No funding to declare.

The skeletal muscle procedure as described follows the guidelines of the Appalachian State University Institutional Review Board.
NOTE: The team consists of an operator (Ph.D. or M.D. trained in the biopsy technique), and at least one, but ideally, three or more technicians. The operator is responsible for conducting and overseeing all aspects of the skeletal muscle biopsy procedure. One technician (technician #1) is immediately responsible for assisting the operator with all aspects of muscle...

<ol>
	<li>Duchene, G. B. A. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Recherches+sur+la+paralysie+musculaire+pseudohypertrophique+ou+paralysie+myo-sclerosique.">Recherches sur la paralysie musculaire pseudohypertrophique ou paralysie myo-sclerosique.</a> Arch Gen Med. 11 (30), (1868).</li><li>Bergstrom, J. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Muscle+electrolytes+in+man.+Determined+by+neutron+activation+analysis+on+needle+biopsy+specimens.">Muscle electrolytes in man. Determined by neutron activation analysis on needle biopsy specimens.</a> Scand J Clin Lab Invest (England). 14, (1962).</li><li>Bergstrom, J. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Percutaneous+needle+biopsy+of+skeletal+muscle+in+physiological+and+clinical+research).">Percutaneous needle biopsy of skeletal muscle in physiological and clinical research).</a> Scand J Clin Lab Invest. 35, 609-616 (1975).</li><li>Bergstrom, J., Hultman, E. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=A+study+of+the+glycogen+metabolism+during+exercise+in+man.">A study of the glycogen metabolism during exercise in man.</a> Scand J Clin Lab Invest. 19, 218-228 (1967).</li><li>Evans, W. J., Phinney, S. D., Young, V. R. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Suction+applied+to+a+muscle+biopsy+maximizes+sample+size.">Suction applied to a muscle biopsy maximizes sample size.</a> Med Sci Sports Exerc. 14, 101-102 (1982).</li><li>Hennessey, J. V., Chromiak, J. A., Della Ventura, S., Guertin, J., MacLean, D. B. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Increase+in+percutaneous+muscle+biopsy+yield+with+a+suction-enhancement+technique.">Increase in percutaneous muscle biopsy yield with a suction-enhancement technique.</a> J Appl Phys. 82, 1739-1742 (1997).</li><li>Tarnopolsky, M. A., Pearce, E., Smith, K., Lach, B. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Suction-modified+Bergstrom+muscle+biopsy+technique:+experience+with+13,500+procedures.">Suction-modified Bergstrom muscle biopsy technique: experience with 13,500 procedures.</a> Muscl., &amp; Nerve. 43, 717-725 (2011).</li><li>Nieman, D. C., et al. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Carbohydrate+ingestion+influences+skeletal+muscle+cytokine+mRNA+and+plasma+cytokine+levels+after+a+3-h+run.">Carbohydrate ingestion influences skeletal muscle cytokine mRNA and plasma cytokine levels after a 3-h run.</a> J Appl Physiol. 94, 1917-1925 (2003).</li><li>Nieman, D. C., et al. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Influence+of+carbohydrate+ingestion+on+immune+changes+after+2+h+of+intensive+resistance+training.">Influence of carbohydrate ingestion on immune changes after 2 h of intensive resistance training.</a> J Appl Physiol. 96, 1292-1298 (2004).</li><li>Utter, A. C., et al. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Carbohydrate+supplementation+and+perceived+exertion+during+prolonged+running.">Carbohydrate supplementation and perceived exertion during prolonged running.</a> Med Sci Sports Exerc. 36, 1036-1041 (2004).</li><li>Nieman, D. C., et al. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Muscle+cytokine+mRNA+changes+after+2.5+h+of+cycling:+influence+of+carbohydrate.">Muscle cytokine mRNA changes after 2.5 h of cycling: influence of carbohydrate.</a> Med Sci Sports Exerc. 37, 1283-1290 (2005).</li><li>Nieman, D. C., et al. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Effects+of+quercetin+and+EGCG+on+mitochondrial+biogenesis+and+immunity.">Effects of quercetin and EGCG on mitochondrial biogenesis and immunity.</a> Med Sci Sports Exerc. 41, 1467-1475 (2009).</li><li>Nieman, D. C., et al. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Quercetin's+Influence+on+Exercise+Performance+and+Muscle+Mitochondrial+Biogenesis.">Quercetin's Influence on Exercise Performance and Muscle Mitochondrial Biogenesis.</a> Med Sci Sports Exerc. 42, 338-345 (2010).</li><li>Dumke, C. L., et al. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Quercetin's+effect+on+cycling+efficiency+and+substrate+utilization.">Quercetin's effect on cycling efficiency and substrate utilization.</a> Appl Physiol Nut Metab. 34, 993-1000 (2009).</li><li>Nieman, D. C., et al. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Quercetin's+influence+on+exercise-induced+changes+in+plasma+cytokines+and+muscle+and+leukocyte+cytokine+mRNA.">Quercetin's influence on exercise-induced changes in plasma cytokines and muscle and leukocyte cytokine mRNA.</a> J Appl Physiol. 103, 1728-1735 (2007).</li><li>. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Guideline+for+Disinfection+and+Sterilization+in+Healthcare+Facilities.">Guideline for Disinfection and Sterilization in Healthcare Facilities.</a> http://www.cdc.gov/hicpac/Disinfection_Sterilization/toc.html. , (2008).</li><li>Faria, F. E., et al. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=The+onset+and+duration+of+mobilization+affect+the+regeneration+in+the+rat+muscle.">The onset and duration of mobilization affect the regeneration in the rat muscle.</a> Histol Histopath. 23, 565-571 (2008).</li><li>Carlson, B. M., Shepard, B., Komorowski, T. E. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=A+histological+study+of+local+anesthetic-induced+muscle+degeneration+and+regeneration+in+the+monkey.">A histological study of local anesthetic-induced muscle degeneration and regeneration in the monkey.</a> J Ortho Res. 8, 485-494 (1990).</li><li>Yagiela, J. A., Benoit, P. W., Buoncristiani, R. D., Peters, M. P., Fort, N. 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L. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Muscle+glycogen+utilization+during+prolonged+strenuous+exercise+when+fed+carbohydrate.">Muscle glycogen utilization during prolonged strenuous exercise when fed carbohydrate.</a> J Appl Physiol. 61, 165-172 (1985).</li></ol>

The authors have no conflicts of interest.

This video provides a step-by-step summary of the skeletal muscle biopsy procedure used at the ASU Human Performance Laboratory. This procedure, with small modifications, has been used to collect approximately 1,600 muscle biopsies during the past 13 years. The muscle biopsy samples have provided important data in sports nutrition based investigations, leading to important research discoveries.
There are many critical techniques to be aware of when performing the modified Bergstr&#246;m skelet...

The percutaneous or &#8216;semi-open&#8217; biopsy technique is used to obtain skeletal muscle tissue specimens from human patients and research subjects. Duchenne (1806-1875) is credited as the first to construct a needle with a trocar to obtain skeletal muscle from living subjects through percutaneous biopsy1. In the 1960&#8217;s, Bergstr&#246;m introduced a percutaneous biopsy needle similar to that described by Duchenne2-4. Twenty years later, Evans et al.5 modified the technique by applying suction through the cutting trocar of the Bergstr&#246;m needle. This modification can enhance the yield of tissue 3- to 5-fold6,7 and is employed in clinical and biomedical research settings. This technique has and will continue to foster the diagnosis of myopathies and our understanding of the structure and function of skeletal muscle.
The percutaneous muscle biopsy technique is straightforward. When done correctly, with strict adherence to aseptic technique, the associated risks are minimal. The muscle biopsy procedure is regarded as an investigational tool for research projects. Some academic institutions allow trained faculty researchers with a Ph.D., with direct physician oversight, to obtain muscle biopsies and others require a board-certified physician to perform the technique. The ASU biopsy team has successfully performed over 1,600 muscle biopsies during the past 13 years8-15. The purpose of this video is to describe the modified Bergstr&#246;m needle percutaneous muscle biopsy technique5 to obtain skeletal muscle tissue samples from the vastus lateralis of human subjects.

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			<td height="24" style="height:24px;width:439px;">Name of Material / Equipment</td>
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			<td style="width:204px;">Comments /&#160; Description</td>
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			<td height="24" style="height:24px;">Bergstr&#246;m biopsy needle, 5 x 100mm</td>
			<td style="width:185px;">Stille Surgical Inc.</td>
			<td>119-29187-50</td>
			<td>1 ea</td>
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			<td height="24" style="height:24px;">Durasorb blue pad</td>
			<td>Fisher</td>
			<td>22-031-340</td>
			<td>case of 300</td>
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			<td>Moore Medical</td>
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			<td>1 ea</td>
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			<td height="24" style="height:24px;">Shave Cream</td>
			<td>Moore Medical</td>
			<td>92869</td>
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			<td>Moore Medical</td>
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			<td height="24" style="height:24px;">Povidone-iodine Swabsticks (3 pack)</td>
			<td>Moore Medical</td>
			<td>90691</td>
			<td>pack of 50</td>
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			<td>Fisher</td>
			<td>19-039-690</td>
			<td>case of 50</td>
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			<td height="24" style="height:24px;">Sterile Gloves; sz 6.5</td>
			<td>Moore Medical</td>
			<td>68128</td>
			<td>box of 50 pairs</td>
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			<td height="24" style="height:24px;">Sterile Gloves; sz 7.0</td>
			<td>Moore Medical</td>
			<td>68129</td>
			<td>box of 50 pairs</td>
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			<td>Moore Medical</td>
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			<td>box of 50 pairs</td>
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			<td>Moore Medical</td>
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			<td>case of 50</td>
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			<td height="24" style="height:24px;">Lidocaine (1% HCl, w/o Epi</td>
			<td>Dealmed</td>
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			<td>30cc vial</td>
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			<td>Dealmed</td>
			<td>386020</td>
			<td>3.5 fl. Oz. bottle</td>
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			<td height="24" style="height:24px;">5 mL syringe w/ 21G needle</td>
			<td>Fisher</td>
			<td>14-827-48</td>
			<td>case of 100</td>
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		<tr height="24">
			<td height="24" style="height:24px;">25G 5/8&#34; needle</td>
			<td>Fisher</td>
			<td>14-826AA</td>
			<td>case of 100</td>
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			<td height="24" style="height:24px;">25G 1 1/2&#34; needle</td>
			<td>Fisher</td>
			<td>14-826-49</td>
			<td>case of 100</td>
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		<tr height="24">
			<td height="24" style="height:24px;">Single-Use Scalpels&#160; w/ #11 blade</td>
			<td>Fisher</td>
			<td>0-8927-5B</td>
			<td>box of 20</td>
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		<tr height="24">
			<td height="24" style="height:24px;">60 mL Syringe</td>
			<td>Fisher</td>
			<td>13-689-8</td>
			<td>case of 40</td>
		</tr>
		<tr height="24">
			<td height="24" style="height:24px;">~30 inch extension tubing</td>
			<td>Fisher</td>
			<td>14-169-7A</td>
			<td>roll of 50ft</td>
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			<td height="24" style="height:24px;">Metal stopcock</td>
			<td>Fisher</td>
			<td>01-290-38</td>
			<td>each</td>
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		<tr height="24">
			<td height="24" style="height:24px;">Polypropylene tubing connector w/ tapered ends, 3.2 to 5.5 mm</td>
			<td>Fisher</td>
			<td>15-315-28A</td>
			<td>case of 100</td>
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			<td height="24" style="height:24px;">Yellow pipette tips (1-200 &#181;L)</td>
			<td>Fisher</td>
			<td>02-681-2</td>
			<td>cut off&#160; ~15-18 mm of the tip</td>
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			<td height="24" style="height:24px;">Topical surgical adhesive</td>
			<td>Medline</td>
			<td>MSC091076</td>
			<td>case of 36 tubes</td>
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		<tr height="24">
			<td height="24" style="height:24px;">Topical surgical adhesive</td>
			<td>Medline</td>
			<td>MSC091076Z</td>
			<td>box of 6 tubes</td>
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		<tr height="24">
			<td height="24" style="height:24px;">Butterfly stitches (adhesive strips) 1/2&#34; x 4&#34; (6 per pack)</td>
			<td>Moore Medical</td>
			<td>93050</td>
			<td>box/300</td>
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			<td height="24" style="height:24px;">Bandadge, Strip, 3/4 x 3 in.</td>
			<td>Fisher</td>
			<td>19-027-202</td>
			<td>pack of 100</td>
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		<tr height="24">
			<td height="24" style="height:24px;">Adhesive bandage (5m rolls)</td>
			<td>Fisher</td>
			<td>19-027-768</td>
			<td>case of 36</td>
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			<td height="24" style="height:24px;">1&#34; paper surgical tape</td>
			<td>Fisher</td>
			<td>19-027-761</td>
			<td>case of 12</td>
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			<td height="24" style="height:24px;">Sutures (4-0 reverse cutting, FS2)</td>
			<td>Moore Medical</td>
			<td>82926</td>
			<td>box of 36</td>
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		<tr height="24">
			<td height="24" style="height:24px;">4 x 4 sterile gauze pads</td>
			<td>Moore Medical</td>
			<td>66949</td>
			<td>pkg/50</td>
		</tr>
		<tr height="24">
			<td height="24" style="height:24px;">2 x 2 non-sterile gauze pads</td>
			<td>Moore Medical</td>
			<td>37336</td>
			<td>pkg/200</td>
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		<tr height="24">
			<td height="24" style="height:24px;">3 x 4 Non-Adherent Pads</td>
			<td>Moore Medical</td>
			<td>74389</td>
			<td>bx/100</td>
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			<td height="24" style="height:24px;">Autoclave bags 3.5 x 9</td>
			<td>Moore Medical</td>
			<td>40390</td>
			<td>box of 200</td>
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		<tr height="24">
			<td height="24" style="height:24px;">Autoclave bags 5.25 x 10</td>
			<td>Moore Medical</td>
			<td>40391</td>
			<td>box of 200</td>
		</tr>
		<tr height="24">
			<td height="24" style="height:24px;">Autoclave indicator tape</td>
			<td>Moore Medical</td>
			<td>31608</td>
			<td>box of 250</td>
		</tr>
		<tr height="24">
			<td height="24" style="height:24px;">Lab Coats&#8212;small</td>
			<td>Fisher</td>
			<td>23-900-520A&#160;</td>
			<td>10/pk</td>
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		<tr height="24">
			<td height="24" style="height:24px;">Lab Coats&#8212;medium</td>
			<td>Fisher</td>
			<td>23-900-520B&#160;</td>
			<td>10/pk</td>
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			<td height="24" style="height:24px;">Lab Coats&#8212;large</td>
			<td>Fisher</td>
			<td>23-900-520C&#160;</td>
			<td>10/pk</td>
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		<tr height="24">
			<td height="24" style="height:24px;">Germicidal Disposable Cloth Wipes</td>
			<td>Moore Medical</td>
			<td>62879</td>
			<td>Can/160</td>
		</tr>
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</table>

human skeletal muscle biopsy procedures using the modified bergstr&#246;m technique

The percutaneous biopsy technique enables researchers and clinicians to collect skeletal muscle tissue samples. The technique is safe and highly effective. This video describes the percutaneous biopsy technique using a modified Bergstr&#246;m needle to obtain skeletal muscle tissue samples from the vastus lateralis of human subjects. The Bergstr&#246;m needle consists of an outer cannula with a small opening (&#8216;window&#8217;) at the side of the tip and an inner trocar with a cutting blade at the distal end. Under local anesthesia and aseptic conditions, the needle is advanced into the skeletal muscle through an incision in the skin, subcutaneous tissue, and fascia. Next, suction is applied to the inner trocar, the outer trocar is pulled back, skeletal muscle tissue is drawn into the window of the outer cannula by the suction, and the inner trocar is rapidly closed, thus cutting or clipping the skeletal muscle tissue sample. The needle is rotated 90&#176;&#160;and another cut is made. This process may be repeated three more times. This multiple cutting technique typically produces a sample of 100-200 mg or more in healthy subjects and can be done immediately before, during, and after a bout of exercise or other intervention. Following post-biopsy dressing of the incision site, subjects typically resume their activities of daily living right away and can fully participate in vigorous physical activity within 48-72 hr. Subjects should avoid heavy resistance exercise for 48 hr to reduce the risk of herniation of the muscle through the incision in the fascia.

The muscle biopsy procedure as described above allows the researcher to quickly and consistently collect skeletal muscle tissue samples. The typical yield in healthy, athletic subjects is 200 mg or more in a single pass with 3-4 clips. The procedure takes 15-20 min, most of which is spent in preparation for the incision. In exercise-based studies, muscle samples are often taken pre- and post-exercise, with one or two samples collected during recovery. With this design, the hair on the post-exercise (contralateral) thigh ...

Watch this Scientific Journal Video about Human Skeletal Muscle Biopsy Procedures Using the Modified BergstrÃ¶m Technique at JoVE.com

Human Skeletal Muscle Biopsy Procedures Using the Modified Bergstr&amp;#246;m Technique

The purpose of this video is to present the modified Bergstr&#246;m skeletal muscle biopsy technique on human subjects.

Human Skeletal Muscle Biopsy Procedures Using the Modified Bergstr&#246;m Technique

The percutaneous biopsy technique enables researchers and clinicians to collect skeletal muscle tissue samples. The technique is safe and highly ...

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Research

JoVE Journal

Medicine

39.4K visualizações.  Appalacian State University. The purpose of this video is to present the modified Bergström skeletal muscle biopsy technique on human subjects. 