I'm new here, and I'm pretty sure that nobody will believe me, but I used to test quite a bit for TTI. I also talked with Victor Ireland at Working Designs quite a bit.
Victor had very strong convictions in terms of retaining the integrity of the games that they converted. the nudity and a part where a girl flips someone off are the only things pulled from CF2 as far as I can remember. It's been a few years
I was a tester for Splash Lake, and to tell the truth, for the last couple of years, the only game that actually went through any graphical changes was Air Zonk. Everything else became merely a language translation.
The changes in Air Zonk consisted mainly the Charged Bomb, that was originally a big pile of poo in the Japanese version. That game was on such a fast track, that the US names of the characters and levels were applied via a hasty phone call. "I need to rename all of this for a meeting taht's in a half hour!" The names that John and I came up with are what were applied to the final game.