None really, reg cleaners are supposed to help speed your system up, remove obsolete reg entries from deleted programs and such, usually I do not notice a big difference though. A lot of them work pretty much the same.
This site has one of the best, jvtools, but he has started charging for it, there is a 30 day trial though.
Yep I ran a registry cleaner program on my friends spyware infested computer a week ago and it came up with about 700 fixes that needed to be done (to go along with the 1300 instances of spyware). After that his comp actually ran like the pentium 4 2.8 it is .
It is amazing what can happen to a computer without a properly configured firewall/spyware app.
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