Using iPod Touch out of USA

It will work the same anywhere.

You will only be restricted by where your iTunes account is registered to obtain new apps.

It should work fine.

Yes, you probably will be able to use it although the Terms of Service for the iTunes store state;
http://www.apple.com/legal/itunes/us/terms.html#SERVICE

"11. Territory. The Service is available to you only in the United States. You agree not to use or attempt to use the Service from outside of the available territory, and that Apple may use technologies to verify your compliance."

It works "normal". In the same way if you buy it in Europe.

I live in the US and have an iTouch I got from Canada, it has been refurbed by Apple but when using the app store on the unit it will not allow me to direct download to it. Now if I use iTunes from my PC I have no problems getting apps, music, and videos I have purchased from the app store. I am trying to find a way to change this but so far have had no luck.

could you restart or delate your iPod touch ??

I live in England, Yes I bought my iPod touch in Los Angeles. I have a US iTunes account and an English one. Some apps are only available in the US, while some are only available in the UK. So I do use both. But prepaid itune cards are only good for that country that you buy it in.