America's Best Hospitals
Tomorrow's cures usually are born at the nation's research hospitals. Here's a look at a few breathtaking breakthroughs
For more information, see U.S. News Online at http://www.usnews.com on the Internet.
EDITOR'S NOTE After Pages 68 to 87 went to press, an error was discovered. The Mayo Clinic should be listed as a member of the Council of Teaching Hospitals (COTH) in all applicable specialties. Its score for cancer care should be 47.6; cardiology, 96.0; endocrinology, 95.1; geriatrics, 60.1; otolaryngology, 42.9; and urology, 83.8. The corrected scores do not affect Mayo's rankings in these specialties.
THE HONOR ROLL To make the U.S. News honor roll that defines America's elite hospitals, a hospital had to rank among the top 10 in at least three specialties and score at least 10 points. Points were based on 10 for a No. 1 ranking, 9 for a No. 2 ranking and so on, down to 1 point for a No. 10 ranking. 1. Johns Hopkins Hospital, Baltimore (117 POINTS IN 15 SPECIALTIES) 2. Mayo Clinic, Rochester, Minn. (109 POINTS IN 15 SPECIALTIES) 3. Massachusetts General Hospital, Boston (89 POINTS IN 11 SPECIALTIES) 4. UCLA Medical Center, Los Angeles (52 POINTS IN 10 SPECIALTIES) 5. Duke University Medical Center, Durham, N.C. (47 POINTS IN 10 SPECIALTIES) 6. Cleveland Clinic (37 POINTS IN SEVEN SPECIALTIES) 7. University of California, San Francisco Medical Center (31 POINTS IN SEVEN SPECIALTIES) 8. Brigham and Women's Hospital, Boston (25 POINTS IN SIX SPECIALTIES) 9. University of Texas M.D. Anderson Cancer Center, Houston (22 POINTS IN FOUR SPECIALTIES) 10. (TIE) Barnes-Jewish Hospital, St. Louis (18 POINTS IN FOUR SPECIALTIES) 10. Memorial Sloan-Kettering Cancer Center, New York (18 POINTS IN FOUR SPECIALTIES) 12. University of Washington Medical Center, Seattle (16 POINTS IN FOUR SPECIALTIES) 13. University of Iowa Hospitals and Clinics, Iowa City (16 POINTS IN THREE SPECIALTIES) 14. New York University Medical Center (12 POINTS IN THREE SPECIALTIES) 15. University of Michigan Medical Center, Ann Arbor (11 POINTS IN THREE SPECIALTIES) 16. Stanford University Hospital, Stanford, Calif. (10 POINTS IN FOUR SPECIALTIES)
[Photograph captions]: Prebirth assist. Still 14 weeks from his due date, this fetus undergoes surgery at the University of California, San Francisco Medical Center to repair a hole in his diaphragm. A temporary plug has been inserted in his trachea. It will keep normally expelled lung fluid in the lungs, helping to accelerate lung growth after he is returned to the uterus.
Mission: Conception. Penetrating the membrane of a human egg in a petri dish, a thread-thin glass needle injects a single sperm--invisible within the tip even in this enlarged photograph--directly into the ovum's fluid center. The egg was removed at the University of California, San Francisco Medical Center from a woman whose mate suffers from azoospermia, a condition in which no sperm are present in the ejaculate, usually because of a vasectomy or infection. Instead of millions of sperm racing to be first to penetrate the egg, this technique, called intracytoplasmic sperm injection, provides one lucky sperm with a direct hit and results in a fertilized egg about 70 percent of the time. The egg is then transferred to the uterus. UCSF has done more than 100 single-sperm injection fertilizations; its 35 percent success rate equals that of the center's ordinary in vitro fertilization program. "You need a team," says UCSF reproductive endocrinologist Carolyn Givens: "a urologist with special training in obtaining the sperm. Someone skilled in andrology [male infertility]. A good IVF team. And people skilled at micromanipulation."
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