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90% of the patches (from 2005-2018) were done entirely through manual translation with mtl only being used for individual words. This was because it was only recently that some MTL apps/sites/etc could actually translate a complete sentence from Japanese to English coherently. Even now, they can't handle proverbs, colloquialisms, and slang/local dialects, so they are only used for 'rough' first-day patches, mostly on indie VNs. Edit: The reason I feel a need to mention this is because these people put a ton of work into something that didn't get them anything but prestige and has mostly been forgotten in the years since. This is literally hundreds or even thousands of hours of work in some cases, done in people's free time. While some of these fan patches were later purchased by localization companies and retooled for localization, there are still a number of games where my statement still applies.