George "Chip” Shaw wears a few hats as an associate professor in the department of emergency medicine. As an emergency medicine physician, he treats patients in the UC Health University Hospital emergency department, and, with a PhD in physics, he researches ultrasound and stroke therapy in his lab in the Center for Cardiovascular Research. Shaw completed his undergraduate degree at the University of Virginia in 1985 and went on to obtain his PhD in physics from the University of Maryland and his medical degree from Georgetown University. Shaw came to UC in 1997 for his residency training in emergency medicine, joining the department’s faculty in 2001 and receiving a secondary appointment in biomedical engineering in 2002. He serves as a reviewer for several journals, includes the Journal of Neuroscience Methods, Physics in Medicine and Biology and Critical Care Medicine.
What is your current research focus?
"I’m working with Christy Holland, PhD, division of cardiovascular diseases, on ultrasound-enhanced thrombolysis. We’re trying to come up with a new stroke therapy that uses ultrasound to break up blood clots and improving the delivery of clot-busting medication like tPA to the clot.
But if you’re going to use ultrasound in the skull, there can be bioeffects if the pressure is over a certain threshold. So we’ve placed a human skull inside a tank with a transducer—the transducer creates a pressure wave against and inside the skull.
Then we’re using a hydrophone to measure the pressure as a function of position inside the skull and see if the pressure is too high or too low. If it’s too low, it won’t help the tPA; If it’s too high, it can cause bleeding. With tPA, we have a good therapy for stroke, but we can do better.
About 6 percent of the time, a stroke patient gets tPA and, as a side effect, has hemorrhaging in the brain. That’s always bad. I’ve seen it three times in my career and it’s horrible. So if we can get tPA to work more effectively with ultrasound, then maybe we can cut back the dosage.
Personally, that drives a lot of my work. I saw a hemorrhage case two or three weeks ago and came back to the lab in a daze thinking, "We’ve got to get this to work better.” What led you to study stroke therapies?
"It really started with Joe Broderick and the Greater Cincinnati/Northern Kentucky Stroke Team. Those are the physicians who are treating stroke patients in this area and they were the ones asking, ‘Is there anything better than tPA?
They identified a therapeutic need and brought it to the basic science researchers and engineers, like Dr. Holland, and it has mushroomed from that. From my viewpoint, I think it’s a good way to do the science.
If you’re just coming up with a new therapy at your lab bench, it’s going to be hard to get that into practice—you don’t know if clinicians need it and you don’t know who is going to use it. But with this approach, we’ll be able to take our results directly to the clinicians and see how they like it. It’s a much more targeted way to develop new medical therapeutics, and I think it’s going to be a much more effective way.”
When do you expect your research to impact patient care?
"Five to 10 years. Part of the work is just figuring out what kind of ultrasound would work best, what’s feasible.
I think we have a pretty good idea of that now. The other big limitation is designing the therapy—we need to make this as well-engineered and as easy to use as possible for the patient and for the people who are going to be using it.”
What do you do outside your work at UC and the hospital?
"I’m very involved in Cub Scouts and in our parish, St. Vivian’s in Finneytown. I have nine kids, from 4 years old to 24 years old, with five sons. So I’m going to be in Scouts for a long time, at least another decade.”