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We demonstrated the advantage of 3-D visualization over 2-D visualization for inexperienced subjects. Further quantitative clinical studies are required to confirm whether stereoendoscopy actually provides benefits in clinical settings.

Idiopathic gastric volvulus is not rare, especially in the neonate and in infancy. Between 1966 and 1980 we managed 44 cases of gastric volvulus. In 22 of the cases, initial examination was performed under 1 year of age. The main symptoms in this group were vomiting and abdominal distention, while those in the group over 2 years of age were abdominal distention, weight loss, nausea, appetite loss etc. The upper G.I. series were the most important in diagnosis. There was only one case of acute volvulus, which was treated operatively on an emergency basis. Chronic volvulus could be treated conservatively, except in 2 cases. This consisted in the positioning of the patient in the upright right recumbent position after feeding, for at least 1 hour. In the supine position, the gastric fundus is filled and dilated when the milk is poured into the stomach, the fundus is pulled postero-caudally and the antrum is pulled upwards, resulting in the combined type of organo-axial and mesenterico-axial volvulus. Over 2 years of age, 77% required operation. The fixation of the gastric fornix with the diaphragm was performed, using 5 or 6 stitches. The result was quite satisfactory. We recommend this procedure in this operation.

Cerebrospinal fluid (CSF) shunts are frequently used to treat hydrocephalus. The use of a programmable shunt valve allows physicians to easily change the opening pressure. Since patients with adjustable CSF shunt valves may use portable game machines, the permanent magnets in these machines may alter the shunt valve programmed settings or permanently damage the device. This study investigated the risk of unintentional valve adjustment associated with the use of game machines in patients with programmable CSF shunt valves. Four adjustable valves from 4 different manufacturers, Sophysa Polaris model SPV (Polaris valve), Miethke proGAV (proGAV), Codman Hakim programmable valve (CHPV), and Strata II small valve (Strata valve), were evaluated. Magnetic field interactions were determined using the portable game machine, Nintendo DS Lite (DS). The maximum distance between the valve and the DS that affected the valve pressure setting was measured by x-ray cinematography. The Polaris valve and proGAV were immune to unintentional reprogramming by the DS. However, the settings of the CHPV and Strata valves were randomly altered by the DS. Patients with an implanted shunt valve should be made aware of the risks posed by the magnetic fields associated with portable game machines and commonly used home electronics.

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