Document:

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                                                                  Exhibit 10.183

                              TERMINATION AGREEMENT

         This Termination Agreement (the "Agreement"), dated this 30/th/ day of
April, 2002, by and between PPD Development, LP, a Texas limited partnership and
successor-in-interest to PPD Development, LLC ("PPD Development"), and Francis
J. Casieri ("Employee").

         WHEREAS, PPD Development and Employee are parties to that certain
Employment Agreement dated December 17, 1999, as amended by that certain First
Amendment to Employment Agreement dated February 19, 2001 (the "Employment
Agreement"); and

         WHEREAS, Employee has previously expressed his interest in retiring
from the Company for personal reasons and now desires to do so; and

         WHEREAS, PPD Development and Employee desire to mutually terminate the
Employment Agreement upon the terms and conditions set forth herein.

         NOW, THEREFORE, in consideration of the mutual promises, covenants and
considerations contained herein, and other good and valuable consideration, the
receipt and sufficiency of which are hereby acknowledged, the parties agree as
follows:

         1. Termination of Employment Agreement. The Employment Agreement shall
be deemed terminated as of the close of business on April 30, 2002 (the
"Termination Date").

         2. Rights and Obligations. From and after the Termination Date, neither
party hereto shall have any rights or obligations under the Employment
Agreement, except that (i) the Company shall pay Employee's base salary set
forth in Section 3 of the Employment Agreement through the Termination Date,
(ii) the Company shall pay the Employee a bonus for the first quarter of 2002 in
the amount of $15,927.01 within ten (10) days of the Termination Date, (iii) the
Company shall pay Employee for any remaining accrued and unused vacation time,
and (iv) the Company shall reimburse Employee for any unreimbursed expenses
pursuant to Section 10 of the Employment Agreement. Employee acknowledges and
agrees that the Proprietary Information and Inventions Agreement dated September
7, 1999 executed by Employee shall not be affected by the termination of the
Employment Agreement and shall continue in full force and effect in accordance
with the terms thereof.

         3. Miscellaneous.

            a. This Agreement constitutes the entire agreement between the
parties with respect to the subject matter hereof and may not be altered or
amended except by writing signed by the parties.

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            b. This Agreement shall be governed by the laws of State of North
Carolina.

            c. This Agreement shall inure to the benefit of and be binding upon
the PPD Development, Employee and their respective heirs, successors, assigns
and personal representatives.

            d. The parties agree that any dispute under this Agreement or the
Employment Agreement shall be submitted to arbitration pursuant to Section 19 of
the Employment Agreement.

         IN WITNESS WHEREOF, the parties have caused this agreement to be
executed as of the date first hereinabove set forth.

                                       PPD DEVELOPMENT, LP

                                       By:     PPD GP, LLC
                                               Its General Partner

                                       By: /s/ Fred B. Davenport, Jr.
                                          --------------------------------------
                                       Name:   Fred B. Davenport, Jr.
                                               ---------------------------------
                                       Title:  Vice President
                                               ---------------------------------

                                       /s/ Francis J. Casieri
                                       -----------------------------------------
                                       Francis J. Casieri<PAGE>

                                                                  Exhibit 10.184

                                 THIRD AMENDMENT

         THIS THIRD AMENDMENT (this "Amendment") dated as of June 30, 2002, to
the Loan Agreement referenced below, is by and among Spotlight Health, Inc., a
Delaware corporation (the "Borrower"), Pharmaceutical Product Development, Inc.,
a North Carolina corporation (the "Company"), and Wachovia Bank, National
Association (formerly known as First Union National Bank) (the "Bank"). Terms
used herein but not otherwise defined herein shall have the meanings provided to
such terms in the Loan Agreement.

                               W I T N E S S E T H

         WHEREAS, a $2 million credit facility has been established in favor of
the Borrower pursuant to the terms of that Loan Agreement dated as of January
24, 2001 (as amended and modified from time to time, the "Loan Agreement") among
the Borrower, the Company and the Bank;

         WHEREAS, the Borrower has requested certain modifications to Loan
Agreement; and

         WHEREAS, the Bank has agreed to the modifications on the terms and
conditions set forth herein.

         NOW, THEREFORE, IN CONSIDERATION of the premises and other good and
valuable consideration, the receipt and sufficiency of which are hereby
acknowledged, the parties hereto agree as follows:

         1.  The Loan Agreement is amended in the following respects:

             (a)   In Section 1 of the Loan Agreement, the definition of
         "Termination Date" is amended to read as follows:

                   "Termination Date" means December 31, 2002, or such later
                   date as to which the Bank may agree in its sole discretion.

         2.  This Amendment shall be effective upon satisfaction of the
following conditions precedent:

             (a)   execution of this Amendment by the Borrower, the Company and
         the Bank; and

             (b)   receipt by the Bank of certified resolutions of the Company
         approving this Amendment and the terms hereof.

         3.  Except as expressly modified hereby, all of the terms and
provisions of the Loan Documents (including schedules and exhibits thereto)
shall remain in full force and effect.

         4.  The Borrower agree to pay all reasonable costs and expenses of the
Bank in connection with the preparation, execution and delivery of this
Amendment, including without limitation the reasonable fees and expenses of
Moore & Van Allen, PLLC.

         5.  This Amendment may be executed in any number of counterparts, each
of which when so executed and delivered shall be deemed an original and it shall
not be necessary in making proof of this Amendment to produce or account for
more than one such counterpart.

         6.  This Amendment shall be deemed to be a contract made under, and for
all purposes shall be construed in accordance with, the laws of the State of
North Carolina.

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         IN WITNESS WHEREOF, each of the parties hereto has caused a counterpart
of this Amendment to be duly executed and delivered as of the date first above
written.

BORROWER:                           SPOTLIGHT HEALTH, INC.,
                                    a Delaware corporation

                                    By: /s/ Tyler J. Spring
                                        -------------------
                                    Name:  Tyler J. Spring
                                    Title: Chief Financial Officer and Treasurer

COMPANY:                            PHARMACEUTICAL PRODUCT DEVELOPMENT, INC.,
                                    a North Carolina corporation

                                    By: /s/ Fred B. Davenport Jr.
                                        ---------------------------
                                    Name:  Fred B. Davenport Jr.
                                    Title: President

BANK:                               WACHOVIA BANK, NATIONAL ASSOCIATION

                                    By: /s/ Douglas T. Davis
                                        --------------------
                                    Name:  Douglas T. Davis
                                    Title: Director<PAGE>

                                                                  Exhibit 10.185

                                EIGHTH AMENDMENT

         THIS EIGHTH AMENDMENT (this "Amendment") dated as of June 29, 2002, to
the Loan Agreement referenced below, is by and among Pharmaceutical Product
Development, Inc., a North Carolina corporation (the "Borrower"), the Subsidiary
of the Borrower identified on the signature pages hereto (the "Guarantor") and
Wachovia Bank, National Association (formerly known as First Union National
Bank) (the "Bank"). Terms used herein but not otherwise defined herein shall
have the meanings provided to such terms in the Loan Agreement.

                               W I T N E S S E T H

         WHEREAS, a $50 million credit facility has been established in favor of
the Borrower pursuant to the terms of that Loan Agreement dated as of June 24,
1998 (as amended and modified from time to time, the "Loan Agreement") among the
Borrower, the Guarantor and the Bank;

         WHEREAS, the Borrower has requested certain modifications to Loan
Agreement; and

         WHEREAS, the Bank has agreed to the modifications on the terms and
conditions set forth herein.

         NOW, THEREFORE, IN CONSIDERATION of the premises and other good and
valuable consideration, the receipt and sufficiency of which are hereby
acknowledged, the parties hereto agree as follows:

         1.    Amendment. In Section 1 of the Loan Agreement, the definition of
"Termination Date" is amended to read as follows:

               "Termination Date" means June 30, 2003, or such later date as to
         which the Bank may agree in its sole discretion.

         2.    This Amendment shall be effective upon execution by the Borrower,
the Guarantor and the Bank.

         3.    Except as expressly modified hereby, all of the terms and
provisions of the Loan Agreement (including schedules and exhibits thereto)
shall remain in full force and effect.

         4.    The Borrower agrees to pay all reasonable costs and expenses of
the Bank in connection with the preparation, execution and delivery of this
Amendment, including without limitation the reasonable fees and expenses of
Moore & Van Allen, PLLC.

         5.    This Amendment may be executed in any number of counterparts,
each of which when so executed and delivered shall be deemed an original and it
shall not be necessary in making proof of this Amendment to produce or account
for more than one such counterpart. Delivery of an executed counterpart of this
Amendment by telecopy by any party hereto shall be effective as such party's
original executed counterpart and shall constitute a representation that such
party's original executed counterpart will be delivered.

         6.    This Amendment shall be deemed to be a contract made under, and
for all purposes shall be construed in accordance with, the laws of the State of
North Carolina.

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         IN WITNESS WHEREOF, each of the parties hereto has caused a counterpart
of this Amendment to be duly executed and delivered as of the date first above
written.

BORROWER:                  PHARMACEUTICAL PRODUCT DEVELOPMENT, INC.,
                           a North Carolina corporation

                           By: /s/ Fredric N. Eshelman
                               ------------------------------------------
                           Name:   Fredric N. Eshelman
                           Title:  Chief Executive Officer

GUARANTOR:                 PPD DEVELOPMENT, LP,
                           a Texas limited partnership

                           By:     PPD GP, LLC,
                                   a Delaware limited liability company
                           Its:    General Partner

                                   By: /s/ Fredric N. Eshelman
                                   --------------------------------------
                                   Name:   Fredric N. Eshelman
                                   Title:  Chief Executive Officer

BANK:                      WACHOVIA BANK, NATIONAL ASSOCIATION

                           By: /s/ Douglas T. Davis
                               ------------------------------------------
                           Name:   Douglas T. Davis
                           Title:  Director

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