Make sure your PSU fan is blowing out. There was a short period where the ATX specs called for the PSU to blow air into the case. However, the consensus there was that that was a mistake, and the PSU should exhaust. If your PSU is "sucking" instead of blowing, it's a pretty easy change to make.
What kind of case do you have? I was able to get a squirrel cage cooler (nidec) from Radio Shack, and made a little adapter/holder for it, and then drilled a few extra holes in my Enlight 7237 (followed the pattern, just extended it up a few more rows). This gave me some additional exhaust in the case, and was very quiet.
I'm not sure which is a better philosophy in cooling, tho. Should your case have negative pressure, thus forcing a bigger inrush of "cooler" air through all those little leaky holes, or should your case have positive pressure, thus trying to force the hot air out of all those little leaky holes. Seems to me that negative pressure would be a bit more efficient in removing the heat, but you don't get much cooling in a vacuum, so I'm not sure. Probably the best would be to have a balanced system where the air is moving freely.
On a side note, how efficient would natural convection be in addition to either positive or negative pressure?