The EarthWatts 380W power supply is so quiet, I can't even hear the fan running. The 120mm TriCool case fan is also pretty quiet when it is set to the slowest speed, and I can still feel the air coming out of the case. There are vent holes directly in front of the hard drive cage, so I think the hard drive gets plenty of air, as long as you don't mount the hard drive all the way to the front of the case.
This case is nice if you like having a compact minitower case. It is about 2" shorter than most cases from the front of the case to the back of the case. Unfortunately, that means that the interior is cramped. Due to the position of the hard drive cage, any video card (no matter how large or small) has a tendency to interfere with the hard drive cables, no matter which drive bay you use. It is difficult to install a full-length video card, and there's really only enough room for one hard drive. I usually mount the hard drive in the middle 3.5" internal bay. At the top of the case, there's really only enough room for one optical drive due to the way I route my cables. On the positive side, there are two external 3.5" bays, so you can install a card reader as well as a floppy drive.
As with most cases, there's plenty of air flow inside the case as long as you bundle and route all of the cables in a professional manner. (I use about 30-40 4" cable ties, and it takes me about half an hour, but it might take a lot longer if you're doing it for the first time.) Basically, I tie all of the power supply cables into one long bundle with some of the longer ones doubled back to shorten them, with various connectors branching off like tree limbs from the main "trunk", which lies next to the front end of motherboard. I twist the cables for the front panel connectors into one bundle, and I use round drive cables for the floppy drive and IDE optical drive. I tie the ends of the SATA cables into a "J" so that the cables run back under the hard drive instead of sticking out away from the hard drive, which reduces interference with the video card. You can stop the rattling of the side panels with the strategic use of small pieces of electrical tape, but I agree that the design of the side panels is poor.
I wouldn't say the case is "perfect", but if you have an ATX or MicroATX motherboard, a small video card, one hard drive, a DVD burner, a card reader, and a floppy drive, you'll have a nice-looking compact computer wirh a full-size 80+ power supply. I decided a long time ago it's easier and a lot less expensive to use a case like this than it is to use a cube case or a slimline case.