Document:

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                                                                   EXHIBIT 10.10

                                 PROMISSORY NOTE

$4,600,000                                                        April 3, 2000

                  FOR VALUE RECEIVED, the undersigned, Appalachian Bancshares,
Inc., a Georgia Corporation (the "Borrower"), promises to pay to the order of
CRESCENT BANK & TRUST COMPANY (the "Lender" and, together with any holder
hereof, called the "Holder"), at 251 Hwy. 515S, Jasper, Georgia 30143 (or at
such other place as the Holder may designate in writing to the Borrower), in
lawful money of the United States of America, the principal sum of Four Million
Six Hundred Thousand and No/100 Dollars ($4,600,000), plus interest as
hereinafter provided.

                  This Note is the Note made and given as described in that
certain Loan and Stock Pledge Agreement dated as of April 3, 2000, between the
Borrower and the Lender (the "Loan Agreement"). In the event of any
inconsistency between this Note and the Loan Agreement, this Note shall control.
All capitalized terms used herein shall have the meanings ascribed to such terms
in the Loan Agreement, except to the extent such capitalized terms are otherwise
defined or limited herein.

                  The Borrower shall be entitled to borrow funds hereunder
pursuant to the terms and conditions of the Loan Agreement.

                  The Borrower promises to pay interest on the unpaid principal
amount outstanding hereunder (the "Loan"), at a simple interest rate per annum
equal to the Prime Rate Basis. "Prime Rate Basis" shall mean, on any day, a
simple interest rate per annum equal to the Prime Rate less twenty-five (25)
basis points.

                  "Prime Rate" shall mean, on any day, the rate of interest
published as the "Prime Rate" as of such day appearing in the "Money Rates"
section of the Wall Street Journal, Eastern Edition, or any successor to such
section. If more than one rate shall be published, then the Prime Rate shall be
the higher or highest of such rates. The Prime Rate in effect as of the close of
business each day shall be the applicable Prime Rate for the day and each
succeeding non-business day in determining the applicable Prime Rate Basis.

                  Interest shall be calculated on the basis of a 360-day year
for the actual number of days elapsed.

                  Interest under this Note shall be due and payable quarterly in
arrears on the first day of each calendar quarter, commencing July 1, 2000, and
continuing to be due on the first day of each calendar quarter thereafter until
this Note is paid in full. Interest shall also be due and payable when this Note
shall become due (whether at maturity, by reason of acceleration or otherwise).
After default, interest shall also be due and payable upon demand from time to
time by the Holder as provided below.

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                  The entire outstanding balance of the indebtedness evidenced
by this Note, together with all accrued and unpaid interest, shall be due and
payable in a final installment on March 31, 2002.

                  Borrower shall have the right to prepay the Loan in whole or
in part without prepayment penalty or premium.

                  Overdue principal shall bear interest for each day from the
date it became so due until paid in full, payable on demand, at a rate per annum
(computed on the basis of a 360-day year for the actual number of days elapsed)
equal to the Prime Rate Basis plus 3%.

                  In no event shall the amount of interest due or payable
hereunder exceed the maximum rate of interest allowed by applicable law, and in
the event any such payment is inadvertently paid by the Borrower or
inadvertently received by the Holder, then such excess sum shall be credited as
a payment of principal, unless the Borrower shall notify the Holder in writing,
that the Borrower elects to have such excess sum returned to it forthwith. It is
the express intent hereof that the Borrower not pay and the Holder not receive,
directly or indirectly, in any manner whatsoever, interest in excess of that
which may be lawfully paid by the Borrower under applicable law.

                  All parties now or hereafter liable with respect to this Note,
whether the Borrower, any guarantor, endorser, or any other person or entity,
hereby waive presentment for payment, demand, notice of nonpayment or dishonor,
protest and notice of protest, or any other notice of any kind with respect
thereto.

                  Time is the essence of this Note.

                  No delay or omission on the part of the Holder in the exercise
of any right or remedy hereunder or any Financing Document, or at law or equity,
shall operate as a waiver thereof, and no single or partial exercise by the
Holder of any right or remedy hereunder, under the Loan Agreement or any
Financing Document, or at law or in equity, shall preclude or estop another or
further exercise thereof or the exercise of any other right or remedy.

                  Should this Note, or any part of the indebtedness evidenced
hereby, be collected by law or through an attorney-at-law or under advice
therefrom, the Holder shall be entitled to collect reasonable attorneys' fees
and all collection costs.

                  This Note is entitled to the benefits of the Loan Agreement,
which contains provisions with respect to the acceleration of the maturity of
this Note upon the happening of certain stated events, and for prepayment of the
Loan. Prepayment of the Loan may be made by the Borrower only as provided in the
Loan Agreement.

                  The Holder shall be under no duty to exercise any or all other
rights and remedies given by this Note and the Loan Agreement or under any of
the other Financing

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Documents and no party to this instrument shall be discharged from the
obligations or undertakings hereunder (a) should the Holder release or agree not
to sue any person against whom the party has, to the knowledge of the Holder, a
right to recourse, or (b) should the Holder agree to suspend the right to
enforce this Note or Holder's interest in any collateral pledged or any
guarantee given to secure this Note against such person or otherwise discharge
such person.

                  This Note shall be deemed to be made pursuant to the laws of
the State of Georgia.

                  IN WITNESS WHEREOF, the duly authorized officers of the
Borrower have executed, sealed and delivered this Note, as of the day and year
first above written.

                                  APPALACHIAN BANCSHARES, INC.

                                  By:     /s/ Kent Sanford
                                          -------------------------------------
                                          Kent Sanford
                                          Executive Vice-President

                                  Attest: /s/ Alan May
                                          -------------------------------------
                                          Alan May
                                          Chief Financial Officer

                                                                [CORPORATE SEAL]

                                       3<PAGE>   1
                                                                   EXHIBIT 10.28

             AMENDMENT TO FLOATING RATE CONVERTIBLE PROMISSORY NOTE

         Amendment dated March 15, 2000 (this "Amendment") to the Floating Rate
Convertible Promissory Note made June 26, 1998 (the "Promissory Note"), in the
original principal amount of CND$500,000, between AccuMed International, Inc.
("AccuMed") and Xillix Technologies Corp. (the "Payee"). All capitalized terms
not otherwise defined herein shall have the same meaning as assigned in the
Promissory Note.

         Whereas, the parties have previously extended the Maturity Date under
the Promissory Note until February 25, 2000; and the parties currently desire to
amend the terms for payment and interest under the Promissory Note.

         Now, therefore, based upon the mutual covenants and promises set forth
below, and for other good and valuable consideration, the receipt and
sufficiency of which are hereby acknowledged, the parties agree as follows.

         1.  Payment Schedule for Approximately One-third of Principal Balance.

                  (a) On March 15, 2000, AccuMed paid to the Payee US$27,344.26
allocated as (i) US$25,000 in repayment of principal, and (ii) US$2,344.26 in
payment of accrued interest.

                  (b) On each of April 14, 2000, May 15, 2000, June 15, 2000,
and July 14, 2000, AccuMed will pay the Payee US$25,000 in principal, plus the
interest accrued on the entire principal balance outstanding since the most
recent prior payment.

                  (c) On the 15th of each month (or if the 15th is not a banking
day, then on the immediately preceding banking day), commencing on August 15,
2000, AccuMed will make a minimum payment of US$25,000 in principal plus
interest accrued on the entire principal balance outstanding since the most
recent prior payment until such time as the principal and interest have been
converted into AccuMed common stock or repaid in full.

         2. Payment or Conversion of Approximately Two-thirds of Principal
Amount. The balance of the principal amount not provided to be repaid pursuant
to Sections 1(a) and 1(b), together with accrued and unpaid interest thereon,
shall be due and payable on demand of the Payee. At the Payee's election, such
principal amount and accrued interest may be converted into AccuMed common stock
at the rate of US$1.43 per share pursuant to the terms of the Promissory Note.

         3.  Interest Rate.  Beginning on March 16, 2000, interest on the unpaid
principal balance shall accrue at a rate of the Prime Rate plus 6%.

         4.  Registration Statement. AccuMed will use its best efforts to cause
the Registration Statement on Form S-3 (file no. 333-90637) to be declared
effective by the Securities and

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Exchange Commission following filing by AccuMed of its Annual Report on Form
10-K for the year ended December 31, 1999.

         5.  Other Terms in Effect.  All other terms and conditions of the
Promissory Note shall remain in full force and effect.

         6.  Counterparts.  This Amendment may be executed in one or two
counterparts, each of which shall be deemed an original and together shall
constitute one and the same Amendment.

         The parties have caused this Amendment to be duly executed as of the
date first above written.

 ACCUMED INTERNATIONAL, INC.                        XILLIX TECHNOLOGIES CORP.

 By: /s/ PAUL F. LAVALLEE                           By: /s/ PIERRE LEDUC
     --------------------                               ----------------
      Paul F. Lavallee                                  Pierre Leduc
      Chairman and Chief Executive Officer              President and Chief
                                                        Executive Officer

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