although their translational applications are limited by the development of local foreign body reaction(FBR) of the surrounding tissue, compromising their long-term efficacy. Understanding molecular mechanisms of FBR will enable us to produce successful prevention strategies.

Miss Ruth Benson

Ruth Benson

St George's Hospital

 

Post-operative cognitive decline in patients undergoing endovascular aortic aneurysm repair: prevalence and prevention

'Does aneurysm surgery lead to cognitive decline?'

There have been significant advances in surgical treatment of aortic aneurysms (enlargement of the body’s largest blood vessel) which can be deadly if left untreated. However up to one-third of patients suffer from post-operative cognitive decline after surgery (POCD). This means problems with memory and concentration, sometimes so bad they prevent patients driving or living independently.

Little is known about why this happens to our patients. We aim to find factors linking aneurysm surgery to POCD, to guide future changes in practice and to protect our patients from its potentially devastating effects.

Miss Vanessa Brown

Vanessa Brown

Royal Surrey County Hospital

Freemasons’ Fellowship

Does nitrate supplementation improve postoperative recovery in colorectal cancer

‘Does beetroot juice improve post-operative recovery?'

Bowel cancer is the second most common cause of cancer death in the UK, with over 40,000 new diagnoses a year. Every year approximately 16,000 people die from bowel cancer. Surgery is the most effective way of curing bowel cancer.

Beetroot juice contains nitrates which have been proven to improve performance in professional athletes. Surgery for cancer is often described as ‘running a marathon’.
Will giving patients with bowel cancer beetroot juice; before and after surgery; improve their recovery? This research aims to investigate whether we can speed up recovery after an operation and improve patient outcomes.

Mr Pankaj Chandak

Pankaj Chandak

Guy's and St Thomas' Hospitals NHS Trust and MRC Centre for Transplantation

 

A new ex-vivo normothermic perfusion model of human antibody-mediated rejection

'Transplanting the un-transplantable'

For patients with kidney failure (commonly due to diabetes, obesity or high blood pressure), transplantation offers improved survival and quality of life. Kidney transplants are offered on the basis of ‘best match’ However, up to one-third of patients on the waiting list have antibodies (e.g. due to blood groups) making it difficult or impossible for them to receive a kidney transplant.

This research will; a) develop a new model using EVNP to study the effect of antibodies on the kidney; b) test novel drugs designed to protect the kidney from the effects of antibodies.

Mr Mohammed Chowdhury

Mohammed Chowdury

Department of Vascular Surgery, University of Cambridge

Freemasons’ Fellowship

Multi-modality imaging to determine the role of calcification and inflammation on restenosis rates following lower limb angioplasty

'Predicting blood vessel disease with novel imaging'

Furring up of the arteries in the legs is common. It can lead to ulcers, and subsequent amputation. Unlike X-ray techniques, PET/CT imaging is able to measure inflammation and calcium build-up within the arteries of the leg and we believe that the degree of this may explain why treatments aimed at improving a patients circulation may fail. If this is true then such techniques will allow us to (a) identify those requiring aggressive treatment to reduce such inflammation/calcification, and (b) provide a platform for testing effectiveness of new drugs.

Ms Helen Cui

Helen Cui

Churchill Hospital

 

Using innovative technology to develop a personalised surgical care pathway

'Using innovative technology to develop a personalised surgical care pathway'

On average, a person will have four operations in their lifetime. The pathway from initial contact through to the postoperative period is complex and can be confusing. Many factors along the pathway will affect patient experience and outcomes. Most of the research to date has been focused on how to optimise the 'hands on' care by doctors in hospital. Our research will investigate ways of using innovative technology to increase patient involvement, help reduce delays, improve preoperative fitness, aid recovery and ultimately improve a patient's quality of life after surgery.

Ms Ellie Edlmann

Ellie Edlmann

Addenbrookes Hospital

 

How does dexamethasone alter the inflammatory response in chronic subdural haematoma?

'Biochemical analysis in chronic subdural haematoma'

A chronic subdural haematoma (CSDH) is a collection of blood on the surface of the brain. It affects 5000 people aged over 65 in the UK each year. The aetiology is thought to be head trauma followed by an inflammatory response, which propagates formation of the collection. Surgical drainage is often necessary but recurrence can occur despite this. This research aims to clarify the pathophysiological processes causing progression and recurrence of CSDH and how this can be modified by treatment with dexamethasone (an anti-inflammatory drug) to improve outcome.

Miss Amel Ibrahim

Amel Ibrahim

UCL Institute of Child Health

 

Generating custom-shaped vascularised tissue engineered bone implants using human adipose-derived stem cells for the treatment of craniofacial defects in children

'Improving treatment for children with facial deformity'

Abnormal growth of the facial bones is devastating for children and families. It affects vision, speech, eating and self-esteem. Children may have invasive operations to rebuild the missing bones, which are painful and high-risk.

We have built a computer model of the face to accurately plan surgery and generated bone from stem cells using fat from patients. Our research will combine these technologies to make facial bones personalised to the child’s needs. This will provide a life-long minimally invasive solution that grows with the child, restoring them to normal play, school and life beyond.

Ms Susanna Jolly

Susanna Jolly

Department of Oncology, University of Sheffield

 

Delineation of the prostate gland within the zebrafish

'Zebrafish: a model for prostate cancer?'

Prostate cancer is a common disease that affects one in eight men in the UK. Some men with prostate cancer can be successfully treated, whilst in others the disease may spread and become incurable. Little is understood about the biological reasons for this. Zebrafish are used as animal models to study human diseases, including cancer. This project will look to establish whether the zebrafish has a prostate gland. Subsequent development of the zebrafish as a novel animal model for prostate disease will improve our understanding of, and treatments for, prostate cancer.

Ms Rachel O'Connell

Rachel O'Connell

Royal Marsden Hosptial

 

Clinical applications of 3D surface imaging in breast cancer surgery

'3D imaging in breast cancer surgery'

Breast cancer is the most common cancer in the UK, with 49,500 women diagnosed in 2010. When evaluating breast surgery, cancer control and post-treatment appearance must be considered. Appearance after breast surgery impacts on psychological recovery and quality of life. 3D surface imaging objectively measures breast appearance and can simulate probable appearance after surgery. We will use this alongside patient-reported outcomes to investigate the impact of radiotherapy on breast reconstruction, potentially to allow more immediate reconstructions. We will produce simulations of post-operative appearance, and assess whether seeing these helped women to prepare for surgery.

Mr Peter Rees

Peter Rees

Wythenshawe Hospital

 

The role of thrombin pathway activation in the colorectal cancer microenvironment

'Blood clotting in bowel cancer'

Bowel cancer is the second commonest cause of cancer death in the UK. Approximately one quarter of cancer patients develop clots in the legs and lungs. Clots cause early death, but also are associated with earlier cancer death, implying that blood clotting indicates an aggressive cancer. Laboratory studies show that clotting helps cancers grow and spread. Clinically, I shall determine the relationship between levels of clotting in bowel cancer patients and their cancer outcome. In the laboratory, I shall target clotting molecules to try and slow bowel cancer growth, as a novel anti-cancer therapy.

Dr Ramsay Refaie

Ramsay Refaie

Institute of Cellular Medicine, Newcastle University

 

Predicting outcome in joint replacement surgery - the role of peri-operative biomarkers

'Predicting joint replacement outcome using pre- operative blood tests'

Around 20% of patients after knee replacement and 10% of patients after hip replacement remain dissatisfied after their surgery. The reasons for this remain unclear.

We are collecting and analysing blood samples from 2000 patients having joint replacement surgery with the aim of identifying factors in a patient's blood profile that affect the results of this surgery.

This important study may allow us to identify factors that predispose patients to poor outcomes before they have surgery. If these factors are treatable then this research may help improve the outcome for patients having joint replacement surgery.

Mr Ali Salamat

Ali Salamat

Upper Airway Research Group, Academic Unit of Clinical and Experimental Sciences (CES), University Hospital Southampton NHS Foundation Trust

 

Development of an engineered honey (Surgihoney) as a novel topical anti-MRSA treatment

'Surgihoney in the fight against MRSA'

One in five of hospital-acquired infections are attributed to Methicillin-resistant Staphylococcus aureus (MRSA). Current treatments for treating MRSA infections are limited due to expense and the problem of emerging resistance.

Surgihoney is an engineered honey with potent antimicrobial properties. Our preliminary findings have shown that it is very effective at killing MRSA. We would therefore like to develop this honey as a novel treatment for MRSA-associated infections. If successful, this could address the issue of antimicrobial resistance and save the NHS a significant amount of money in the long term.

Miss Anna Sharrock

Anna Sharrock

Centre for Blast Injury Studies (CBIS) and National Heart and Lung Institute (NHLI), Imperial College

 

The generation and function of microvesicles in blast injury

'Blood vessel response in blast injury'

Explosive devices are implicated in the majority of combat casualties and are utilised by non-military fractions against civilian populations. Blast injuries have devastating local tissue trauma and systemic inflammatory effects and are associated with clotting disorders. It is hypothesised that blood vessels linings may propagate this response, as some evidence of vascular activation and microvesicle (small parts of cells which bud off) generation exists in trauma.

Discovering how and when blood vessels are activated opens the potential for modification and targeted treatment of those with progressive inflammatory syndromes in trauma.

Mr Sean Strong

Sean Strong

Centre for Surgical Research, University of Bristol

 

 

Understanding the role of the multidisciplinary team in recruitment to randomised controlled trials in surgical oncology: an exploratory qualitative study

'Teamwork and recruitment to surgical trials'

Randomised clinical trials are important to the NHS and patients because they are the best way to scientifically evaluate surgery. Trials are often hampered because of difficulties recruiting participants. Collaboration between the clinical and research teams is required to make this successful, but has not been previously studied. This research will use interviews to explore how clinical and research teams work and how this influences recruitment. Three cancer trials in bowel, gullet and lung surgery will be studied. Data will be analysed using qualitative methods and guidance developed to optimise recruitment in surgical oncology.

Dr Ajay Sud

Ajay Sud

Royal Liverpool University Hospital

Enid Linder Foundation Fellowship

Resolving the complexities of T-cell mediated cytokine- and tumour necrosis factor-induced inflammatory cascades in the pathogenesis of stratified acute pancreatitis and investigation of their potential efficacy as therapeutic targets.

'Cytokine/T-cells in stratified acute-pancreatitis'

Pancreatitis is heterogeneous condition with an overall incidence of 22.4 per 100,000 population, with a case mortality of 6.7% at 60 days. Mortality is higher in the severest disease forms and in socially deprived.

There remains no treatments for this condition. Inappropriately vigorous activity of the immune system is at the heart of an pancreatitis inflammatory response. Tumour necrosis factor alpha (TNF) is critical in the inflammatory response. We aim to understand this response in detail and use novel TNF blocking medicines for the condition,

Dr Peter Szatmary

Peter Szatmary

Royal Liverpool University Hospital

Freemasons’ Fellowship

The role of neutrophil extracellular traps in the management of acute pancreatitis

'Neutrophil extracellular traps in acute pancreatitis'

Acute pancreatitis affects around 10-15 in 100,000 people in the UK alone, costing the NHS £1 billion each year. Severe disease is complicated by disrupted blood flow to the pancreas as well as injury to other organs, frequently leading to death. The body makes both of these worse through the release of newly discovered neutrophil extracellular traps (NETs).

This project will investigate inhibition of release and breakdown of NETs in clinically relevant models of acute pancreatitis as a new approach in a serious disease for which there is currently no specific treatment.

Mr Tanujan Thangarajah

Tanujan Thangarajah

Royal National Orthopaedic Hosptial

 

Use of demineralised bone matrix and mesenchymal stem cells to regenerate and repair the tendon-bone attachment

'Improving rotator cuff healing following surgery’

Shoulder pain affects up to 26% of adults. Rotator cuff tears account for the majority of these and are found in 54% of those over the age of 60 years. The symptoms are disabling and often require surgical intervention. As such, the rate of surgical repair has increased by 500% since 2001. Outcomes are poor though, with 90% of cases failing due to poor tissue healing.

By developing a novel biomaterial to improve tendon-bone healing following surgery, fewer revision procedures will be required. This will improve patient outcomes and reduce the cost to the NHS.

Mr Simon Timbrell

Simon Timbrell

Institute of Cancer Sciences, University of Manchester

 

 

FAK - an invasive breast cancer target

FAK - an invasive breast cancer target

Breast cancer affects 50,000 women, killing 12,000 each year in the UK. Cancer stem cells (CSCs), a sub-population within tumours, are resistant to current therapies suggesting they are responsible for recurrence. Focal adhesion kinase (FAK) signalling is important in CSC regulation and is induced by cancer associated fibroblasts (CAFs) within the tumour microenvironment. We will discover if FAK inhibition prevents the induction of CSC activity via CAFs in clinical samples. Furthermore we will validate biomarkers of response and determine which subtype of invasive breast cancer patients will benefit from FAK inhibition.

Mr Navin Vig

Navin Vig

Centre for Cell Biology and Cutaneous Research, The Blizard Institute

 

Prognostic and therapeutic implications of oral cancer stem cell phenotypes

'Understanding the spread of oral cancer'

In the UK, approximately 7,000 people a year are diagnosed with oral cancer. This is cancer of the tongue, mouth, lips or gums and generally affects people over 60 and those who smoke or chew tobacco, drink alcohol, or are infected with the human papilloma virus (HPV).

Oral cancer, like many other cancers, becomes significantly more difficult to treat successfully when it has spread. This research aims to identify and investigate cells that are responsible for this spread, with the intention to improve treatments currently available and so to improve patient survival rates.

Mr Akira Wiberg

Akira Wiberg

Botnar Research Centre, University of Oxford

 

The molecular genetics of carpal tunnel syndrome

'The genetics of carpal tunnel syndrome'

Carpal tunnel syndrome (CTS) is a disabling condition of the hand that affects between 5-10% of the population. Symptoms include numbness, tingling and pain in the hand, and thumb weakness. Tens of thousands of carpal tunnel release operations are performed in the UK each year.

We aim to understand the genetic basis of CTS by studying the effects of genetic variants on the proteins and cells in CTS. This will help us to understand what causes CTS, and lead to the development of new treatments in the future, reducing the need for, and recurrence after surgery.

Mr Tom Wiggins

Tom Wiggins

Department of Surgery and Cancer, Imperial College London

Freemasons’ Fellowship

Investigation of phenol and amino acid metabolism dysfunction in gastro-oesophageal cancer

'Phenol dysfunction in gastro-oesophageal cancer'

In 2012, there were 11,516 new diagnoses of oesophageal/stomach cancer in the UK. Only one-third of patients are treated with curative intent due to late presentation. Discovery and validation of new biomarkers to identify these patients with early stage disease could improve survival.

This research aims to establish the biological mechanisms responsible for phenol dysfunction in gastro-oesophageal cancer. Understanding these processes will allow phenols to be targeted in urine and breath diagnostic tests for detecting early gastro-oesophageal cancer. Early diagnosis will increase the proportion of patients treated curatively, improving survival.

Mr Pouya Youssefi

Pouya Youssefi

St George's Hospital

H & S Fellowship

 

Bicuspid aortic valves and aortic aneurysms - the importance of wall shear stress and proteomic changes in the aortic wall

'Bicuspid aortic valves cause aortic aneurysms'

Bicuspid aortic valve (BAV) is the commonest congenital heart abnormality, affecting 1.2 million people in the UK. Complications related to BAV account for more than that of all other congenital heart diseases. BAV is linked with aneurysms (abnormal enlargement) of the aorta, the main artery leaving the heart. Aneurysms pose a major life-threatening risk to the patient. The cause of aneurysm formation in BAV patients is still controversial. We aim to investigate the link between aneurysm and BAV, identify patients at high risk of rupture, and clarify the appropriate and timely treatment of this condition.

 Mr Ankur Mukherjee

 

University of Newcastle Upon Tyne

Shears Northern Research Fellowship

 

Investigating an innovative self-care model for patients with prostate cancer

Prostate cancer is the commonest cancer in men.  Currently, 215,000 men are living with a diagnosis of prostate cancer in England, with 39% prescribed hormone therapy, requiring regular blood monitoring.  By 2040 this figure is projected to rise to 830,000.

 

The aim of our research is to assess if prostate cancer patients can be monitored and managed at home, with benefits to their quality of life and in a cost effective manner.  For this we need a reliable, rapid “home test”, which could be linked to mobile communication to report values to the clinic

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