A 79-year-old white man of Irish descent presented with lattice corneal dystrophy, blepharochalasis, and peripheral seventh cranial nerve palsies. Family studies revealed that his 23-year-old daughter had early lattice cornea dystrophy. The corneal button removed by penetrating keratoplasty exhibited characteristic amyloid accumulation by light and electron microscopy. Biopsy of the patient's normal appearing conjunctiva and skin of the lower lid revealed amyloid. Biopsy of the daughter's conjunctiva was negative for amyloid, but her lid skin had characteristic amyloid deposits by light and electron microscopy. Immunoperoxidase strains were negative for AA and AP and serum prealbumin and SAA proteins were normal. Meretoja's syndrome has rarely been described outside a small geographic region in Finland. The clinical and histopathologic findings of this entity are discussed and contrasted to isolated "lattice corneal dystrophy."

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Clinical research opportunities: what you need to know for your practice.

Cardiologists and cardiovascular practitioners are facing significant reimbursement constraints. In this setting, increasing numbers of practitioners are looking to participate in clinical research as a new source of revenue. An aging population and consolidation among pharmaceutical companies, medical device companies, and contract research organizations are placing great emphasis on speed of new products to market. Opportunities exist for well-positioned and knowledgeable clinical investigators to enhance their practices, increase their professional knowledge, and expand their network of scientific colleagues. This article provides an overview of the drug and pharmaceutical industry referable to clinical investigation, the tools necessary to become a valued, principal investigator and an outline of challenges and opportunities for clinicians wishing to engage and enhance their clinical research activities.

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