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The usefulness and relative safety of the technique of jet injection, mainly used in mass immunization, have been well established. A patient who developed a traumatic ulnar neuroma at the site of jet injection of swine flu vaccine is reported. This unusual and previously unreported complication of this procedure is thought to have occurred because of the patient's extremely small size and small muscles.
Primary vaccination by intradermal jet injection, using diluted smallpox vaccine, was compared with multiple-pressure vaccination in 625 Jamaican children. The cutaneous and antibody response patterns were evaluated. The primary take rates among those jet vaccinated were 97% or more in those receiving vaccines with a titre of 10(6.3) TCID(50)/ml and 10(7.0)TCID(50)/ml, and 96% in those vaccinated by multiple pressure, using undiluted vaccine. The primary take rates in subjects receiving jet-injected vaccine with titres of 10(6.0) TCID(50)/ml and 10(5.0) TCID(50)/ml were 90% and 62%, respectively. Among subjects tested who developed Jennerian vesicles, all but 3 demonstrated seroconversion. In those who failed to develop primary Jennerian vesicles, there was also a failure of neutralizing-antibody development. Vesicle and scar sizes were generally smaller in the jet-vaccinated subjects than in those vaccinated by the multiple-pressure technique. Infants tolerated jet vaccination without difficulty. Vaccinial complications did not occur in any subject. The intradermal jet injection of 0.1 ml of vaccine with a titre 10(6.3) TCID(50)/ml or higher is recommended as a highly effective method for achieving successful primary smallpox vaccination. The method appears best suited for use in mass smallpox-vaccination programmes.
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An animal model was used to establish the risk of transmitting a virus infection by subcutaneous jet injection. Virus transmission was studied with mice chronically infected with LDH virus. The virus infection was transmitted by subcutaneous jet injection in 16 cases out of 49. Other routes of cross-infection were ruled out. Before using the jet injector as a harmless instrument for mass subcutaneous injection, further experiments on the risks of virus transmission should be performed.
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Successful keratinocyte gene therapy requires the development of efficient methods of gene transfer to keratinocytes. Jet injection of a solution containing DNA can be used to transfer genes to several tissues in vivo. In this article, we tried to introduce DNA into rat and human keratinocytes using this method. First, we fired a beta-gal expression vector into rat skin at several distances using a jet injector and examined beta-gal activity in the epidermal keratinocytes. The highest activity in keratinocytes was found when the plasmid was fired at 10 cm from the skin surface; the activity lessened as the firing distance became shorter than 10 cm. Next, we transplanted human skin on to a nude rat, fired the vector into the human skin from a distance of 10 cm and examined the beta-gal activity. We also injected the same amount of plasmid with a needle to compare jet with needle injections. The results showed that jet injection of the naked DNA could introduce and express DNA in human keratinocytes in vivo and that jet injection exhibited much higher activity than needle injection. Jet injection of the naked DNA will provide a method for keratinocyte gene therapy in the future.
BACKGROUND: Pain and needle-phobia can be a problem during the application of local anesthesia with syringe and needle. OBJECTIVE: To evaluate a jet-injection device (without needle) to deliver local anesthesia. METHODS: Two hundred and six minor dermatological procedures using a jet-injection device for administering local anesthesia into skin tissue were performed. We comment on the technical procedures, application, usefulness in relation to areas involved and the anatomical location of lesion, and total dosage of the anesthetic agent. RESULTS: Total absence of pain during installation of anesthetic (N = 194; 94%). Good level of anesthesia in all patients. No local adverse effects. CONCLUSION: The jet-injection device is easy to handle, it is harmless, it provides good levels of anesthesia, and the dosage of anesthetic agent is smaller than the dosage administered with conventional methods.
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Needle free jet injection guns have been used extensively in both veterinary and human health to deliver both vaccine and drugs, but in recent years, concerns have mounted for their potential to transmit blood borne disease agents among consecutive vaccinates. A Ped-O-Jet type jet injection device was used to deliver serial subcutaneous injections of 0.5 mL saline (as a surrogate for vaccine) into calves and pigs, with intervening ejectates collected in vials to represent what the next vaccinate would have received. An enzyme linked immunosorbant assay was developed to detect species specific albumin as a marker for blood, using calibration standards from known dilutions of bovine or porcine blood. Assay sensitivity of 20 pL/mL corresponded to the estimated minimal chimpanzee infectious dose of 10 pL for hepatitis B virus. The methodology and available results for evaluating the safety of jet injector devices are reported.
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Smallpox vaccinations were performed in a well-vaccinated prison population by multiple-pressure technique and by intradermal jet injection using serial dilutions of vaccine. A total of 140 subjects were divided into groups, and each group was vaccinated by the multiple-pressure technique or by jet injection using 1 of 3 vaccine dilutions with the following calculated titres: ID-Jet 1 = 10(7.0) TCID(50)/ml, ID-Jet 1a = 10(6.3) TCID(50)/ml, ID-Jet 2 = 10(6.0) TCID(50)/ml. Clinical observations were made at intervals during the first week after vaccination. Prevaccination and post-vaccination serum samples were obtained immediately before and 30 days after the vaccination. Results based on clinical and serological evaluations indicated that smallpox vaccination by jet injection with the ID-Jet 1 vaccine was at least as efficacious as vaccination by the standard multiple-pressure technique.
Depot-medroxy progesterone acetate (DMPA) was jet deposited into the uterus/cervix of rats, rabbits and rhesus monkeys with the help of a modified jet injection apparatus. Since the drug was delivered under pressure, it was distributed deep into the muscular layers around the place of deposition. After one deposition the drug acted as an effective contraceptive for a period of three months. The merits of this delivery technique are discussed.
The jet injector route for ketamine was used on 30 children 1-6 years of age undergoing various surgical procedures. A randomly selected dose of 2.5, 3.5, or 6.0 mg/kg of ketamine was given to induce anesthesia. Peak plasma ketamine levels did not follow a simple arithmetic increment related to dose. Dosage based on mg/m2 body surface area or mg/kg body weight provided similar blood levels of ketamine. The beta-phase t1/2 of ketamine in these children was shorter than that found in adults. Considerable individual variability was observed in both the plasma levels to a given dose of jet-injected ketamine and in the beta-phase t1/2. The ketamine beta-t1/2s were not dose related.
Previously, we have established an in vivo electroporation method for gene transfer into muscle by injection of DNA with a needle followed by electric pulse delivery using needle-type electrodes and proved that this method is effective for the systemic delivery of cytokines. To perform the needleless gene delivery, we combined jet injection of DNA with electroporation using plate-type electrodes. For delivery of beta-galactosidase- and enhanced green fluorescent protein (EGFP)-expressing plasmids into muscles, there was no significant difference between the previous needle-mediated method and the newly developed jet-injection method. When pCAGGS-IL-5 was introduced into tibialis anterior, quadricipital and back sural muscles by this new method, the serum IL-5 levels reached 3.4 +/- 0.9, 5.7 +/- 1.7 and 8.4 +/- 2.7 ng/ml at day 5, respectively. Although the peak values of IL-5 achieved by the jet-injection method in these muscles were lower than that of the highest value achieved by needle-mediated gene delivery into anterior tibial muscle, this new method could deliver plasmid into relatively large muscles with better efficiency than the needle-mediated method. Thus the jet-injection method provides a useful means of gene delivery into large muscles, which is essential for future use in human gene therapy.