Minor technical issue: I recently downloaded Cave Story from the official website, and unfortunately it appears that the English text wraps around on itself in any given scene so that you can't read it as the text overlaps. Is there any way to get around that issue?
Otherwise the game works excellently for me; I'm using an HP Pavilion dv9000 on Vista.
Interesting. Where did you pick up the translation patch? I'm pretty sure Pixel's site (the official site) doesn't carry the English translation, so it's necessary to download it from here or here. Though I think they're the same file either way. :0
The readme says "Please use Courier New as the font. Others cannot be guaranteed to work." Maybe this?
I actually originally got it from here: www.acid-play.com/
It already had the English translation built in.
But then I tried downloading from the first link you mentioned; the exact same result happened when I played the game. As it turns out, the second site just redirects to the first site you posted as far as downloading translation goes.
And Courier is the ONLY text option available - you can't change it to something else even if you want to, which I presume was done to prevent text errors from occurring. So I don't think this is the problem since I cannot change that option.
I haven't tried using different video modes, as I think about it; only fullscreen. I might try messing with that and see if something else works better.