One of my recent import acquisitions -- for the PC Engine Super CD, it's:
Mahjong Clinic Special hardly seems to require the Super CD-ROM format, although it does have some nice piano lounge music for gameplay, and a slightly more rockin' desperation theme as my money disappears into the pockets of the clinic's nurses and patients, all of whom are female, attractive, and quite capable of kicking my butt at mahjong.
At least I have a shot at learning how to play this one well enough to beat a few of the lower-level opponents; it's not heavily dependent on comprehension of Japanese. I am far from good at the game, but I think I am starting to understand the basic rules of play and the esoteric scoring system. It's entertaining to play for a few minutes now and then, and I'm glad of an opportunity to honor more traditional gaming.
(And no, as far as I have discovered this is not a "sexy mahjong" game, though there are certainly plenty of those available on the PC Engine.)