Just heard about this:
http://us.shuttle.com/H7_G4500SDXi.aspx
It looks like they have a block on the cpu, but for some reason they don't hook the graphics card up, or do anything innovative like cooling off the psu, usually the noisiest part of a shuttle system. It's close, but I don't think it's quite there yet. I wonder how easy it would be to mod this up and turn it into something quiet, though.
water cooled shuttle box
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